Monadnock Dental Associates

123 Main Street Jaffrey, NH 03452
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1160%$116
Dental Cleaning - Child$950%$95
Dental Exam - Comprehensive$1100%$110
Dental Exam - Periodic, Established Patient$570%$57
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2350%$235
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3730%$373
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$3010%$301
Dental Filling - White (Resin): One Surface, Anterior$2180%$218
Dental Filling - White (Resin): One Surface, Posterior$2350%$235
Dental Filling - White (Resin): Three Surfaces, Posterior$3730%$373
Dental Filling - White (Resin): Two Surfaces, Anterior$2650%$265
Dental Filling - White (Resin): Two Surfaces, Posterior$3010%$301
Flouride - Topical Varnish Application$370%$37
Fluoride - Topical Application$370%$37
Maintenance Therapy - Periodontal$1770%$177
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3180%$318
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1050%$105
Root Canal - Bicuspid Tooth$2,3000%$2,300
Sealant - Placed on Tooth Surface to Prevent Decay$770%$77
Tooth Extraction - Elevation and/or Forceps Removal$2720%$272
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$430%$43
X-Ray - Complete Intraoral Series$1650%$165
X-Ray - Four Images, Bitewings$810%$81
X-Ray - Intraoral, Periapical Radiographic Image$450%$45
X-Ray - Two Images, Bitewings$660%$66
X-Ray - Whole Mouth from Outside Mouth$1580%$158