Monadnock Pediatric Dentistry

56 Peterborough Street Jaffrey, NH 03452
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1640%$164 Medium
Dental Cleaning - Child$620%$62 Medium
Dental Exam - Comprehensive$790%$79 Medium
Dental Exam - Periodic, Established Patient$420%$42 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1500%$150 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2140%$214 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$1920%$192 Medium
Dental Filling - White (Resin): One Surface, Anterior$1430%$143 Medium
Dental Filling - White (Resin): One Surface, Posterior$1500%$150 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$4330%$433 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$1880%$188 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3890%$389 Medium
Flouride - Topical Varnish Application$420%$42 Medium
Fluoride - Topical Application$650%$65 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$670%$67 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$630%$63 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2730%$273 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$250%$25 Medium
X-Ray - Four Images, Bitewings$710%$71 Medium
X-Ray - Intraoral, Periapical Radiographic Image$330%$33 Medium
X-Ray - Two Images, Bitewings$440%$44 Medium
X-Ray - Whole Mouth from Outside Mouth$1070%$107 Medium