Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$89N/A$89
Dental Cleaning - Child$88N/A$88
Dental Exam - Comprehensive$105N/A$105
Dental Exam - Periodic, Established Patient$43N/A$43
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$155N/A$155
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$326N/A$326
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$259N/A$259
Dental Filling - White (Resin): One Surface, Anterior$165N/A$165
Dental Filling - White (Resin): One Surface, Posterior$203N/A$203
Dental Filling - White (Resin): Three Surfaces, Posterior$368N/A$368
Dental Filling - White (Resin): Two Surfaces, Anterior$173N/A$173
Dental Filling - White (Resin): Two Surfaces, Posterior$259N/A$259
Fluoride - Topical Application$37N/A$37
Maintenance Therapy - Periodontal$154N/A$154
Oral Hygiene Instructions$38N/A$38
Orthodontic Treatment - Periodic Visit, Part of a Contract$155N/A$155
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$395N/A$395
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$97N/A$97
Sealant - Placed on Tooth Surface to Prevent Decay$60N/A$60
Tooth Extraction - Elevation and/or Forceps Removal$184N/A$184
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$23N/A$23
X-Ray - Complete Intraoral Series$164N/A$164
X-Ray - Four Images, Bitewings$61N/A$61
X-Ray - Intraoral, Periapical Radiographic Image$36N/A$36
X-Ray - Two Images, Bitewings$56N/A$56
X-Ray - Whole Mouth from Outside Mouth$139N/A$139