New Hampshire Dental Design
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $119 | N/A | $119 |
| Dental Cleaning - Child | $120 | N/A | $120 |
| Dental Exam - Comprehensive | $116 | N/A | $116 |
| Dental Exam - Periodic, Established Patient | $56 | N/A | $56 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $321 | N/A | $321 |
| Flouride - Topical Varnish Application | $53 | N/A | $53 |
| Maintenance Therapy - Periodontal | $164 | N/A | $164 |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $298 | N/A | $298 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $100 | N/A | $100 |
| Root Canal - Bicuspid Tooth | $1,362 | N/A | $1,362 |
| Root Canal - Molar | $1,219 | N/A | $1,219 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $29 | N/A | $29 |
| X-Ray - Complete Intraoral Series | $181 | N/A | $181 |
| X-Ray - Four Images, Bitewings | $85 | N/A | $85 |
| X-Ray - Intraoral, Periapical Radiographic Image | $38 | N/A | $38 |
| X-Ray - Two Images, Bitewings | $76 | N/A | $76 |