New Hampshire Family Dentistry

2626 Brown Avenue Manchester, NH 03103
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1040%$104 Medium
Dental Cleaning - Child$890%$89 Medium
Dental Exam - Comprehensive$950%$95 Medium
Dental Exam - Periodic, Established Patient$600%$60 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1940%$194 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3410%$341 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2730%$273 Medium
Dental Filling - White (Resin): One Surface, Anterior$1730%$173 Medium
Dental Filling - White (Resin): One Surface, Posterior$1940%$194 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3410%$341 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2050%$205 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2730%$273 Medium
Flouride - Topical Varnish Application$430%$43 Medium
Fluoride - Topical Application$480%$48 Medium
Maintenance Therapy - Periodontal$1680%$168 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$930%$93 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2890%$289 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$950%$95 Medium
Root Canal - Anterior Tooth$9560%$956 Medium
Root Canal - Bicuspid Tooth$1,0660%$1,066 Medium
Root Canal - Molar$1,3130%$1,313 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$630%$63 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2020%$202 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$360%$36 Medium
X-Ray - Complete Intraoral Series$1580%$158 Medium
X-Ray - Four Images, Bitewings$860%$86 Medium
X-Ray - Intraoral, Periapical Radiographic Image$370%$37 Medium
X-Ray - Two Images, Bitewings$670%$67 Medium
X-Ray - Whole Mouth from Outside Mouth$1580%$158 Medium