New Hampshire Family Dentistry

2626 Brown Avenue Manchester, NH 03103
Dental Procedures
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My Health Insurance:

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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1100%$110
Dental Cleaning - Child$930%$93
Dental Exam - Comprehensive$1260%$126
Dental Exam - Periodic, Established Patient$600%$60
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1970%$197
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3480%$348
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2730%$273
Dental Filling - White (Resin): One Surface, Anterior$1760%$176
Dental Filling - White (Resin): One Surface, Posterior$1970%$197
Dental Filling - White (Resin): Three Surfaces, Posterior$3480%$348
Dental Filling - White (Resin): Two Surfaces, Anterior$2090%$209
Dental Filling - White (Resin): Two Surfaces, Posterior$2780%$278
Flouride - Topical Varnish Application$440%$44
Fluoride - Topical Application$480%$48
Maintenance Therapy - Periodontal$1710%$171
Orthodontic Treatment - Periodic Visit, Part of a Contract$930%$93
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2940%$294
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$950%$95
Root Canal - Anterior Tooth$1,2920%$1,292
Root Canal - Bicuspid Tooth$1,0280%$1,028
Root Canal - Molar$1,2240%$1,224
Sealant - Placed on Tooth Surface to Prevent Decay$630%$63
Tooth Extraction - Elevation and/or Forceps Removal$2020%$202
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$360%$36
X-Ray - Complete Intraoral Series$1580%$158
X-Ray - Four Images, Bitewings$880%$88
X-Ray - Intraoral, Periapical Radiographic Image$370%$37
X-Ray - Two Images, Bitewings$680%$68
X-Ray - Whole Mouth from Outside Mouth$1580%$158