Newburyport Dental Associates
37.5 Forrester Street Newburyport, MA 01950
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $117 | 0% | $117 | Medium |
| Child Dental Cleaning | $92 | 0% | $92 | Medium |
| Fluoride - Topical Application | $44 | 0% | $44 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $596 | 0% | $596 | Medium |
| Sealant placed on the tooth surface to prevent decay | $76 | 0% | $76 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $105 | 0% | $105 | Medium |
| Periodic dental exam - established patient | $55 | 0% | $55 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $100 | 0% | $100 | Medium |
| X-Ray Dental - Complete intraoral series | $179 | 0% | $179 | Medium |
| X-Ray Dental - Four images - bitewings | $100 | 0% | $100 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $38 | 0% | $38 | Medium |
| X-Ray Dental - Two images - bitewings | $58 | 0% | $58 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $34 | 0% | $34 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $182 | 0% | $182 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $202 | 0% | $202 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $280 | 0% | $280 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $404 | 0% | $404 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $202 | 0% | $202 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $280 | 0% | $280 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $209 | 0% | $209 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $404 | 0% | $404 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $252 | 0% | $252 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $141 | 0% | $141 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $233 | 0% | $233 | Medium |