Newburyport Pediatric Dentistry
3 Cherry 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 | $124 | 0% | $124 | Medium |
| Child Dental Cleaning | $95 | 0% | $95 | Medium |
| Sealant placed on the tooth surface to prevent decay | $81 | 0% | $81 | Medium |
| Topical fluoride varnish application | $57 | 0% | $57 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $114 | 0% | $114 | Medium |
| Periodic dental exam - established patient | $81 | 0% | $81 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $99 | 0% | $99 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $38 | 0% | $38 | Medium |
| X-Ray Dental - Two images - bitewings | $59 | 0% | $59 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $30 | 0% | $30 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $159 | 0% | $159 | 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 | $221 | 0% | $221 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $284 | 0% | $284 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $221 | 0% | $221 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $284 | 0% | $284 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $355 | 0% | $355 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $216 | 0% | $216 | Medium |