Norma Colletta
45 Streetorey Ave Newburyport, MA 01950
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $116 | 0% | $116 | Medium |
| Child Dental Cleaning | $105 | 0% | $105 | Medium |
| Fluoride - Topical Application | $73 | 0% | $73 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $310 | 0% | $310 | Medium |
| Sealant placed on the tooth surface to prevent decay | $79 | 0% | $79 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $107 | 0% | $107 | Medium |
| Periodic dental exam - established patient | $74 | 0% | $74 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $100 | 0% | $100 | Medium |
| X-Ray Dental - Complete intraoral series | $149 | 0% | $149 | 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 | $68 | 0% | $68 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $53 | 0% | $53 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $144 | 0% | $144 | 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 | $181 | 0% | $181 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $231 | 0% | $231 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $289 | 0% | $289 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $181 | 0% | $181 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $243 | 0% | $243 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $201 | 0% | $201 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $378 | 0% | $378 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $275 | 0% | $275 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $183 | 0% | $183 | Medium |