Northwood Family Dental Center
1505 First New Hampshire Tpke Northwood, NH 03261
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $120 | 0% | $120 | Medium |
| Child Dental Cleaning | $87 | 0% | $87 | Medium |
| Fluoride - Topical Application | $48 | 0% | $48 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $437 | 0% | $437 | Medium |
| Sealant placed on the tooth surface to prevent decay | $63 | 0% | $63 | Medium |
| Topical fluoride varnish application | $48 | 0% | $48 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $103 | 0% | $103 | Medium |
| Periodic dental exam - established patient | $58 | 0% | $58 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $111 | 0% | $111 | Medium |
| X-Ray Dental - Complete intraoral series | $234 | 0% | $234 | Medium |
| X-Ray Dental - Four images - bitewings | $82 | 0% | $82 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $44 | 0% | $44 | Medium |
| X-Ray Dental - Two images - bitewings | $56 | 0% | $56 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $27 | 0% | $27 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $152 | 0% | $152 | 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 | $209 | 0% | $209 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $274 | 0% | $274 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $331 | 0% | $331 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $209 | 0% | $209 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $278 | 0% | $278 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $182 | 0% | $182 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $356 | 0% | $356 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $246 | 0% | $246 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $180 | 0% | $180 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $197 | 0% | $197 | Medium |