O'Neill Dentistry
8 Stiles Road, Suite 105 Salem, NH 03079
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $112 | 0% | $112 | Medium |
| Child Dental Cleaning | $82 | 0% | $82 | Medium |
| Fluoride - Topical Application | $46 | 0% | $46 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $289 | 0% | $289 | Medium |
| Sealant placed on the tooth surface to prevent decay | $80 | 0% | $80 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $168 | 0% | $168 | Medium |
| Periodic dental exam - established patient | $60 | 0% | $60 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $102 | 0% | $102 | Medium |
| X-Ray Dental - Complete intraoral series | $173 | 0% | $173 | Medium |
| X-Ray Dental - Four images - bitewings | $90 | 0% | $90 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $47 | 0% | $47 | Medium |
| X-Ray Dental - Two images - bitewings | $70 | 0% | $70 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $36 | 0% | $36 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $171 | 0% | $171 | 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 | $234 | 0% | $234 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $289 | 0% | $289 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $355 | 0% | $355 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $234 | 0% | $234 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $289 | 0% | $289 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $201 | 0% | $201 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $355 | 0% | $355 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $245 | 0% | $245 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $190 | 0% | $190 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $267 | 0% | $267 | Medium |