Paul Decker, DDS
35 S Park Street Hanover, NH 03755
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $121 | 0% | $121 | Medium |
| Child Dental Cleaning | $89 | 0% | $89 | Medium |
| Fluoride - Topical Application | $49 | 0% | $49 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $319 | 0% | $319 | Medium |
| Sealant placed on the tooth surface to prevent decay | $70 | 0% | $70 | Medium |
| Topical fluoride varnish application | $55 | 0% | $55 | 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 | $58 | 0% | $58 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $96 | 0% | $96 | Medium |
| X-Ray Dental - Complete intraoral series | $176 | 0% | $176 | Medium |
| X-Ray Dental - Four images - bitewings | $82 | 0% | $82 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $37 | 0% | $37 | 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 | $30 | 0% | $30 | 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 | $224 | 0% | $224 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $291 | 0% | $291 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $362 | 0% | $362 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $224 | 0% | $224 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $286 | 0% | $286 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $223 | 0% | $223 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $362 | 0% | $362 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $269 | 0% | $269 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $173 | 0% | $173 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $226 | 0% | $226 | Medium |