Pediatric Dentistry of Salem

389 Main Street Salem, NH 03079
Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$118N/A$118
Dental Cleaning - Child$93N/A$93
Dental Exam - Comprehensive$100N/A$100
Dental Exam - Periodic, Established Patient$61N/A$61
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$187N/A$187
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$299N/A$299
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$231N/A$231
Dental Filling - White (Resin): One Surface, Anterior$187N/A$187
Dental Filling - White (Resin): One Surface, Posterior$187N/A$187
Dental Filling - White (Resin): Three Surfaces, Posterior$299N/A$299
Dental Filling - White (Resin): Two Surfaces, Anterior$226N/A$226
Dental Filling - White (Resin): Two Surfaces, Posterior$231N/A$231
Flouride - Topical Varnish Application$43N/A$43
Fluoride - Topical Application$43N/A$43
Orthodontic Treatment - Periodic Visit, Part of a Contract$98N/A$98
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$98N/A$98
Sealant - Placed on Tooth Surface to Prevent Decay$64N/A$64
Tooth Extraction - Elevation and/or Forceps Removal$210N/A$210
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$35N/A$35
X-Ray - Complete Intraoral Series$204N/A$204
X-Ray - Four Images, Bitewings$79N/A$79
X-Ray - Intraoral, Periapical Radiographic Image$40N/A$40
X-Ray - Two Images, Bitewings$57N/A$57
X-Ray - Whole Mouth from Outside Mouth$147N/A$147