Pediatric Dentistry of Salem

389 Main Street Salem, NH 03079
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1160%$116 Medium
Dental Cleaning - Child$910%$91 Medium
Dental Exam - Comprehensive$980%$98 Medium
Dental Exam - Periodic, Established Patient$590%$59 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1840%$184 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2960%$296 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2280%$228 Medium
Dental Filling - White (Resin): One Surface, Anterior$1840%$184 Medium
Dental Filling - White (Resin): One Surface, Posterior$1840%$184 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$5920%$592 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$4450%$445 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2280%$228 Medium
Flouride - Topical Varnish Application$490%$49 Medium
Fluoride - Topical Application$420%$42 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$960%$96 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$620%$62 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2050%$205 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$330%$33 Medium
X-Ray - Complete Intraoral Series$1980%$198 Medium
X-Ray - Four Images, Bitewings$770%$77 Medium
X-Ray - Intraoral, Periapical Radiographic Image$380%$38 Medium
X-Ray - Two Images, Bitewings$550%$55 Medium
X-Ray - Whole Mouth from Outside Mouth$1440%$144 Medium