Peter S Katz, DDS
1 Phoenix Mill Lane Peterborough, NH 03458
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 | $42 | 0% | $42 | Medium |
| Topical fluoride varnish application | $44 | 0% | $44 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $89 | 0% | $89 | Medium |
| Periodic dental exam - established patient | $60 | 0% | $60 | Medium |
| X-Ray Dental - Complete intraoral series | $158 | 0% | $158 | Medium |
| X-Ray Dental - Four images - bitewings | $79 | 0% | $79 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $32 | 0% | $32 | Medium |
| X-Ray Dental - Two images - bitewings | $54 | 0% | $54 | 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 | $213 | 0% | $213 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $284 | 0% | $284 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $331 | 0% | $331 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $213 | 0% | $213 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $270 | 0% | $270 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $193 | 0% | $193 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $368 | 0% | $368 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $177 | 0% | $177 | Medium |