Peter Skeirik, DDS
24 Central Street Georgetown, MA 01833
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $124 | 0% | $124 | Medium |
| Topical fluoride varnish application | $47 | 0% | $47 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $116 | 0% | $116 | Medium |
| Periodic dental exam - established patient | $63 | 0% | $63 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $100 | 0% | $100 | Medium |
| X-Ray Dental - Complete intraoral series | $184 | 0% | $184 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $32 | 0% | $32 | 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 | $25 | 0% | $25 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $152 | 0% | $152 | 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 | $188 | 0% | $188 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $289 | 0% | $289 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $260 | 0% | $260 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $213 | 0% | $213 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $289 | 0% | $289 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $191 | 0% | $191 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $334 | 0% | $334 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $236 | 0% | $236 | Medium |