Peter Wojtkun, DMD
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $122 | N/A | $122 |
| Dental Cleaning - Child | $176 | N/A | $176 |
| Dental Exam - Periodic, Established Patient | $56 | N/A | $56 |
| Dental Filling - White (Resin): One Surface, Anterior | $201 | N/A | $201 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $322 | N/A | $322 |
| Dental Filling - White (Resin): Two Surfaces, Anterior | $250 | N/A | $250 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $278 | N/A | $278 |
| Flouride - Topical Varnish Application | $61 | N/A | $61 |
| Maintenance Therapy - Periodontal | $160 | N/A | $160 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $191 | N/A | $191 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $27 | N/A | $27 |
| X-Ray - Complete Intraoral Series | $154 | N/A | $154 |
| X-Ray - Four Images, Bitewings | $83 | N/A | $83 |
| X-Ray - Intraoral, Periapical Radiographic Image | $54 | N/A | $54 |