Peterson Family Dental

240 Locust Street Dover, NH 03820
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$930%$93 Medium
Dental Cleaning - Child$640%$64 Medium
Dental Exam - Comprehensive$860%$86 Medium
Dental Exam - Periodic, Established Patient$470%$47 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1770%$177 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3130%$313 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2510%$251 Medium
Dental Filling - White (Resin): One Surface, Anterior$1590%$159 Medium
Dental Filling - White (Resin): One Surface, Posterior$1770%$177 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3130%$313 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$1940%$194 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2510%$251 Medium
Flouride - Topical Varnish Application$390%$39 Medium
Fluoride - Topical Application$390%$39 Medium
Maintenance Therapy - Periodontal$1390%$139 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2540%$254 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$850%$85 Medium
Root Canal - Anterior Tooth$8010%$801 Medium
Root Canal - Bicuspid Tooth$9290%$929 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$560%$56 Medium
Tooth Extraction - Elevation and/or Forceps Removal$1770%$177 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$230%$23 Medium
X-Ray - Complete Intraoral Series$1350%$135 Medium
X-Ray - Four Images, Bitewings$660%$66 Medium
X-Ray - Intraoral, Periapical Radiographic Image$300%$30 Medium
X-Ray - Two Images, Bitewings$460%$46 Medium
X-Ray - Whole Mouth from Outside Mouth$1230%$123 Medium