Piscataqua Dental Partners

288 Lafayette Road, Suite 3, Building A Portsmouth, NH 03801
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1090%$109 Medium
Dental Cleaning - Child$760%$76 Medium
Dental Exam - Comprehensive$1060%$106 Medium
Dental Exam - Periodic, Established Patient$620%$62 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1800%$180 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2610%$261 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2240%$224 Medium
Dental Filling - White (Resin): One Surface, Anterior$2050%$205 Medium
Dental Filling - White (Resin): One Surface, Posterior$2120%$212 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3640%$364 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2500%$250 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3030%$303 Medium
Flouride - Topical Varnish Application$440%$44 Medium
Maintenance Therapy - Periodontal$1500%$150 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$1070%$107 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2980%$298 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$980%$98 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$660%$66 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2680%$268 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$290%$29 Medium
X-Ray - Complete Intraoral Series$1730%$173 Medium
X-Ray - Four Images, Bitewings$770%$77 Medium
X-Ray - Intraoral, Periapical Radiographic Image$360%$36 Medium
X-Ray - Two Images, Bitewings$550%$55 Medium
X-Ray - Whole Mouth from Outside Mouth$1730%$173 Medium