Portside Family Dental
7 Brown Sq Newburyport, MA 01950
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $116 | 0% | $116 | Medium |
| Child Dental Cleaning | $82 | 0% | $82 | Medium |
| Fluoride - Topical Application | $46 | 0% | $46 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $284 | 0% | $284 | Medium |
| Sealant placed on the tooth surface to prevent decay | $69 | 0% | $69 | Medium |
| Topical fluoride varnish application | $51 | 0% | $51 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $100 | 0% | $100 | Medium |
| Periodic dental exam - established patient | $63 | 0% | $63 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $95 | 0% | $95 | Medium |
| X-Ray Dental - Complete intraoral series | $168 | 0% | $168 | Medium |
| X-Ray Dental - Four images - bitewings | $92 | 0% | $92 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $40 | 0% | $40 | Medium |
| X-Ray Dental - Two images - bitewings | $70 | 0% | $70 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $17 | 0% | $17 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $141 | 0% | $141 | 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 | $152 | 0% | $152 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $263 | 0% | $263 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $294 | 0% | $294 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $208 | 0% | $208 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $263 | 0% | $263 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $192 | 0% | $192 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $320 | 0% | $320 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $166 | 0% | $166 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $221 | 0% | $221 | Medium |