Portsmouth Pediatric Dentistry

150 Griffin Road, Suite 1 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$1050%$105 Medium
Dental Cleaning - Child$1010%$101 Medium
Dental Exam - Comprehensive$1170%$117 Medium
Dental Exam - Periodic, Established Patient$610%$61 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2030%$203 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2650%$265 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2160%$216 Medium
Dental Filling - White (Resin): One Surface, Anterior$2080%$208 Medium
Dental Filling - White (Resin): One Surface, Posterior$2360%$236 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$4040%$404 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2390%$239 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3110%$311 Medium
Flouride - Topical Varnish Application$610%$61 Medium
Fluoride - Topical Application$510%$51 Medium
Maintenance Therapy - Periodontal$1490%$149 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$680%$68 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1050%$105 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$690%$69 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2210%$221 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$330%$33 Medium
X-Ray - Complete Intraoral Series$1460%$146 Medium
X-Ray - Four Images, Bitewings$860%$86 Medium
X-Ray - Intraoral, Periapical Radiographic Image$400%$40 Medium
X-Ray - Two Images, Bitewings$610%$61 Medium
X-Ray - Whole Mouth from Outside Mouth$1530%$153 Medium