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
Dental Cleaning - Adult$1060%$106
Dental Cleaning - Child$1010%$101
Dental Exam - Comprehensive$1170%$117
Dental Exam - Periodic, Established Patient$640%$64
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2080%$208
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3260%$326
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2630%$263
Dental Filling - White (Resin): One Surface, Anterior$2120%$212
Dental Filling - White (Resin): One Surface, Posterior$2360%$236
Dental Filling - White (Resin): Three Surfaces, Posterior$3910%$391
Dental Filling - White (Resin): Two Surfaces, Anterior$2530%$253
Dental Filling - White (Resin): Two Surfaces, Posterior$3110%$311
Flouride - Topical Varnish Application$610%$61
Fluoride - Topical Application$510%$51
Maintenance Therapy - Periodontal$1510%$151
Orthodontic Treatment - Periodic Visit, Part of a Contract$620%$62
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1050%$105
Sealant - Placed on Tooth Surface to Prevent Decay$740%$74
Tooth Extraction - Elevation and/or Forceps Removal$2470%$247
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$330%$33
X-Ray - Complete Intraoral Series$1460%$146
X-Ray - Four Images, Bitewings$860%$86
X-Ray - Intraoral, Periapical Radiographic Image$400%$40
X-Ray - Two Images, Bitewings$610%$61
X-Ray - Whole Mouth from Outside Mouth$1530%$153