Premier Family Dental Care
850 Main Street, Suite 1 Tewksbury, MA 01876
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $113 | 0% | $113 | Medium |
| Child Dental Cleaning | $172 | 0% | $172 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Periodic dental exam - established patient | $59 | 0% | $59 | Medium |
| X-Ray Dental - Complete intraoral series | $247 | 0% | $247 | Medium |
| X-Ray Dental - Four images - bitewings | $79 | 0% | $79 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $44 | 0% | $44 | 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 | $147 | 0% | $147 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $207 | 0% | $207 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $184 | 0% | $184 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $201 | 0% | $201 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $253 | 0% | $253 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $231 | 0% | $231 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $382 | 0% | $382 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $158 | 0% | $158 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $315 | 0% | $315 | Medium |