Rabeh H Ebeed Bds, DDS FAGD
5 George Street Hudson, NH 03051
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $189 | 0% | $189 | Medium |
| Child Dental Cleaning | $145 | 0% | $145 | Medium |
| Fluoride - Topical Application | $82 | 0% | $82 | Medium |
| Sealant placed on the tooth surface to prevent decay | $97 | 0% | $97 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $145 | 0% | $145 | Medium |
| Periodic dental exam - established patient | $88 | 0% | $88 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $137 | 0% | $137 | Medium |
| X-Ray Dental - Complete intraoral series | $265 | 0% | $265 | Medium |
| X-Ray Dental - Four images - bitewings | $113 | 0% | $113 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $61 | 0% | $61 | Medium |
| X-Ray Dental - Two images - bitewings | $92 | 0% | $92 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $21 | 0% | $21 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $182 | 0% | $182 | 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 | $252 | 0% | $252 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $289 | 0% | $289 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $352 | 0% | $352 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $281 | 0% | $281 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $389 | 0% | $389 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $256 | 0% | $256 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $473 | 0% | $473 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $328 | 0% | $328 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $212 | 0% | $212 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $260 | 0% | $260 | Medium |