Raymond R Farland, DDS
160 Dover Road, #2 Chichester, NH 03258
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $106 | 0% | $106 | Medium |
| Child Dental Cleaning | $137 | 0% | $137 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $260 | 0% | $260 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $92 | 0% | $92 | Medium |
| Periodic dental exam - established patient | $49 | 0% | $49 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $88 | 0% | $88 | Medium |
| X-Ray Dental - Complete intraoral series | $200 | 0% | $200 | Medium |
| X-Ray Dental - Four images - bitewings | $71 | 0% | $71 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $34 | 0% | $34 | Medium |
| X-Ray Dental - Two images - bitewings | $50 | 0% | $50 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $27 | 0% | $27 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $128 | 0% | $128 | 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 | $183 | 0% | $183 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $264 | 0% | $264 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $351 | 0% | $351 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $183 | 0% | $183 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $264 | 0% | $264 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $168 | 0% | $168 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $351 | 0% | $351 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $206 | 0% | $206 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $145 | 0% | $145 | Medium |