Richard A. Workman, DMD
115 Indian Rock Road Windham, NH 03087
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $89 | 0% | $89 | Medium |
| Child Dental Cleaning | $68 | 0% | $68 | Medium |
| Fluoride - Topical Application | $47 | 0% | $47 | Medium |
| Sealant placed on the tooth surface to prevent decay | $53 | 0% | $53 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $74 | 0% | $74 | Medium |
| Periodic dental exam - established patient | $42 | 0% | $42 | Medium |
| X-Ray Dental - Complete intraoral series | $131 | 0% | $131 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $32 | 0% | $32 | Medium |
| X-Ray Dental - Two images - bitewings | $53 | 0% | $53 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $24 | 0% | $24 | 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 | $142 | 0% | $142 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $158 | 0% | $158 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $378 | 0% | $378 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $336 | 0% | $336 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $158 | 0% | $158 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $263 | 0% | $263 | Medium |