Richard Kozlowski, DDS
1229 Main Street St. Johnsbury, VT 05819
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $98 | N/A | $98 |
| Dental Cleaning - Child | $78 | N/A | $78 |
| Dental Exam - Comprehensive | $83 | N/A | $83 |
| Dental Exam - Periodic, Established Patient | $43 | N/A | $43 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $179 | N/A | $179 |
| Fluoride - Topical Application | $39 | N/A | $39 |
| Maintenance Therapy - Periodontal | $144 | N/A | $144 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $80 | N/A | $80 |
| Sealant - Placed on Tooth Surface to Prevent Decay | $47 | N/A | $47 |
| X-Ray - Complete Intraoral Series | $140 | N/A | $140 |
| X-Ray - Four Images, Bitewings | $65 | N/A | $65 |
| X-Ray - Intraoral, Periapical Radiographic Image | $34 | N/A | $34 |
| X-Ray - Whole Mouth from Outside Mouth | $126 | N/A | $126 |