Richard Michael Roy, DDS

103 Main Street Wilton, NH 03086
Dental Procedures
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My Health Insurance:

  • I do not have dental insurance
ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1220%$122 Medium
Dental Cleaning - Child$900%$90 Medium
Dental Exam - Comprehensive$1040%$104 Medium
Dental Exam - Periodic, Established Patient$530%$53 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$4160%$416 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3290%$329 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2710%$271 Medium
Dental Filling - White (Resin): One Surface, Anterior$2040%$204 Medium
Dental Filling - White (Resin): One Surface, Posterior$2080%$208 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$6570%$657 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2590%$259 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2710%$271 Medium
Flouride - Topical Varnish Application$530%$53 Medium
Fluoride - Topical Application$530%$53 Medium
Maintenance Therapy - Periodontal$1710%$171 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2930%$293 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1020%$102 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$530%$53 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2040%$204 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$330%$33 Medium
X-Ray - Complete Intraoral Series$2050%$205 Medium
X-Ray - Four Images, Bitewings$750%$75 Medium
X-Ray - Intraoral, Periapical Radiographic Image$440%$44 Medium
X-Ray - Two Images, Bitewings$530%$53 Medium
X-Ray - Whole Mouth from Outside Mouth$1350%$135 Medium