Robert A Blake, DDS
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Dental Cleaning - Adult | $131 | 0% | $131 | Medium |
| Dental Cleaning - Child | $74 | 0% | $74 | Medium |
| Dental Exam - Periodic, Established Patient | $47 | 0% | $47 | Medium |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $310 | 0% | $310 | Medium |
| Dental Filling - White (Resin): One Surface, Posterior | $179 | 0% | $179 | Medium |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $215 | 0% | $215 | Medium |
| Flouride - Topical Varnish Application | $44 | 0% | $44 | Medium |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $95 | 0% | $95 | Medium |
| Sealant - Placed on Tooth Surface to Prevent Decay | $68 | 0% | $68 | Medium |
| Tooth Extraction - Elevation and/or Forceps Removal | $158 | 0% | $158 | Medium |
| X-Ray - Complete Intraoral Series | $131 | 0% | $131 | Medium |
| X-Ray - Four Images, Bitewings | $79 | 0% | $79 | Medium |
| X-Ray - Two Images, Bitewings | $47 | 0% | $47 | Medium |
