Robert J. Perreault, DDS
12 Main Street Atkinson, NH 03811
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $125 | 0% | $125 | Medium |
| Child Dental Cleaning | $97 | 0% | $97 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $520 | 0% | $520 | Medium |
| Sealant placed on the tooth surface to prevent decay | $68 | 0% | $68 | Medium |
| Topical fluoride varnish application | $46 | 0% | $46 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $125 | 0% | $125 | Medium |
| Periodic dental exam - established patient | $61 | 0% | $61 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $187 | 0% | $187 | Medium |
| X-Ray Dental - Complete intraoral series | $184 | 0% | $184 | Medium |
| X-Ray Dental - Four images - bitewings | $83 | 0% | $83 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $37 | 0% | $37 | Medium |
| X-Ray Dental - Two images - bitewings | $65 | 0% | $65 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $32 | 0% | $32 | 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 | $261 | 0% | $261 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $335 | 0% | $335 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $408 | 0% | $408 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $261 | 0% | $261 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $335 | 0% | $335 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $251 | 0% | $251 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $408 | 0% | $408 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $272 | 0% | $272 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $272 | 0% | $272 | Medium |