Rudusky Dental
1662 Post Road Wells, ME 04090
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $90 | 0% | $90 | Medium |
| Child Dental Cleaning | $63 | 0% | $63 | Medium |
| Sealant placed on the tooth surface to prevent decay | $50 | 0% | $50 | Medium |
| Topical fluoride varnish application | $35 | 0% | $35 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $91 | 0% | $91 | Medium |
| Periodic dental exam - established patient | $47 | 0% | $47 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $86 | 0% | $86 | Medium |
| X-Ray Dental - Complete intraoral series | $132 | 0% | $132 | Medium |
| X-Ray Dental - Four images - bitewings | $64 | 0% | $64 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $34 | 0% | $34 | Medium |
| X-Ray Dental - Two images - bitewings | $48 | 0% | $48 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $27 | 0% | $27 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $126 | 0% | $126 | 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 | $200 | 0% | $200 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $242 | 0% | $242 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $284 | 0% | $284 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $200 | 0% | $200 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $242 | 0% | $242 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $247 | 0% | $247 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $281 | 0% | $281 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $202 | 0% | $202 | Medium |