Salem Family Dental

220 Main Street Salem, NH 03079
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1040%$104 Medium
Dental Cleaning - Child$780%$78 Medium
Dental Exam - Comprehensive$900%$90 Medium
Dental Exam - Periodic, Established Patient$490%$49 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1680%$168 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2520%$252 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2150%$215 Medium
Dental Filling - White (Resin): One Surface, Anterior$1660%$166 Medium
Dental Filling - White (Resin): One Surface, Posterior$1680%$168 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$2520%$252 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2130%$213 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2150%$215 Medium
Flouride - Topical Varnish Application$430%$43 Medium
Fluoride - Topical Application$430%$43 Medium
Maintenance Therapy - Periodontal$1530%$153 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$870%$87 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$610%$61 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2000%$200 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$350%$35 Medium
X-Ray - Complete Intraoral Series$1450%$145 Medium
X-Ray - Four Images, Bitewings$710%$71 Medium
X-Ray - Intraoral, Periapical Radiographic Image$350%$35 Medium
X-Ray - Two Images, Bitewings$560%$56 Medium