Santavicca Dental Professionals

367 Route 120, Suite C Lebanon, NH 03766
Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$107N/A$107
Dental Cleaning - Child$107N/A$107
Dental Exam - Comprehensive$139N/A$139
Dental Exam - Periodic, Established Patient$65N/A$65
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$275N/A$275
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$370N/A$370
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$344N/A$344
Dental Filling - White (Resin): One Surface, Anterior$174N/A$174
Dental Filling - White (Resin): One Surface, Posterior$196N/A$196
Dental Filling - White (Resin): Three Surfaces, Posterior$348N/A$348
Dental Filling - White (Resin): Two Surfaces, Anterior$216N/A$216
Dental Filling - White (Resin): Two Surfaces, Posterior$275N/A$275
Flouride - Topical Varnish Application$44N/A$44
Fluoride - Topical Application$44N/A$44
Maintenance Therapy - Periodontal$231N/A$231
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$540N/A$540
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$92N/A$92
Root Canal - Bicuspid Tooth$983N/A$983
Sealant - Placed on Tooth Surface to Prevent Decay$59N/A$59
Tooth Extraction - Elevation and/or Forceps Removal$191N/A$191
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$27N/A$27
X-Ray - Complete Intraoral Series$252N/A$252
X-Ray - Four Images, Bitewings$75N/A$75
X-Ray - Intraoral, Periapical Radiographic Image$33N/A$33
X-Ray - Two Images, Bitewings$101N/A$101
X-Ray - Whole Mouth from Outside Mouth$131N/A$131