Scott G Robitaille, DMD
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $89 | 0% | $89 |
| Dental Cleaning - Child | $147 | 0% | $147 |
| Dental Exam - Comprehensive | $74 | 0% | $74 |
| Dental Exam - Periodic, Established Patient | $53 | 0% | $53 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $167 | 0% | $167 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $473 | 0% | $473 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $200 | 0% | $200 |
| Dental Filling - White (Resin): One Surface, Posterior | $334 | 0% | $334 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $236 | 0% | $236 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $58 | 0% | $58 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $17 | 0% | $17 |
| X-Ray - Complete Intraoral Series | $221 | 0% | $221 |
| X-Ray - Four Images, Bitewings | $99 | 0% | $99 |
| X-Ray - Intraoral, Periapical Radiographic Image | $23 | 0% | $23 |
| X-Ray - Two Images, Bitewings | $53 | 0% | $53 |