Scott Goldberg, DMD
17 Bridge Street, Suite 204 Billerica, MA 01821
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $116 | 0% | $116 | Medium |
| Child Dental Cleaning | $82 | 0% | $82 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $536 | 0% | $536 | Medium |
| Topical fluoride varnish application | $47 | 0% | $47 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $95 | 0% | $95 | Medium |
| Periodic dental exam - established patient | $53 | 0% | $53 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $89 | 0% | $89 | Medium |
| X-Ray Dental - Complete intraoral series | $173 | 0% | $173 | Medium |
| X-Ray Dental - Four images - bitewings | $80 | 0% | $80 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $37 | 0% | $37 | Medium |
| X-Ray Dental - Two images - bitewings | $58 | 0% | $58 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $32 | 0% | $32 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $147 | 0% | $147 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| White (Resin) Dental Filling - One surface, posterior | $236 | 0% | $236 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $394 | 0% | $394 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $326 | 0% | $326 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $155 | 0% | $155 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $200 | 0% | $200 | Medium |