Sharon E Johnson, DMD
15 Daniel Webster Hwy Belmont, NH 03220
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $121 | 0% | $121 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $320 | 0% | $320 | Medium |
| Topical fluoride varnish application | $49 | 0% | $49 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Periodic dental exam - established patient | $62 | 0% | $62 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $105 | 0% | $105 | Medium |
| X-Ray Dental - Complete intraoral series | $172 | 0% | $172 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $40 | 0% | $40 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $33 | 0% | $33 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $179 | 0% | $179 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $394 | 0% | $394 | Medium |