Shawsheen Family Dental
1455 Main Street Tewksbury, MA 01876
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $109 | 0% | $109 | Medium |
| Child Dental Cleaning | $103 | 0% | $103 | Medium |
| Fluoride - Topical Application | $49 | 0% | $49 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $100 | 0% | $100 | Medium |
| Periodic dental exam - established patient | $49 | 0% | $49 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $90 | 0% | $90 | Medium |
| X-Ray Dental - Complete intraoral series | $158 | 0% | $158 | 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 | $17 | 0% | $17 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $215 | 0% | $215 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $255 | 0% | $255 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $215 | 0% | $215 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $208 | 0% | $208 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $193 | 0% | $193 | Medium |