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 | $109 | 0% | $109 | Medium |
| Fluoride - Topical Application | $49 | 0% | $49 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $315 | 0% | $315 | 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 | $59 | 0% | $59 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $101 | 0% | $101 | Medium |
| X-Ray Dental - Complete intraoral series | $177 | 0% | $177 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $40 | 0% | $40 | 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 |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $315 | 0% | $315 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $221 | 0% | $221 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $300 | 0% | $300 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $208 | 0% | $208 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $370 | 0% | $370 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $255 | 0% | $255 | 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 |