Stefan H Wittner, DMD
31 Hanson Street Rochester, NH 03867
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $103 | 0% | $103 | Medium |
| Child Dental Cleaning | $97 | 0% | $97 | Medium |
| Fluoride - Topical Application | $50 | 0% | $50 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Periodic dental exam - established patient | $58 | 0% | $58 | Medium |
| X-Ray Dental - Complete intraoral series | $171 | 0% | $171 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $39 | 0% | $39 | Medium |
| X-Ray Dental - Two images - bitewings | $59 | 0% | $59 | 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 | $170 | 0% | $170 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $211 | 0% | $211 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $259 | 0% | $259 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $219 | 0% | $219 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $194 | 0% | $194 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $235 | 0% | $235 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $212 | 0% | $212 | Medium |