Stephen A Sewall, DDS
9 Hampton Road Exeter, NH 03833
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Dental Cleaning - Adult | $121 | 0% | $121 | Medium |
| Dental Cleaning - Child | $141 | 0% | $141 | Medium |
| Dental Exam - Comprehensive | $153 | 0% | $153 | Medium |
| Dental Exam - Periodic, Established Patient | $49 | 0% | $49 | Medium |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $143 | 0% | $143 | Medium |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $179 | 0% | $179 | Medium |
| Fluoride - Topical Application | $84 | 0% | $84 | Medium |
| Maintenance Therapy - Periodontal | $131 | 0% | $131 | Medium |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $88 | 0% | $88 | Medium |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $17 | 0% | $17 | Medium |
| X-Ray - Complete Intraoral Series | $147 | 0% | $147 | Medium |
| X-Ray - Four Images, Bitewings | $71 | 0% | $71 | Medium |
| X-Ray - Intraoral, Periapical Radiographic Image | $27 | 0% | $27 | Medium |
| X-Ray - Two Images, Bitewings | $43 | 0% | $43 | Medium |
