Stephen Ananian, DDS
278 Lafayette Road Portsmouth, NH 03801
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $126 | 0% | $126 | Medium |
| Child Dental Cleaning | $92 | 0% | $92 | Medium |
| Fluoride - Topical Application | $47 | 0% | $47 | Medium |
| Sealant placed on the tooth surface to prevent decay | $63 | 0% | $63 | Medium |
| Topical fluoride varnish application | $47 | 0% | $47 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $102 | 0% | $102 | Medium |
| Periodic dental exam - established patient | $58 | 0% | $58 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $95 | 0% | $95 | Medium |
| X-Ray Dental - Complete intraoral series | $155 | 0% | $155 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $37 | 0% | $37 | Medium |
| X-Ray Dental - Two images - bitewings | $63 | 0% | $63 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $38 | 0% | $38 | 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 | $173 | 0% | $173 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $336 | 0% | $336 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $347 | 0% | $347 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $200 | 0% | $200 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $273 | 0% | $273 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $171 | 0% | $171 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $349 | 0% | $349 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $210 | 0% | $210 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $158 | 0% | $158 | Medium |