Stephen Robert Boone, DDS
85 Spring 301 Laconia, NH 03246
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Dental Cleaning - Adult | $142 | 0% | $142 | Medium |
| Dental Exam - Periodic, Established Patient | $60 | 0% | $60 | Medium |
| Maintenance Therapy - Periodontal | $142 | 0% | $142 | Medium |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $313 | 0% | $313 | Medium |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $89 | 0% | $89 | Medium |
| Tooth Extraction - Elevation and/or Forceps Removal | $218 | 0% | $218 | Medium |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $26 | 0% | $26 | Medium |
| X-Ray - Complete Intraoral Series | $173 | 0% | $173 | Medium |
| X-Ray - Four Images, Bitewings | $121 | 0% | $121 | Medium |
| X-Ray - Intraoral, Periapical Radiographic Image | $32 | 0% | $32 | Medium |
