Sullivan County Oral Health Collaborative
1 Tremont Street Claremont, NH 03743http://www.communitydentalnh.org/ (603) 287-1300
All cost information is based on claims data collected in the New Hampshire Comprehensive Healthcare Information System which is updated quarterly. All quality information is based on claims and administrative data collected by the Centers for Medicare and Medicaid Services which is updated annually. For more information click the links above and review our methodology section.
Methodology| Procedure |
Estimate of Procedure Cost
Estimate of Procedure Cost This is an estimate of the total charge for the health care service before any discounts provided to the uninsured. |
Number of Visits
Number of Visits When the number of visits varies, it is difficult to estimate the total cost of care. This indicates the number of visits you can expect, calculated using the median. To determine the total you might pay, multiply the Estimate of Procedure Cost and the Statewide Average for Number of Visits. - Above Average: Expect to visit the provider more than the average number of visits. - Near Average: Expect the visit the provider close to the average number of visits. - Below Average: Expect to visit the provider less than the average number of visits. |
What You Will Pay
What You Will Pay The estimated charge amount minus the uninsured discount (when available). |
|---|---|---|---|
| Adult Dental Cleaning | $107 | N/A | $107 |
| Child Dental Cleaning | $81 | N/A | $81 |
| Complete Intraoral X-Ray Series | $149 | N/A | $149 |
| Comprehensive Dental Exam | $93 | N/A | $93 |
| Dental Crown, Porcelain/Ceramic | $1,313 | N/A | $1,313 |
| Four Bitewing X-Ray Images | $69 | N/A | $69 |
| Intraoral X-Ray, Periapical Radiographic Image | $37 | N/A | $37 |
| Maintenance Therapy | $150 | N/A | $150 |
| Periodic Dental Exam for an Established Patient | $58 | N/A | $58 |
| Problem Focused Evaluation, Limited to a Specific Oral Health Problem or Complaint | $83 | N/A | $83 |
| Tooth Extraction, Elevation and/or Forceps Removal | $203 | N/A | $203 |
| Topical Varnish Fluoride Application | $43 | N/A | $43 |
| Two Bitewing X-Ray Images | $47 | N/A | $47 |
| White (Resin) Dental Filling: One Surface, Anterior | $168 | N/A | $168 |
| White (Resin) Dental Filling: One Surface, Posterior | $197 | N/A | $197 |
| White (Resin) Dental Filling: Three Surfaces, Posterior | $307 | N/A | $307 |
| White (Resin) Dental Filling: Two Surfaces, Anterior | $210 | N/A | $210 |
| White (Resin) Dental Filling: Two Surfaces, Posterior | $251 | N/A | $251 |
Before seeking care, contact your health or dental insurance company to confirm if a provider is covered by your plan.