Summit Dental

248 Pleasant Street, Suite 202 Concord, NH 03301
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1310%$131 Medium
Dental Cleaning - Child$1030%$103 Medium
Dental Exam - Comprehensive$1080%$108 Medium
Dental Exam - Periodic, Established Patient$780%$78 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2220%$222 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$4580%$458 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$3450%$345 Medium
Dental Filling - White (Resin): One Surface, Anterior$2420%$242 Medium
Dental Filling - White (Resin): One Surface, Posterior$2610%$261 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$4580%$458 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$3450%$345 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3450%$345 Medium
Flouride - Topical Varnish Application$510%$51 Medium
Fluoride - Topical Application$510%$51 Medium
Maintenance Therapy - Periodontal$1770%$177 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$890%$89 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$4040%$404 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1260%$126 Medium
Root Canal - Bicuspid Tooth$1,2980%$1,298 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$680%$68 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2730%$273 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$470%$47 Medium
X-Ray - Complete Intraoral Series$1980%$198 Medium
X-Ray - Four Images, Bitewings$1470%$147 Medium
X-Ray - Intraoral, Periapical Radiographic Image$500%$50 Medium
X-Ray - Two Images, Bitewings$970%$97 Medium
X-Ray - Whole Mouth from Outside Mouth$1260%$126 Medium