The Center For Oral & Maxillofacial Surgery
Rr 120 Hanover, NH 03755
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Dental Exam - Comprehensive | $179 | 0% | $179 | Medium |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $134 | 0% | $134 | Medium |
| Tooth Extraction - Elevation and/or Forceps Removal | $266 | 0% | $266 | Medium |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $38 | 0% | $38 | Medium |
| X-Ray - Intraoral, Periapical Radiographic Image | $54 | 0% | $54 | Medium |
| X-Ray - Whole Mouth from Outside Mouth | $185 | 0% | $185 | Medium |
