The Center For Oral & Maxillofacial Surgery
Rr 120 Hanover, NH 03755
Dental Procedures
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $179 | 0% | $179 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $131 | 0% | $131 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $53 | 0% | $53 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $38 | 0% | $38 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $151 | 0% | $151 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $259 | 0% | $259 | Medium |