Thomas A Johnston & Associates

206 Heater Road Lebanon, NH 03766
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1180%$118 Medium
Dental Cleaning - Child$850%$85 Medium
Dental Exam - Comprehensive$1470%$147 Medium
Dental Exam - Periodic, Established Patient$590%$59 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2100%$210 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3150%$315 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2520%$252 Medium
Dental Filling - White (Resin): One Surface, Anterior$2310%$231 Medium
Dental Filling - White (Resin): One Surface, Posterior$2440%$244 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3890%$389 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2890%$289 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3150%$315 Medium
Flouride - Topical Varnish Application$560%$56 Medium
Maintenance Therapy - Periodontal$1630%$163 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1060%$106 Medium
Root Canal - Bicuspid Tooth$1,1550%$1,155 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2360%$236 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$260%$26 Medium
X-Ray - Complete Intraoral Series$2320%$232 Medium
X-Ray - Four Images, Bitewings$860%$86 Medium
X-Ray - Intraoral, Periapical Radiographic Image$390%$39 Medium
X-Ray - Two Images, Bitewings$820%$82 Medium
X-Ray - Whole Mouth from Outside Mouth$1470%$147 Medium