Thomas Borbotsina, DDS

179 Lowell Street Manchester, NH 03104
Dental Procedures
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My Health Insurance:

  • I do not have dental insurance
ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1160%$116 Medium
Dental Cleaning - Child$860%$86 Medium
Dental Exam - Comprehensive$1000%$100 Medium
Dental Exam - Periodic, Established Patient$490%$49 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2210%$221 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3730%$373 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2730%$273 Medium
Dental Filling - White (Resin): One Surface, Anterior$1790%$179 Medium
Dental Filling - White (Resin): One Surface, Posterior$2210%$221 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3730%$373 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2020%$202 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2940%$294 Medium
Maintenance Therapy - Periodontal$1520%$152 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2780%$278 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$870%$87 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$570%$57 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2680%$268 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27 Medium
X-Ray - Complete Intraoral Series$2230%$223 Medium
X-Ray - Four Images, Bitewings$760%$76 Medium
X-Ray - Intraoral, Periapical Radiographic Image$390%$39 Medium
X-Ray - Two Images, Bitewings$550%$55 Medium
X-Ray - Whole Mouth from Outside Mouth$1470%$147 Medium