Thomas J Bara, DMD
82 W Main Street Hillsbororo, NH 03244
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $103 | 0% | $103 | Medium |
| Child Dental Cleaning | $83 | 0% | $83 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $272 | 0% | $272 | Medium |
| Sealant placed on the tooth surface to prevent decay | $58 | 0% | $58 | Medium |
| Topical fluoride varnish application | $46 | 0% | $46 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $90 | 0% | $90 | Medium |
| Periodic dental exam - established patient | $58 | 0% | $58 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $87 | 0% | $87 | Medium |
| X-Ray Dental - Complete intraoral series | $144 | 0% | $144 | Medium |
| X-Ray Dental - Four images - bitewings | $70 | 0% | $70 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $16 | 0% | $16 | Medium |
| X-Ray Dental - Two images - bitewings | $50 | 0% | $50 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $16 | 0% | $16 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $127 | 0% | $127 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $186 | 0% | $186 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $259 | 0% | $259 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $337 | 0% | $337 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $186 | 0% | $186 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $259 | 0% | $259 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $169 | 0% | $169 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $337 | 0% | $337 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $208 | 0% | $208 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $149 | 0% | $149 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $185 | 0% | $185 | Medium |