Tyngsboro Family Dental Practice
94 Middlesex Road, #1 Tyngsboro, MA 01879
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $137 | 0% | $137 | Medium |
| Child Dental Cleaning | $105 | 0% | $105 | Medium |
| Fluoride - Topical Application | $78 | 0% | $78 | Medium |
| Sealant placed on the tooth surface to prevent decay | $79 | 0% | $79 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $108 | 0% | $108 | Medium |
| Periodic dental exam - established patient | $95 | 0% | $95 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $104 | 0% | $104 | Medium |
| X-Ray Dental - Complete intraoral series | $212 | 0% | $212 | Medium |
| X-Ray Dental - Four images - bitewings | $126 | 0% | $126 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $56 | 0% | $56 | Medium |
| X-Ray Dental - Two images - bitewings | $101 | 0% | $101 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $45 | 0% | $45 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $236 | 0% | $236 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| White (Resin) Dental Filling - One surface, posterior | $247 | 0% | $247 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $278 | 0% | $278 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $236 | 0% | $236 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $352 | 0% | $352 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $272 | 0% | $272 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $184 | 0% | $184 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $236 | 0% | $236 | Medium |