U & I Dental
2 Pillsbury Street Concord, NH 03301
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $129 | 0% | $129 | Medium |
| Child Dental Cleaning | $105 | 0% | $105 | Medium |
| Fluoride - Topical Application | $56 | 0% | $56 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $276 | 0% | $276 | Medium |
| Sealant placed on the tooth surface to prevent decay | $75 | 0% | $75 | Medium |
| Topical fluoride varnish application | $56 | 0% | $56 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $129 | 0% | $129 | Medium |
| Periodic dental exam - established patient | $66 | 0% | $66 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $113 | 0% | $113 | Medium |
| X-Ray Dental - Complete intraoral series | $189 | 0% | $189 | Medium |
| X-Ray Dental - Four images - bitewings | $105 | 0% | $105 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $45 | 0% | $45 | Medium |
| X-Ray Dental - Two images - bitewings | $65 | 0% | $65 | 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 | $148 | 0% | $148 | 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 | $242 | 0% | $242 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $339 | 0% | $339 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $428 | 0% | $428 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $242 | 0% | $242 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $339 | 0% | $339 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $231 | 0% | $231 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $442 | 0% | $442 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $271 | 0% | $271 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $189 | 0% | $189 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $184 | 0% | $184 | Medium |