Webster Dental Association

40 Webster Street Manchester, NH 03104
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1380%$138
Dental Cleaning - Child$970%$97
Dental Exam - Comprehensive$1050%$105
Dental Exam - Periodic, Established Patient$600%$60
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2600%$260
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3580%$358
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2840%$284
Dental Filling - White (Resin): One Surface, Anterior$2180%$218
Dental Filling - White (Resin): One Surface, Posterior$2600%$260
Dental Filling - White (Resin): Three Surfaces, Posterior$3580%$358
Dental Filling - White (Resin): Two Surfaces, Anterior$2420%$242
Dental Filling - White (Resin): Two Surfaces, Posterior$2840%$284
Fluoride - Topical Application$630%$63
Maintenance Therapy - Periodontal$3530%$353
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3100%$310
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1640%$164
Root Canal - Anterior Tooth$1,0240%$1,024
Root Canal - Bicuspid Tooth$1,2340%$1,234
Root Canal - Molar$1,4490%$1,449
Sealant - Placed on Tooth Surface to Prevent Decay$840%$84
Tooth Extraction - Elevation and/or Forceps Removal$2630%$263
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$380%$38
X-Ray - Complete Intraoral Series$1960%$196
X-Ray - Four Images, Bitewings$910%$91
X-Ray - Intraoral, Periapical Radiographic Image$420%$42
X-Ray - Two Images, Bitewings$680%$68
X-Ray - Whole Mouth from Outside Mouth$2000%$200