Westford Dentistry
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $123 | N/A | $123 |
| Dental Cleaning - Child | $92 | N/A | $92 |
| Dental Exam - Periodic, Established Patient | $69 | N/A | $69 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $315 | N/A | $315 |
| Dental Filling - White (Resin): One Surface, Posterior | $249 | N/A | $249 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $385 | N/A | $385 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $315 | N/A | $315 |
| Flouride - Topical Varnish Application | $58 | N/A | $58 |
| Root Canal - Bicuspid Tooth | $2,510 | N/A | $2,510 |
| Sealant - Placed on Tooth Surface to Prevent Decay | $77 | N/A | $77 |
| X-Ray - Complete Intraoral Series | $177 | N/A | $177 |
| X-Ray - Four Images, Bitewings | $89 | N/A | $89 |
| X-Ray - Two Images, Bitewings | $62 | N/A | $62 |