Wilmington Family Dental
306 Main Street Wilmington, MA 01887
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $119 | 0% | $119 | Medium |
| Child Dental Cleaning | $92 | 0% | $92 | Medium |
| Fluoride - Topical Application | $53 | 0% | $53 | Medium |
| Sealant placed on the tooth surface to prevent decay | $67 | 0% | $67 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $106 | 0% | $106 | Medium |
| Periodic dental exam - established patient | $68 | 0% | $68 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $95 | 0% | $95 | Medium |
| X-Ray Dental - Complete intraoral series | $165 | 0% | $165 | Medium |
| X-Ray Dental - Four images - bitewings | $79 | 0% | $79 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $46 | 0% | $46 | Medium |
| X-Ray Dental - Two images - bitewings | $66 | 0% | $66 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $32 | 0% | $32 | 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 | $221 | 0% | $221 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $277 | 0% | $277 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $334 | 0% | $334 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $269 | 0% | $269 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $277 | 0% | $277 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $227 | 0% | $227 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $452 | 0% | $452 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $244 | 0% | $244 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $201 | 0% | $201 | Medium |