Yan Lu, DDS
66t Concord 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 | $108 | 0% | $108 | Medium |
| Child Dental Cleaning | $95 | 0% | $95 | Medium |
| Fluoride - Topical Application | $42 | 0% | $42 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $252 | 0% | $252 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $92 | 0% | $92 | Medium |
| Periodic dental exam - established patient | $64 | 0% | $64 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $103 | 0% | $103 | Medium |
| X-Ray Dental - Complete intraoral series | $135 | 0% | $135 | Medium |
| X-Ray Dental - Four images - bitewings | $72 | 0% | $72 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $38 | 0% | $38 | 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 | $208 | 0% | $208 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $246 | 0% | $246 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $313 | 0% | $313 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $233 | 0% | $233 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $321 | 0% | $321 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $188 | 0% | $188 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $313 | 0% | $313 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $247 | 0% | $247 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $174 | 0% | $174 | Medium |