Office Fees
Giving You the Full Picture
At Nashoba Family Dentists, we put you at the center of everything we do, which means being as transparent as possible about not only who we are and the services we offer, but also about how our fees are structured. We’ve listed most of our services with fee structures below. Please understand that each procedure could vary in price from these numbers depending on the need—every patient and every case is different.
Preventative Care
Certain insurance plans may cover up to 100%
Dental Exam
$74-$159
Periodic Exam (D0120) - $74
Limited Exam (D0140) - $119
Exam < 3 years old (D0145) - $107
New Patient Exam (D0150) - $130
Perio Exam (D0180) - $159
Teeth Cleaning (Prophylaxis)
$95-$138
Adult Teeth Cleaning (D1110) - $138
Child Teeth Cleaning (D1120) - $95
Sealants (D1351)
$79
Amalgam (Silver) Fillings
$194-$309
1 Surface (D2140) - $194
2 Surfaces (D2150) - $228
3 Surfaces (D2160) - $260
4+ Surfaces (D2161) - $309
Composite (White) Anterior Fillings
$240-$446
1 Surface (D2330) - $240
2 Surfaces (D2331) - $292
3 Surfaces (D2332) - $355
4+ Surfaces (D2335) - $446
Composite (White) Posterior Fillings
$259-$478
1 Surface (D2391) - $259
2 Surfaces (D2392) - $329
3 Surfaces (D2393) - $407
4+ Surfaces (D2394) - $478
Osseous Surgery
$1,442-$1,782
1-3 Teeth (D4261) - $1,442
Quad (D4260) - $1,782
Tissue Graft (D4273)
$1,602
Scaling & Root Planing
$292-$386
1-3 Teeth (D4342) - $292
Quad (D4341) - $386
Periodontal Maintenance (D4910)
$207
Restorative Dental
Certain insurance plans may cover up to 100%
Dental Crowns
$424-$1,677
Crown - Porcelain/Ceramic (D2740) - $1,677
Crown - Porcelain Fused to Metal (D2750) - $1,677
Crown Build Up (D2950) - $424
Root Canal
$1,167-$1,697
Anterior (D3310) - $1,167
Bicuspid (D3320) - $1,485
Molar (D3330) - $1,697
Dentures
$2,671-$2,731
Partial Upper Denture (D5213) - $2,731
Partial Lower Denture (D5214) - $2,731
Complete Upper Denture (D5110) - $2,671
Complete Lower Denture (D5120) - $2,671
Dental Bridges
$1,673/tooth
Retainer - Porcelain/Ceramic (D6740) - $1,673
Pontic - Porcelain/Ceramic (D6245) - $1,673
Dental Implants
$5,914
Custom Abutment (D6057) - $1,287
Implant Crown - Porcelain/Ceramic (D6058) - $1,975
Surgical Place Implant (D6010) - $2,652
Tooth Extractions
$292-$429
Simple Extraction (D7140) - $292
Surgical Extraction (D7210) - $429
Sinus Augmentation (D7952)
$1,591
Augmentation w/Bone (D7951) - $2,652
Bone Graft
$833
w/Implant (D6104) - $833
w/Extraction Only (D7953) - $833
Additional Services
Certain insurance plans may cover up to 100%
Fluoride (D1206)
$62
Dental X-rays
$37-$191
FMX (D0210) - $186
PA (D0220) - $42
Addt’l PAs (D0230) - $37
2 BWX (D0272) - $64
4 BWX (D0274) - $95
Panoramic X-ray (D0330) - $191
