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
$58-$150
Periodic Exam (D0120) - $58
Limited Exam (D0140) - $112
Exam < 3 years old (D0145) - $90
New Patient Exam (D0150) - $113
Perio Exam (D0180) - $150
Teeth Cleaning (Prophylaxis)
$87-$115
Adult Teeth Cleaning (D1110) - $115
Child Teeth Cleaning (D1120) - $87
Sealants (D1351)
$70
Amalgam (Silver) Fillings
$165-$318
1 Surface (D2140) - $165
2 Surfaces (D2150) - $199
3 Surfaces (D2160) - $242
4+ Surfaces (D2161) - $318
Composite (White) Anterior Fillings
$190-$369
1 Surface (D2330) - $190
2 Surfaces (D2331) - $229
3 Surfaces (D2332) - $289
4+ Surfaces (D2335) - $369
Composite (White) Posterior Fillings
$207-$410
1 Surface (D2391) - $207
2 Surfaces (D2392) - $273
3 Surfaces (D2393) - $333
4+ Surfaces (D2394) - $410
Osseous Surgery
$1,250-$1,650
1-3 Teeth (D4261) - $1,250
Quad (D4260) - $1,650
Tissue Graft (D4273)
$1,510
Scaling & Root Planing
$236-$311
1-3 Teeth (D4342) - $236
Quad (D4341) - $331
Periodontal Maintenance (D4910)
$164
Restorative Dental
Certain insurance plans may cover up to 100%
Dental Crowns
$375-$1,524
Crown - Porcelain/Ceramic (D2740) - $1,524
Crown - Porcelain Fused to Metal (D2750) - $1,384
Crown Build Up (D2950) - $375
Root Canal
$1,100-$1,600
Anterior (D3310) - $1,100
Bicuspid (D3320) - $1,400
Molar (D3330) - $1,600
Dentures
$1,956-$2,001
Partial Upper Denture (D5213) - $1,956
Partial Lower Denture (D5214) - $1,956
Complete Upper Denture (D5110) - $2,001
Complete Lower Denture (D5120) - $2,001
Dental Bridges
$1,802
Retainer - Porcelain/Ceramic (D6740) - $1,802
Pontic - Porcelain/Ceramic (D6245) - $1,802
Dental Implants
$1,065-$2,450
Custom Abutment (D6057) - $1,065
Implant Crown - Porcelain/Ceramic (D6058) - $1,778
Surgical Place Implant (D6010) - $2,450
Tooth Extractions
$246-$387
Simple Extraction (D7140) - $246
Surgical Extraction (D7210) - $387
Sinus Augmentation (D7952)
$1,500
Augmentation w/Bone (D7951) - $2,500
Bone Graft
$751-785
w/Implant (D6104) - $751
w/Extraction Only (D7953) - $785
Additional Services
Certain insurance plans may cover up to 100%
Fluoride (D1206)
$58
Dental X-rays
$33-$180
FMX (D0210) - $164
PA (D0220) - $39
Addt’l PAs (D0230) - $33
2 BWX (D0272) - $57
4 BWX (D0274) - $82
Panoramic X-ray (D0330) - $180
