Financial Options
Payment and any co-payments are due at the time of service.
We accept:
- MaineCare, for patients under 21 (pediatric and young adult)
- MaineCare, for patients 21 and older, for select procedures
- Delta Dental
- Cash, check, or credit card
Patients with Dental Insurance: We accept most major dental insurances. However, we are only a participating provider with Delta Dental and Mainecare. As a courtesy, we will submit a claim to your primary insurance. This is not a guarantee of payment by your insurance company. Patients will be required to pay all denied claims. Patients are responsible for the payment of all non-covered services, deductible, and co-payments at the time of service. We do not submit claims to secondary insurance companies.
Payment options: Cash, Personal check, Credit card payment with Visa, MasterCard, Discover. Payment is due in full at time of service. ** We do not offer payment plans**
Fees
Many of our patients have no dental insurance, or insurance that reimburses poorly. Understanding your insurance benefits, or the lack of them, is your responsibility, and we’ve worked to keep our fees reasonable while maintaining the quality of care we provide.
If you’ve recently visited another dental provider and received a treatment plan or bill, the fees below may help you make a rough cost comparison. These are our prices for the procedures we perform most often, listed with their ADA codes.
Fees are subject to change.
| Procedure | ADA Code | Fee |
|---|---|---|
| Exams | ||
| Initial oral exam | D0150 | $75.00 |
| Limited oral exam | D0140 | $65.00 |
| Adult Hygiene Services | ||
| Adult Prophy | D1110 | $110.00 |
| X-rays | ||
| First periapical X-ray | D0220 | $35.00 |
| Second periapical X-ray | D0230 | $25.00 |
| Two bitewing X-rays | D0272 | $45.00 |
| Four bitewing X-rays | D0274 | $55.00 |
| Panoramic X-ray | D0330 | $100.00 |
| Full mouth series | D0210 | $120.00 |
| Composite (white) fillings, anterior and posterior | ||
| 1 surface | D2330 | $150.00 |
| 2 surface | D2331 | $185.00 |
| 3 surface | D2332 | $205.00 |
| 4 surface | D2335 | $250.00 |
| Procedure | ADA Code | Fee |
|---|---|---|
| Amalgam fillings, posterior | ||
| 1 surface | D2140 | $150.00 |
| 2 surface | D2150 | $185.00 |
| 3 surface | D2160 | $205.00 |
| 4 surface | D2161 | $250.00 |
| Surgery and extractions | ||
| Simple extraction | D7140 | $200.00 |
| Surgical extraction | D7210 | $300.00 |
| Nitrous oxide | D9230 | $70.00 |
| Pediatric services | ||
| Child prophylaxis (cleaning) | D1120 | $90.00 |
| Silver diamine fluoride, per tooth | D1354 | $20.00 |
| Fluoride varnish | D1206 | $12.00 |
| Bilateral fixed spacer | D1516 | $358.18 |
| Bilateral fixed spacer | D1517 | $358.18 |
| Nitrous oxide | D9230 | $70.00 |
No two dental practices will recommend the identical treatment plan. You’ll need a new exam with us to develop a treatment plan suited to your individual needs.
The fees above are intended for comparison against a recent bill or treatment plan from another dental clinic. They’re meant to inform you, not to serve as a quote for your own care.