Office Fees
Giving You the Full Picture
At Leominster 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
$70-$150
Periodic Exam (D0120) - $70
Limited Exam (D0140) - $112
Exam < 3 years old (D0145) - $101
New Patient Exam (D0150) - $123
Perio Exam (D0180) - $150
Teeth Cleaning (Prophylaxis)
$90-$130
Adult Teeth Cleaning (D1110) - $130
Child Teeth Cleaning (D1120) - $90
Sealants (D1351)
$74
Amalgam (Silver) Fillings
$183-$291
1 Surface (D2140) - $183
2 Surfaces (D2150) - $215
3 Surfaces (D2160) - $245
4+ Surfaces (D2161) - $291
Composite (White) Anterior Fillings
$226-$420
1 Surface (D2330) - $226
2 Surfaces (D2331) - $275
3 Surfaces (D2332) - $335
4+ Surfaces (D2335) - $420
Composite (White) Posterior Fillings
$244-$451
1 Surface (D2391) - $244
2 Surfaces (D2392) - $310
3 Surfaces (D2393) - $384
4+ Surfaces (D2394) - $451
Osseous Surgery
$1,359-$1,680
1-3 Teeth (D4261) - $1,359
Quad (D4260) - $1,680
Tissue Graft (D4273)
$1,510
Scaling & Root Planing
$275-$364
1-3 Teeth (D4342) - $275
Quad (D4341) - $364
Periodontal Maintenance (D4910)
$195
Restorative Dental
Certain insurance plans may cover up to 100%
Dental Crowns
$400-$1,581
Crown - Porcelain/Ceramic (D2740) - $1,581
Crown - Porcelain Fused to Metal (D2750) - $1,581
Crown Build Up (D2950) - $400
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) - $2,574
Partial Lower Denture (D5214) - $2,574
Complete Upper Denture (D5110) - $2,518
Complete Lower Denture (D5120) - $2,518
Dental Bridges
$1,577
Retainer - Porcelain/Ceramic (D6740) - $1,577
Pontic - Porcelain/Ceramic (D6245) - $1,577
Dental Implants
$1,213-$2,500
Custom Abutment (D6057) - $1,213
Implant Crown - Porcelain/Ceramic (D6058) - $1,862
Surgical Place Implant (D6010) - $2,500
Tooth Extractions
$275-$404
Simple Extraction (D7140) - $275
Surgical Extraction (D7210) - $404
Sinus Augmentation (D7952)
$1,500
Augmentation w/Bone (D7951) - $2,500
Bone Graft
$785
w/Implant (D6104) - $785
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) - $175
PA (D0220) - $40
Addt’l PAs (D0230) - $35
2 BWX (D0272) - $60
4 BWX (D0274) - $90
Panoramic X-ray (D0330) - $180