Dental Hygiene Therapy (Cleaning) |
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Adult Hygiene Therapy (Class 0, I, and II)
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$20
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Adult Hygiene Therapy (Class IIP)
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$30
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Adult Hygiene Therapy (Class III )
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$40
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Adult Hygiene Therapy (Class IV)
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$50
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Child Hygiene Therapy
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$15
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Radiographs |
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Full Mouth Series X-rays
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$25
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Panoramic X-ray
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$30
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Vertical Bitewing X-rays (4-7)
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$15-$20
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Bitewing X-ray (4)
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$15
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Bitewing X-ray (2)
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$10
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X-ray single film
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$5
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Each additional x-ray
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$2
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FMX or Pano duplicate film (non-SFSC x-ray)
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$10
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Bitewing duplicate film (non-SFSC x-ray)
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$10
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Digital X-rays
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Same as traditional
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Other Procedures |
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Sealants per tooth
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$8
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Local Anesthesia (non-operative/non-surgical)
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$8
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Night Guards and Bleaching Trays
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$20
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Fissurotomy (when needed prior to sealant)
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$7 per tooth
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