COVERAGE · NEW HAMPSHIRESHEET 30 / 51

New Hampshire, measured.

1,969 licensed dental providers on record, refreshed monthly from the federal registry. The Medicaid floors below come from the official state fee-for-service schedule, effective January 1, 2026 (view the source document). Practice costs index at 1.013 against the 1.000 national baseline.

EFFECTIVE JANUARY 1, 2026 · FLOORS 22 OF 25 CODES Official schedule on file
1,969Licensed providers
22Medicaid fee rows
1.013Geo cost index / 1.000
$22.73 to $1,313.82Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The New Hampshire fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$38.52$44$61$95
Comprehensive exam (new patient)$71.98$73$101$157
Full-mouth X-ray series$73.25$117$162$235
Bitewing X-rays (set of 4)$40.41$51$71$103
Panoramic X-ray$73.25$102$142$206
Emergency
Emergency visit for pain relief$34.10$106$147$228
Endodontics
Root canal, front toothNo published floor$693$962$1,491
Root canal, molarNo published floor$934$1,297$2,010
Implants
Dental implant placementNo published floor$1,495$2,077$3,219
Oral surgery
Simple tooth extraction$126.28$143$198$307
Surgical tooth extraction$157.86$240$334$518
Orthodontics
Full braces treatment, adolescent$1,313.82$4,157$5,774$7,795
Periodontics
Deep cleaning below gumline (per quadrant)$144.10$186$258$400
Ongoing gum maintenance visit$84.07$117$162$251
Preventive
Adult teeth cleaning$66.93$76$106$164
Child teeth cleaning$41.60$58$81$126
Fluoride varnish treatment$22.73$37$51$79
Protective tooth sealant$36.68$40$56$87
Restorative
Metal filling (1 surface)$122.50$113$157$243
Tooth-colored filling, front tooth$112.39$143$198$307
Tooth-colored filling, back tooth (1 surface)$122.50$153$213$330
Tooth-colored filling, back tooth (2 surfaces)$140.17$182$253$392
Ceramic crown$600$1,021$1,418$2,198
Porcelain-on-metal crown$600$839$1,165$1,806
Crown foundation buildup$148$219$304$471

Floor. Official New Hampshire Medicaid fee-for-service dental schedule, effective January 1, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the New Hampshire geographic cost index (1.013 against a 1.000 national baseline), with the insurer-typical amount modeled at roughly 72 percent of area billed charges. Estimates, not quotes.

HOW TO READ IT

Reading this table

The Medicaid floor is the exact fee on the state schedule: the lowest rate a practice accepts for that procedure, and the anchor of the revenue spectrum. Insurer typical models what a commercial plan tends to allow, about 72 percent of area billed charges. Private-pay p50 and p90 are modeled billed-charge bands: the national median scaled by the state cost index, and the top of the usual range. Where a practice actually lands depends on its payer mix. The floor is owned data; the bands are estimates.

CROSS REFERENCE
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