Lee Richheimer, DDS
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $99 | 0% | $99 |
| Dental Cleaning - Child | $68 | 0% | $68 |
| Dental Exam - Comprehensive | $84 | 0% | $84 |
| Dental Exam - Periodic, Established Patient | $47 | 0% | $47 |
| Dental Filling - White (Resin): One Surface, Anterior | $155 | 0% | $155 |
| Dental Filling - White (Resin): One Surface, Posterior | $210 | 0% | $210 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $318 | 0% | $318 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $252 | 0% | $252 |
| Flouride - Topical Varnish Application | $38 | 0% | $38 |
| Tooth Extraction - Elevation and/or Forceps Removal | $161 | 0% | $161 |
| X-Ray - Complete Intraoral Series | $139 | 0% | $139 |
| X-Ray - Four Images, Bitewings | $67 | 0% | $67 |
| X-Ray - Two Images, Bitewings | $47 | 0% | $47 |