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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | PERIODONTAL FLAP SURGERY / AUTOGMOUS BONE GRAFT /SITE | 97232-00[456] | 320217 | 1,760.00 | |||
0 | PERIODONTAL FLAP SURGERY / MEMBRANES (RES. NON-RES) /SITE | 320218 | 2,800.00 | ||||
0 | PERIODONTAL FLAP SURGERY / QUAD | 97232-00[456] | 320219 | 1,760.00 | |||
0 | PERIODONTAL FLAP SURGERY / SEXTANT | 97232-00[456] | 320220 | 1,440.00 | |||
0 | PERIODONTAL FLAP SURGERY /TOOTH | 97232-00[456] | 320221 | 1,200.00 | |||
0 | PHASE I REMOVABLE ORTHO TREATMENT | 320222 | 5,200.00 | ||||
0 | PHOTOGRAPH SERIES | 320223 | 580 | ||||
0 | PHOTOGRAPHY (FULL SET) | 320224 | 260 | ||||
0 | PLASMA TEETH WHITENING 2 ARCH | 320225 | 1,900.00 | ||||
0 | PLASMA TEETH WHITENING ONE ARCH | 320226 | 1,600.00 | ||||
0 | POLISHING & SCALING | 97113-00[453] | 320227 | 320 | |||
0 | PORCELAIN FUSED P/M PONTIC | 320228 | 1,300.00 |
PERIODONTAL FLAP SURGERY / AUTOGMOUS BONE GRAFT /SITE
1,760.00
PERIODONTAL FLAP SURGERY / MEMBRANES (RES. NON-RES) /SITE
2,800.00
PERIODONTAL FLAP SURGERY / QUAD
1,760.00
PERIODONTAL FLAP SURGERY / SEXTANT
1,440.00
PERIODONTAL FLAP SURGERY /TOOTH
1,200.00
PHASE I REMOVABLE ORTHO TREATMENT
5,200.00
PHOTOGRAPH SERIES
580
PHOTOGRAPHY (FULL SET)
260
PLASMA TEETH WHITENING 2 ARCH
1,900.00
PLASMA TEETH WHITENING ONE ARCH
1,600.00
POLISHING & SCALING
320
PORCELAIN FUSED P/M PONTIC
1,300.00
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