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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | PORCELAIN FUSED TO METAL > 1 UNIT, PER | 320229 | 1,880.00 | ||||
UNIT(INCLUDING COST OF 3GM GOLD) | |||||||
0 | PORCELAIN FUSED TO METAL CROWN ( + 3 GM) SINGLE | 320230 | 2,040.00 | ||||
2 | ROOT CANAL TREATMENT , ANTERIOR TOOTH | 97417-00[462] | 320231 | 9741700 | Y | 1,050.00 | |
3 | ROOT CANAL TREATMENT MOLAR TOOTH | 97417-00[462] | 320232 | 9741700 | Y | 1,250.00 | |
2 | SURGERY FOR WISDOM TEETH UNDER G.A | 97322-00[458] | 320233 | 9732200 | Y | 1,275.00 | |
2 | SURGERY FOR APICECTOMY | 320234 | Y | 1,950.00 | |||
2 | SURGERY FOR APICECTOMY - PK | 97432-00[463] | 320235 | 9743200 | Y | 5,250.00 | |
2 | SURGERY FOR FLAPSPERIO-DENTAL FLAPS(ONE SIDE | 97232-00[456] | 320236 | 9723200 | Y | 900 | |
2 | SURGERY FOR FLPASPERO-DENTAL FLAP(FULL | 97232-01[456] | 320237 | 9723201 | Y | 3,600.00 | |
MOUTH) | |||||||
2 | SURGERY FOR THREE IMPACTED WISDOM TEETH | 97322-03[458] | 320238 | 9732203 | Y | 3,000.00 |
PORCELAIN FUSED TO METAL > 1 UNIT, PER
1,880.00
UNIT(INCLUDING COST OF 3GM GOLD)
PORCELAIN FUSED TO METAL CROWN ( + 3 GM) SINGLE
2,040.00
ROOT CANAL TREATMENT , ANTERIOR TOOTH
1,050.00
ROOT CANAL TREATMENT MOLAR TOOTH
1,250.00
SURGERY FOR WISDOM TEETH UNDER G.A
1,275.00
SURGERY FOR APICECTOMY
1,950.00
SURGERY FOR APICECTOMY - PK
5,250.00
SURGERY FOR FLAPSPERIO-DENTAL FLAPS(ONE SIDE
900
SURGERY FOR FLPASPERO-DENTAL FLAP(FULL
3,600.00
MOUTH)
SURGERY FOR THREE IMPACTED WISDOM TEETH
3,000.00
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