WebFeb 10, 2024 · D2931 Prefabricated stainless steel crown - permanent tooth 165.56 D2932 Prefabricated resin crown 180.87 D2933 Prefabricated stainless steel crown with … Webcrown-permanent tooth $136.93 d2932 prefabricated resin crown $128.22 d2933 prefabricated stainless steel crown with resin window $179.88 d2934 prefabricated esthetic coated stainless steel crown - primary tooth $179.88 d2940 protective restoration $40.98 d2950 core buildup, including any pins ...
2024 FEP Blue/Grid + Fee Schedule
WebD2931 Prefabricated Stainless Steel Crown (SSC) Permanent Tooth $73.40 Y $73.40 Y $73.40 Y D2932 Prefabricated Resin Crown $56.45 Y $56.45 Y $56.45 Y D2933 Prefabricated Stainless Steel crown with resin window $56.45 N N/A N/A D2934 Prefabricated esthetic coated stainless steel crown - primary $73.40 N N/A N/A WebD2930 Prefabricated stainless steel crown – Primary tooth $12.00 D2931 Prefabricated stainless steel crown – Permanent tooth $12.00 D2932 Prefabricated resin crown … greenshield mortgage solutions
Cigna Dental Care (DHMO)* Patient Charge Schedules most …
WebD2932 Prefabricated resin crown 135 D2933 Prefabricated stainless steel crown with resin window 135 D2934 Prefabricated esthetic coated stainless steel crown -primary tooth 145 D2940 Protective restoration 30 D2950 Core … WebD2932 prefabricated resin crown: $344.05: D2933 prefabricated stainless steel crown with resin window: $349.81: D2934 prefabricated esthetic coated stainless steel crown primary tooth: $350.63: D2940 protective restoration: $115.23: D2950 core buildup, including pins: $261.42: WebD2390 Resin-Based Composite Crown, Anterior $389 . D2391 Resin-Based Composite – One Surface, Posterior $224 . D2392 Resin-Based Composite – Two Surface, Posterior $263 ... D2932 Prefabricated Resin Crown $389 . D2940 Protective Restoration $66 . D2949 Restorative Foundation for an Indirect Restoration $252 . D2950 Core Buildup, … green shield mind beacon