25122 Two surfaces
| 20000 | RESTORATION |
||
| 25000 | RESTORATIONS, INLAYS, ONLAYS, PINS AND POSTS |
||
| 25100 | RESTORATIONS INLAYS |
||
| 25120 | Inlays, Composite/Compomer, Indirect (Bonded) |
||
| 25122 | Two surfaces |
$573.4
+Lab Costs |
$573.4
+Lab Costs |