57200 PROSTHESIS, MAXILLOFACIAL, OBTURATORS
| 50000 | PROSTHODONTICS - REMOVABLE |
||
| 57000 | PROSTHESIS, MAXILLOFACIAL |
||
| 57200 | PROSTHESIS, MAXILLOFACIAL, OBTURATORS | ||
| 57201 | Obturator, Cleft Palate (prosthesis extra) |
107.2 - 464.32
+Lab Costs |
107.2 - 464.32
+Lab Costs |
| 57202 | Obturator, Palatal (prosthesis extra) |
107.2 - 464.32
+Lab Costs |
107.2 - 464.32
+Lab Costs |
| 57203 | Obturator, Post-Maxillectomy (prosthesis extra) |
107.2 - 1160.82
+Lab Costs |
107.2 - 1160.82
+Lab Costs |
| 57204 | Obturator, Temporary Palatal (prosthesis extra) |
107.2 - 1160.82
+Lab Costs |
107.2 - 1160.82
+Lab Costs |
| 57205 | Obturator, Resilient (prosthesis extra) |
107.2 - 1160.82
+Lab Costs |
107.2 - 1160.82
+Lab Costs |
| 57206 | Obturator, Hollow Bulb (prosthesis extra) |
107.2 - 1160.82
+Lab Costs |
107.2 - 1160.82
+Lab Costs |
| 57207 | Obturator, Inflatable (prosthesis extra) |
428.84 - 1394.04
+Lab Costs |
428.84 - 1394.04
+Lab Costs |
| 57208 | Obturator Prosthesis, Modification (relines or repairs) |
428.84 - 813.1
+Lab Costs |
428.84 - 813.1
+Lab Costs |
| 57209 | Speech Aid Prosthesis |
750.47 - 1509.6
+Lab Costs |
750.47 - 1509.6
+Lab Costs |