83201 Appliance, Maxillary
| 80000 | ORTHODONTICS |
||
| 83000 | APPLIANCES, RETENTION, ORTHODONTIC RETAINING APPLIANCES |
||
| 83200 | APPLIANCES, FIXED/CEMENTED, RETENTION |
||
| 83201 | Appliance, Maxillary |
$349.31
+Lab Costs |
$349.31
+Lab Costs |