81121 Appliance, Maxillary, Simple
| 80000 | ORTHODONTICS |
||
| 81000 | APPLIANCES, ACTIVE, FOR TOOTH GUIDANCE OR MINOR TOOTH MOVEMENT |
||
| 81100 | APPLIANCES, REMOVABLE |
||
| 81120 | Appliances, Removable, Cross-Bite Correction |
||
| 81121 | Appliance, Maxillary, Simple |
$331.3
+Lab Costs |
$331.3
+Lab Costs |