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S. <br />BON 1 8 PAGE /231 <br />C~ <br />0 <br />11 <br />2160 <br />Amalgam 3 Surf. Permanent <br />102.00 <br />2161 <br />Amalgam 4+ Surf. Permanent <br />115.00 <br />2330 <br />Resin 1 Surf. Anterior <br />63.00 <br />2331 <br />Resin 2 Surf. Anterior <br />94.00 <br />2332 <br />Resin 3 Surf. Anterior <br />110.00 <br />2355 <br />Resin 4+ Surf. Ant. Incl. Incisal <br />125.00 <br />2336 <br />Resin Crown Ant. Prima <br />135.00 <br />2380 <br />Resin 1 Surf. Post. Primary <br />63.00 <br />2381 <br />Resin 2 Surf. Post. Primp <br />83.00 <br />2385 <br />Resin 1 Surf. Post. Perm. <br />63.00 <br />2386 <br />Resin 2 Surf. Post. Perm. <br />125.00 <br />2387 <br />Resin 3 Surf. Post. Perm. <br />157.00 <br />2388 <br />Resin 4+ Surf. Post. Perm. <br />179.00 <br />2920 <br />Recement Crown <br />47.00 <br />2930 <br />Prefab. 55C Primary <br />127.00 <br />2931 <br />Prefab. 55C Permanent <br />190.00 <br />2933 <br />Prefab 55C w/ Resin Window <br />142.00 <br />2940 <br />Sedative Filling <br />47.00 <br />2950 <br />Core Buildup inc. Pins <br />127.00 <br />2951 <br />Pin Retention per Tooth <br />32.00 <br />2970 <br />Temporary (Fractured Tooth) <br />127.00 <br />3110 <br />Direct Pulp Ca <br />40.00 <br />3220 <br />Therapeutic Pul otom <br />95.00 <br />3310 <br />RCT Anterior Permanent <br />310.00 <br />3330 <br />RCT Molar <br />425.00 <br />4341 <br />Periodontal SURP <br />159.00 <br />4355 <br />Full Mouth Debridement <br />80.00 <br />4910 <br />Periodontal Maintenance <br />61.00 <br />5110 <br />Complete Denture-Maxilla <br />806.00 <br />5120 <br />Complete Denture-Mandibular <br />806.00 <br />5130 <br />Immediate Denture-Maxilla <br />886.00 <br />5140 <br />Immediate Denture-Mandibular <br />886.00 <br />5211 <br />Maxilla Partial Denture-Resin Base <br />548.00 <br />5212 <br />Mandibular Partial Denture-Resin <br />Base <br />571.00 <br />5213 <br />Maxillary Partial Denture-Cast Metal <br />967.00 <br />