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| CDT Code | Tooth | Description | Fee |
|---|---|---|---|
| D2740 | #14 | Crown-porcelain/ceramic substrate | $1,200.00 |
| D2391 | #19 | Resin-based comp-1 surf, post | $250.00 |
| D4341 | LL Quad | Perio scaling/root plan 4+ tth | $350.00 |
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