PROCEEDURE
TOOTH SURFACE
Composite 3 Surf Posteri 31
MOD
Subtotal for above proceedure would be $253. Our insurance would cover $177 of it leaving $76 of us to pay. Completely
doable with our budget.
Post & Core Prefab in Add 10
Buildup, Core inclu pin 7
S
Buildup, Core inclu pin 8
S
Buildup, Core inclu pin 9
S
Crown-Porcelain/Ceramic 7
Crown-Porcelain/Ceramic 8
Crown-Porcelain/Ceramic 9
Crown-Porcelain/Ceramic 10
Subtotal for the above phase is $4,773--our insurance would cover $1,131 of it leaving $3,642 to be covered :-0
Bridge Abutment-PFM 4
Bridge Abutment-PFM 6
Bridge Pontic-PFM
5
Subtotal for the above would be $2,992. We would have maxed out our insurance so we would need to pay 100 percent for
this.
Bridge Abutment-PFM 11
Bridge Abutment-PFM 13
Bridge Pontic-PFM
12
Subtotal for the above would be $2,807. Our insurance would already be maxed out and we would need to pay 100 percent
of this.
