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CIGNA Dental Care Patient Charge Schedule

D0460 Pulp Vitality Tests $0.00 D0470 Diagnostic Casts $0.00 D0472 Pathology Report – Gross Examination of Lesion (Only When Tooth Related) $0.00 D0473 Pathology Report – Microscopic Examination of Lesion (Only When Tooth Related) $0.00 D0474 Pathology Report – Microscopic Examination of Lesion and Area (Only When Tooth Related) $0.00

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  Dental, Cigna, Vitality, Cigna dental

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