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Cost Estimator
Dahl Memorial
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Cash Pricing
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Emergency Care
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Select a Service
Select a service.
You may need to get a specific service code from your provider.
Code
Description
12002
LAC SIMPLE NONFACIAL 2.6-7.5CM ER
12004
LAC SIMPLE NONFACIAL 7.6-12.5CM
12005
LAC SIMPLE NONFACIAL 12.6-20CM
12006
LAC SIMPLE NONFACIAL 20.1-30CM
12007
LAC SIMPLE NONFACIAL OVER 30CM ER
12011
LAC SIMPLE FACIAL <2.5CM ER
12013
LAC SIMPLE FACIAL 2.6-5CM ER
12014
LAC SIMPLE FACIAL 5.1-7.5CM ER
12015
LAC SIMPLE FACIAL 7.6-12.5CM ER
12016
LAC SIMPLE FACIAL 12.6-20CM ER
12017
LAC SIMPLE FACIAL 20.1-30CM ER
12031
LAC INTERMED TRUNK/LIMB <2.5CM
12032
LAC INTERMED TRUNK/LIMB 2.6-7.5CM
12034
LAC INTERMED TRUNK/LIMB 7.6-12.5CM
12036
LAC INTERMED TRUNK/LIMB 20.1-30CM
12037
LAC INTERMED TRUNK/LIMB OVER 30CM
12042
LAC INTERMED NONFACIAL 2.6-7.5CM
12044
LAC INTERMED NONFACIAL 7.6-12.5CM
12045
LAC INTERMED NONFACIAL 12.6-20CM
12046
LAC INTERMED NONFACIAL 20.1-30CM
12047
LAC INTERMED NONFACIAL OVER 30CM
12051
LAC INTERMED FACIAL <2.5CM
12052
LAC INTERMED FACIAL 2.6-5.0CM
12053
LAC INTERMED FACIAL 5.1-7.5CM
12054
LAC INTERMED FACIAL 7.6-12.5CM
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