Medical Procedure Costs

38770

Remove pelvis lymph nodes

Surgery - Hemic/Lymphatic

$739

—

38780

Remove abdomen lymph nodes

Surgery - Hemic/Lymphatic

$979

—

38790

Inject for lymphatic x-ray

Surgery - Hemic/Lymphatic

$76

—

38792

Ra tracer id of sentinl node

Surgery - Hemic/Lymphatic

$27

—

38794

Access thoracic lymph duct

Surgery - Hemic/Lymphatic

$259

—

38900

Io map of sent lymph node

Surgery - Hemic/Lymphatic

$123

—

39000

Exploration of chest

Surgery - Mediastinum/Diaphragm

$492

—

39010

Exploration of chest

Surgery - Mediastinum/Diaphragm

$762

—

39200

Resect mediastinal cyst

Surgery - Mediastinum/Diaphragm

$832

—

39220

Resect mediastinal tumor

Surgery - Mediastinum/Diaphragm

$1,068

—

39328004715

HYOSCYAMINE 0.125 MG/ML DROP

Prescription Drug - Generic

$1

—

39328004816

HYOSCYAMINE 0.125 MG/5 ML ELIX

Prescription Drug - Generic

$0

—

39328007920

FLAC OTIC OIL 0.01% EAR DROP

Prescription Drug - Generic

$1

—

39328010610

PRENATAL VITAMIN PLUS LOW IRON

Prescription Drug - Generic

$0

—

39401

Mediastinoscpy w/medstnl bx

Surgery - Mediastinum/Diaphragm

$293

—

39402

Mediastinoscpy w/lmph nod bx

Surgery - Mediastinum/Diaphragm

$378

—

39501

Repair diaphragm laceration

Surgery - Mediastinum/Diaphragm

$810

—

39503

Repair of diaphragm hernia

Surgery - Mediastinum/Diaphragm

$5,352

—

39540

Repair of diaphragm hernia

Surgery - Mediastinum/Diaphragm

$818

—

39541

Repair of diaphragm hernia

Surgery - Mediastinum/Diaphragm

$888

—

39545

Revision of diaphragm

Surgery - Mediastinum/Diaphragm

$873

—

39560

Resect diaphragm simple

Surgery - Mediastinum/Diaphragm

$759

—

39561

Resect diaphragm complex

Surgery - Mediastinum/Diaphragm

$1,218

—

39822020501

PANCRELIPASE DR 5,000 UNIT CAP

Prescription Drug - Generic

$1

—

39822552503

PROMETHAZINE 25 MG/ML AMPUL

Prescription Drug - Generic

$2

—

39822555006

PROMETHAZINE 50 MG/ML AMPUL

Prescription Drug - Generic

$2

—

39822990001

AMMONIA INHALANT AMPULE

Prescription Drug - Generic

$0

—

40076000250

VUSION OINTMENT

Prescription Drug - Brand

$11

—

40076005150

EXTINA 2% FOAM

Prescription Drug - Brand

$14

—

40076006100

EVOCLIN 1% FOAM

Prescription Drug - Brand

$5

—

40076031530

ERYGEL 2% GEL

Prescription Drug - Brand

$6

—

40085022012

PROMETHAZINE 50 MG SUPPOSITORY

Prescription Drug - Generic

$31

—

40490

Biopsy of lip

Surgery - Digestive

$56

—

40500

Partial excision of lip

Surgery - Digestive

$333

—

40510

Partial excision of lip

Surgery - Digestive

$317

—

40520

Partial excision of lip

Surgery - Digestive

$327

—

40525

Reconstruct lip with flap

Surgery - Digestive

$498

—

40527

Reconstruct lip with flap

Surgery - Digestive

$553

—

40530

Partial removal of lip

Surgery - Digestive

$367

—

40650

Rpr lip fth vermilion only

Surgery - Digestive

$350

—

40652

Rpr lip fth<half ver height

Surgery - Digestive

$362

—

40654

Rpr lip fth>1half ver ht/cpx

Surgery - Digestive

$395

—

40700

Repair cleft lip/nasal

Surgery - Digestive

$912

—

40701

Repair cleft lip/nasal

Surgery - Digestive

$1,065

—

40702

Repair cleft lip/nasal

Surgery - Digestive

$899

—

40720

Repair cleft lip/nasal

Surgery - Digestive

$923

—

40761

Repair cleft lip/nasal

Surgery - Digestive

$963

—

40800

Drainage of mouth lesion

Surgery - Digestive

$116

—

40801

Drainage of mouth lesion

Surgery - Digestive

$189

—

40804

Removal foreign body mouth

Surgery - Digestive

$116

—

My Cost List