Medical Procedure Costs

42858008145

METHYLPHENIDATE ER 60 MG CAP

Prescription Drug - Generic

$6

—

42858010250

OXYCODONE-ACETAMINOPHEN 5-325

Prescription Drug - Generic

$0

—

42858023450

DILAUDID 4 MG TABLET

Prescription Drug - Brand

$4

—

42858030301

HYDROMORPHONE 8 MG TABLET

Prescription Drug - Generic

$1

—

42858030416

HYDROMORPHONE 5 MG/5 ML SOLN

Prescription Drug - Generic

$0

—

42858033801

DILAUDID 8 MG TABLET

Prescription Drug - Brand

$7

—

42858040145

APTENSIO XR 10 MG CAPSULE

Prescription Drug - Brand

$8

—

42858040245

APTENSIO XR 15 MG CAPSULE

Prescription Drug - Brand

$8

—

42858040345

APTENSIO XR 20 MG CAPSULE

Prescription Drug - Brand

$8

—

42858040445

APTENSIO XR 30 MG CAPSULE

Prescription Drug - Brand

$8

—

42858040545

APTENSIO XR 40 MG CAPSULE

Prescription Drug - Brand

$8

—

42858040645

APTENSIO XR 50 MG CAPSULE

Prescription Drug - Brand

$8

—

42858040745

APTENSIO XR 60 MG CAPSULE

Prescription Drug - Brand

$8

—

42858051501

MS CONTIN ER 15 MG TABLET

Prescription Drug - Brand

$5

—

42858063101

MS CONTIN ER 30 MG TABLET

Prescription Drug - Brand

$9

—

42860

Excision of tonsil tags

Surgery - Digestive

$180

—

42865030002

ZENPEP DR 5,000 UNITS CAPSULE

Prescription Drug - Brand

$1

—

42865030202

ZENPEP DR 15,000 UNITS CAPSULE

Prescription Drug - Brand

$4

—

42865030302

ZENPEP DR 20,000 UNITS CAPSULE

Prescription Drug - Brand

$5

—

42865030402

ZENPEP DR 3,000 UNITS CAPSULE

Prescription Drug - Brand

$1

—

42865030502

ZENPEP DR 25,000 UNITS CAPSULE

Prescription Drug - Brand

$7

—

42865030602

ZENPEP DR 10,000 UNITS CAPSULE

Prescription Drug - Brand

$3

—

42865030702

ZENPEP DR 40,000 UNITS CAPSULE

Prescription Drug - Brand

$10

—

42870

Excision of lingual tonsil

Surgery - Digestive

$548

—

42890

Limited pharyngectomy

Surgery - Digestive

$1,255

—

42892

Revision of pharyngeal walls

Surgery - Digestive

$1,641

—

42894

Revision of pharyngeal walls

Surgery - Digestive

$2,073

—

42900

Repair throat wound

Surgery - Digestive

$289

—

42950

Reconstruction of throat

Surgery - Digestive

$733

—

42953

Repair throat esophagus

Surgery - Digestive

$894

—

42955

Surgical opening of throat

Surgery - Digestive

$697

—

42960

Control throat bleeding

Surgery - Digestive

$146

—

42961

Control throat bleeding

Surgery - Digestive

$373

—

42962

Control throat bleeding

Surgery - Digestive

$458

—

42970

Control nose/throat bleeding

Surgery - Digestive

$364

—

42971

Control nose/throat bleeding

Surgery - Digestive

$400

—

42972

Control nose/throat bleeding

Surgery - Digestive

$445

—

42975

Dise eval slp do brth flx dx

Surgery - Digestive

$84

—

43020

Incision of esophagus

Surgery - Digestive

$552

—

43030

Cricopharyngeal myotomy

Surgery - Digestive

$467

—

43045

Esophagotomy thrc rmvl fb

Surgery - Digestive

$1,259

—

43068010102

FANAPT 1 MG TABLET

Prescription Drug - Brand

$31

—

43068010202

FANAPT 2 MG TABLET

Prescription Drug - Brand

$31

—

43068010402

FANAPT 4 MG TABLET

Prescription Drug - Brand

$30

—

43068010602

FANAPT 6 MG TABLET

Prescription Drug - Brand

$38

—

43068010802

FANAPT 8 MG TABLET

Prescription Drug - Brand

$37

—

43068011002

FANAPT 10 MG TABLET

Prescription Drug - Brand

$60

—

43068011202

FANAPT 12 MG TABLET

Prescription Drug - Brand

$60

—

43100

Excision of esophagus lesion

Surgery - Digestive

$558

—

43101

Excision of esophagus lesion

Surgery - Digestive

$969

—

My Cost List