Medical Procedure Costs

44087111701

GONAL-F RFF REDI-JECT 900 UNIT PEN

Prescription Drug - Brand

$1,873

—

44087115001

OVIDREL 250 MCG/0.5 ML SYRG

Prescription Drug - Brand

$487

—

44087122501

CETROTIDE 0.25 MG VIAL

Prescription Drug - Brand

$306

—

44087334401

REBIF REBIDOSE 44 MCG/0.5 ML

Prescription Drug - Brand

$1,849

—

44087903001

GONAL-F 450 UNITS VIAL

Prescription Drug - Brand

$1,392

—

44100

Biopsy of bowel

Surgery - Digestive

$92

—

44110

Excise intestine lesion(s)

Surgery - Digestive

$797

—

44111

Excision of bowel lesion(s)

Surgery - Digestive

$906

—

44120

Removal of small intestine

Surgery - Digestive

$1,136

—

44121

Removal of small intestine

Surgery - Digestive

$216

—

44125

Removal of small intestine

Surgery - Digestive

$1,098

—

44126

Enterectomy w/o taper cong

Surgery - Digestive

$2,285

—

44127

Enterectomy w/taper cong

Surgery - Digestive

$2,628

—

44128

Enterectomy cong add-on

Surgery - Digestive

$218

—

44130

Bowel to bowel fusion

Surgery - Digestive

$1,231

—

44139

Mobilization of colon

Surgery - Digestive

$107

—

44140

Partial removal of colon

Surgery - Digestive

$1,250

—

44141

Partial removal of colon

Surgery - Digestive

$1,691

—

44143

Partial removal of colon

Surgery - Digestive

$1,531

—

44144

Partial removal of colon

Surgery - Digestive

$1,635

—

44145

Partial removal of colon

Surgery - Digestive

$1,515

—

44146

Partial removal of colon

Surgery - Digestive

$1,942

—

44147

Partial removal of colon

Surgery - Digestive

$1,759

—

44150

Removal of colon

Surgery - Digestive

$1,731

—

44151

Removal of colon/ileostomy

Surgery - Digestive

$2,011

—

44155

Removal of colon/ileostomy

Surgery - Digestive

$1,920

—

44156

Removal of colon/ileostomy

Surgery - Digestive

$2,148

—

44157

Colectomy w/ileoanal anast

Surgery - Digestive

$2,042

—

44158

Colectomy w/neo-rectum pouch

Surgery - Digestive

$2,091

—

44160

Removal of colon

Surgery - Digestive

$1,157

—

44180

Lap enterolysis

Surgery - Digestive

$864

—

44183020130

TRIP-PSE LIQUID

Prescription Drug - Generic

$1

—

44183020816

PYRIL D SUSPENSION

Prescription Drug - Generic

$0

—

44183050921

ZEMA-PAK 6 DAY 1.5 MG TABLET

Prescription Drug - Generic

$2

—

44186

Lap jejunostomy

Surgery - Digestive

$625

—

44187

Lap ileo/jejuno-stomy

Surgery - Digestive

$1,025

—

44188

Lap colostomy

Surgery - Digestive

$1,140

—

44202

Lap enterectomy

Surgery - Digestive

$1,289

—

44203

Lap resect s/intestine addl

Surgery - Digestive

$216

—

44204

Laparo partial colectomy

Surgery - Digestive

$1,413

—

44205

Lap colectomy part w/ileum

Surgery - Digestive

$1,226

—

44206

Lap part colectomy w/stoma

Surgery - Digestive

$1,601

—

44207

L colectomy/coloproctostomy

Surgery - Digestive

$1,649

—

44208

L colectomy/coloproctostomy

Surgery - Digestive

$1,802

—

44210

Laparo total proctocolectomy

Surgery - Digestive

$1,628

—

44211

Lap colectomy w/proctectomy

Surgery - Digestive

$1,927

—

44212

Laparo total proctocolectomy

Surgery - Digestive

$1,862

—

44213

Lap mobil splenic fl add-on

Surgery - Digestive

$165

—

44227

Lap close enterostomy

Surgery - Digestive

$1,519

—

44300

Open bowel to skin

Surgery - Digestive

$796

—

My Cost List