Medical Procedure Costs

51797

Intraabdominal pressure test

Surgery - Urinary

$155

—

51798

Us urine capacity measure

Surgery - Urinary

$13

—

51800

Revision of bladder/urethra

Surgery - Urinary

$931

—

51801000730

EFFER-K 25 MEQ TABLET EFF

Prescription Drug - Generic

$0

—

51801001230

EFFER-K 20 MEQ TABLET EFF

Prescription Drug - Generic

$1

—

51801001430

EFFER-K 10 MEQ TABLET EFF

Prescription Drug - Generic

$0

—

51820

Revision of urinary tract

Surgery - Urinary

$975

—

51840

Attach bladder/urethra

Surgery - Urinary

$622

—

51841

Attach bladder/urethra

Surgery - Urinary

$718

—

51845

Repair bladder neck

Surgery - Urinary

$530

—

51860

Repair of bladder wound

Surgery - Urinary

$682

—

51862002806

LUTERA-28 TABLET

Prescription Drug - Generic

$0

—

51862003603

ZARAH TABLET

Prescription Drug - Generic

$0

—

51862004591

AMETHIA LO TABLET

Prescription Drug - Generic

$0

—

51862004701

AMETHIA 0.15-0.03-0.01 MG TAB

Prescription Drug - Generic

$0

—

51862009706

LEVORA-28 TABLET

Prescription Drug - Generic

$0

—

51862016250

MULTIVIT & FLUOR 0.5 MG/ML DRP

Prescription Drug - Generic

$0

—

51862016350

MULTIVIT-IRON-FL 0.25 MG/ML

Prescription Drug - Generic

$0

—

51862016450

VITAMINS A,C,D & FLUORIDE DROP

Prescription Drug - Generic

$0

—

51862017901

BUTALBIT-ACETAMINOPHEN-CAFF CP

Prescription Drug - Generic

$2

—

51862018015

PRAMOXINE HCL 1% FOAM

Prescription Drug - Generic

$3

—

51862023801

CAZIANT 28 DAY TABLET

Prescription Drug - Generic

$1

—

51862025801

NEXTSTELLIS 3-14.2 MG TABLET

Prescription Drug - Brand

$7

—

51862026006

ZOVIA 1-35E TABLET

Prescription Drug - Generic

$0

—

51862029510

FABIOR 0.1% FOAM

Prescription Drug - Brand

$12

—

51862037660

SORILUX 0.005% FOAM

Prescription Drug - Brand

$13

—

51862047106

LEENA 28 TABLET

Prescription Drug - Generic

$1

—

51862051006

TRIVORA-28 TABLET

Prescription Drug - Generic

$0

—

51862051401

DESOGESTREL-EE 0.15-0.03 MG TB

Prescription Drug - Generic

$0

—

51862053504

BROMPHENIR-PSEUDOEPHED-DM SYR

Prescription Drug - Generic

$0

—

51862054005

BUTALB-ACETAMINOPHEN-CAFF 50-325-40 TAB

Prescription Drug - Generic

$0

—

51862054506

SRONYX 0.10-0.02 MG TABLET

Prescription Drug - Generic

$0

—

51862055930

DORYX MPC DR 120 MG TABLET

Prescription Drug - Brand

$12

—

51862056060

DORYX MPC DR 60 MG TABLET

Prescription Drug - Brand

$18

—

51862056406

LOW-OGESTREL-28 TABLET

Prescription Drug - Generic

$0

—

51862058701

LORCET HD 10-325 MG TABLET

Prescription Drug - Brand

$0

—

51862064506

NYMYO 0.25-0.035 MG (28) TAB

Prescription Drug - Generic

$0

—

51862064601

TRI-NYMYO 28 TABLET

Prescription Drug - Generic

$0

—

51862064803

MICROGESTIN 24 FE 1 MG-20 MCG

Prescription Drug - Generic

$0

—

51862068201

SOLTAMOX 20 MG/10 ML SOLN

Prescription Drug - Brand

$4

—

51862076530

RHOFADE 1% CREAM

Prescription Drug - Brand

$23

—

51865

Repair of bladder wound

Surgery - Urinary

$810

—

51880

Repair of bladder opening

Surgery - Urinary

$430

—

51900

Repair bladder/vagina lesion

Surgery - Urinary

$745

—

51920

Close bladder-uterus fistula

Surgery - Urinary

$693

—

51925

Hysterectomy/bladder repair

Surgery - Urinary

$946

—

51940

Correction of bladder defect

Surgery - Urinary

$1,457

—

51960

Revision of bladder & bowel

Surgery - Urinary

$1,237

—

51980

Construct bladder opening

Surgery - Urinary

$647

—

51990

Laparo urethral suspension

Surgery - Urinary

$671

—

My Cost List