Medical Procedure Costs

52260

Cystoscopy and treatment

Surgery - Urinary

$186

—

52265

Cystoscopy and treatment

Surgery - Urinary

$144

—

52268001201

SUPREP BOWEL PREP KIT

Prescription Drug - Brand

$0

—

52268010001

GOLYTELY SOLUTION

Prescription Drug - Brand

$0

—

52268020101

SUTAB 1.479-0.225-0.188 GM TAB

Prescription Drug - Brand

$7

—

52268030201

NULYTELY SOLUTION

Prescription Drug - Brand

$0

—

52268040001

NULYTELY WITH FLAVOR PACKS SOL

Prescription Drug - Brand

$0

—

52268052302

HALFLYTELY-BISACODYL BOWEL KIT

Prescription Drug - Brand

$59

—

52268055101

SUFLAVE POWDER

Prescription Drug - Brand

$62

—

52268070001

GOLYTELY PACKET

Prescription Drug - Brand

$12

—

52270

Cystoscopy & revise urethra

Surgery - Urinary

$162

—

52275

Cystoscopy & revise urethra

Surgery - Urinary

$219

—

52276

Cystoscopy and treatment

Surgery - Urinary

$233

—

52277

Cystoscopy and treatment

Surgery - Urinary

$285

—

52281

Cystoscopy and treatment

Surgery - Urinary

$137

—

52282

Cystoscopy implant stent

Surgery - Urinary

$297

—

52283

Cystoscopy and treatment

Surgery - Urinary

$179

—

52284

Cysto rx balo cath urtl strx

Surgery - Urinary

$146

—

52285

Cystoscopy and treatment

Surgery - Urinary

$173

—

52287

Cystoscopy chemodenervation

Surgery - Urinary

$149

—

52290

Cystoscopy and treatment

Surgery - Urinary

$215

—

52300

Cystoscopy and treatment

Surgery - Urinary

$247

—

52301

Cystoscopy and treatment

Surgery - Urinary

$255

—

52304071204

NOVAFERRUM SOLUTION

Prescription Drug - Generic

$0

—

52305

Cystoscopy and treatment

Surgery - Urinary

$245

—

52310

Cystoscopy and treatment

Surgery - Urinary

$135

—

52315

Cystoscopy and treatment

Surgery - Urinary

$242

—

52317

Remove bladder stone

Surgery - Urinary

$304

—

52318

Remove bladder stone

Surgery - Urinary

$414

—

52320

Cystoscopy and treatment

Surgery - Urinary

$216

—

52325

Cystoscopy stone removal

Surgery - Urinary

$282

—

52327

Cystoscopy inject material

Surgery - Urinary

$225

—

52330

Cystoscopy and treatment

Surgery - Urinary

$231

—

52332

Cystoscopy and treatment

Surgery - Urinary

$140

—

52334

Create passage to kidney

Surgery - Urinary

$163

—

52341

Cysto w/ureter stricture tx

Surgery - Urinary

$251

—

52342

Cysto w/up stricture tx

Surgery - Urinary

$272

—

52343

Cysto w/renal stricture tx

Surgery - Urinary

$303

—

52344

Cysto/uretero stricture tx

Surgery - Urinary

$325

—

52345

Cysto/uretero w/up stricture

Surgery - Urinary

$346

—

52346

Cystouretero w/renal strict

Surgery - Urinary

$391

—

52351

Cystouretero & or pyeloscope

Surgery - Urinary

$267

—

52352

Cystouretero w/stone remove

Surgery - Urinary

$312

—

52353

Cystouretero w/lithotripsy

Surgery - Urinary

$344

—

52354

Cystouretero w/biopsy

Surgery - Urinary

$366

—

52355

Cystouretero w/excise tumor

Surgery - Urinary

$410

—

52356

Cysto/uretero w/lithotripsy

Surgery - Urinary

$365

—

52400

Cysto cgen post urtl valves

Surgery - Urinary

$428

—

52402

Cysto trurl rescj ejacul dux

Surgery - Urinary

$231

—

52427027430

NAPRELAN CR 750 MG TABLET

Prescription Drug - Brand

$22

—

My Cost List