Medical Procedure Costs

54015

I&d penis deep

Surgery - Male Genital

$277

—

54050

Destruction penis lesion(s)

Surgery - Male Genital

$97

—

54055

Destruction penis lesion(s)

Surgery - Male Genital

$87

—

54056

Cryosurgery penis lesion(s)

Surgery - Male Genital

$99

—

54057

Laser surg penis lesion(s)

Surgery - Male Genital

$91

—

54060

Excision of penis lesion(s)

Surgery - Male Genital

$123

—

54065

Destruction penis lesion(s)

Surgery - Male Genital

$151

—

54092017112

CARBATROL ER 100 MG CAPSULE

Prescription Drug - Brand

$2

—

54092017212

CARBATROL ER 200 MG CAPSULE

Prescription Drug - Brand

$2

—

54092017312

CARBATROL ER 300 MG CAPSULE

Prescription Drug - Brand

$2

—

54092018981

PENTASA 250 MG CAPSULE

Prescription Drug - Brand

$3

—

54092019112

PENTASA 500 MG CAPSULE

Prescription Drug - Brand

$6

—

54092025245

FOSRENOL 500 MG TABLET CHEW

Prescription Drug - Brand

$12

—

54092025490

FOSRENOL 1,000 MG TABLET CHEW

Prescription Drug - Brand

$12

—

54092038101

ADDERALL XR 5 MG CAPSULE

Prescription Drug - Brand

$7

—

54092038301

ADDERALL XR 10 MG CAPSULE

Prescription Drug - Brand

$7

—

54092038501

ADDERALL XR 15 MG CAPSULE

Prescription Drug - Brand

$7

—

54092038701

ADDERALL XR 20 MG CAPSULE

Prescription Drug - Brand

$7

—

54092038901

ADDERALL XR 25 MG CAPSULE

Prescription Drug - Brand

$7

—

54092039101

ADDERALL XR 30 MG CAPSULE

Prescription Drug - Brand

$7

—

54092046801

MYDAYIS ER 12.5 MG CAPSULE

Prescription Drug - Brand

$11

—

54092047101

MYDAYIS ER 25 MG CAPSULE

Prescription Drug - Brand

$11

—

54092047401

MYDAYIS ER 37.5 MG CAPSULE

Prescription Drug - Brand

$11

—

54092047612

LIALDA DR 1.2 GM TABLET

Prescription Drug - Brand

$9

—

54092047701

MYDAYIS ER 50 MG CAPSULE

Prescription Drug - Brand

$11

—

54092051302

INTUNIV ER 1 MG TABLET

Prescription Drug - Brand

$9

—

54092051502

INTUNIV ER 2 MG TABLET

Prescription Drug - Brand

$9

—

54092051702

INTUNIV ER 3 MG TABLET

Prescription Drug - Brand

$9

—

54092051902

INTUNIV ER 4 MG TABLET

Prescription Drug - Brand

$9

—

54092054601

MOTEGRITY 1 MG TABLET

Prescription Drug - Brand

$18

—

54092054701

MOTEGRITY 2 MG TABLET

Prescription Drug - Brand

$18

—

54100

Biopsy of penis

Surgery - Male Genital

$104

—

54105

Biopsy of penis

Surgery - Male Genital

$195

—

54110

Treatment of penis lesion

Surgery - Male Genital

$568

—

54111

Treat penis lesion graft

Surgery - Male Genital

$720

—

54112

Treat penis lesion graft

Surgery - Male Genital

$843

—

54115

Treatment of penis lesion

Surgery - Male Genital

$396

—

54120

Partial removal of penis

Surgery - Male Genital

$577

—

54123011430

ZUBSOLV 11.4-2.9 MG TABLET SL

Prescription Drug - Brand

$21

—

54123090730

ZUBSOLV 0.7-0.18 MG TABLET SL

Prescription Drug - Brand

$5

—

54123091430

ZUBSOLV 1.4-0.36 MG TABLET SL

Prescription Drug - Brand

$5

—

54123092930

ZUBSOLV 2.9-0.71 MG TABLET SL

Prescription Drug - Brand

$11

—

54123095730

ZUBSOLV 5.7-1.4 MG TABLET SL

Prescription Drug - Brand

$11

—

54123098630

ZUBSOLV 8.6-2.1 MG TABLET SL

Prescription Drug - Brand

$16

—

54125

Removal of penis

Surgery - Male Genital

$747

—

54130

Remove penis & nodes

Surgery - Male Genital

$1,068

—

54135

Remove penis & nodes

Surgery - Male Genital

$1,344

—

54150

Circumcision w/regionl block

Surgery - Male Genital

$84

—

54160

Circumcision neonate

Surgery - Male Genital

$132

—

54161

Circum 28 days or older

Surgery - Male Genital

$181

—

My Cost List