Medical Procedure Costs

54162

Lysis penil circumic lesion

Surgery - Male Genital

$184

—

54163

Repair of circumcision

Surgery - Male Genital

$207

—

54164

Frenulotomy of penis

Surgery - Male Genital

$185

—

54200

Injection px peyronie ds

Surgery - Male Genital

$84

—

54205

Njx px peyronie ds exps plaq

Surgery - Male Genital

$488

—

54220

Irrg crpra cavrnosa priapism

Surgery - Male Genital

$130

—

54230

Njx corpora cavernosograpy

Surgery - Male Genital

$73

—

54231

Dynamic cavernosometry

Surgery - Male Genital

$105

—

54235

Njx corpora cavernosa rx agt

Surgery - Male Genital

$68

—

54240

Penile plethysmography

Surgery - Male Genital

$113

—

54250

Nctrnl pen tmscn&/rgdity tst

Surgery - Male Genital

$124

—

54300

Revision of penis

Surgery - Male Genital

$589

—

54304

Revision of penis

Surgery - Male Genital

$676

—

54308

Reconstruction of urethra

Surgery - Male Genital

$649

—

54312

Reconstruction of urethra

Surgery - Male Genital

$741

—

54316

Reconstruction of urethra

Surgery - Male Genital

$893

—

54318

Reconstruction of urethra

Surgery - Male Genital

$647

—

54322

Reconstruction of urethra

Surgery - Male Genital

$705

—

54324

Reconstruction of urethra

Surgery - Male Genital

$870

—

54326

Reconstruction of urethra

Surgery - Male Genital

$848

—

54328

Revise penis/urethra

Surgery - Male Genital

$843

—

54332

Revise penis/urethra

Surgery - Male Genital

$907

—

54336

Revise penis/urethra

Surgery - Male Genital

$1,064

—

54340

Rpr hypspad comp simple

Surgery - Male Genital

$521

—

54344

Rrp hypspad comp moblj&urtp

Surgery - Male Genital

$849

—

54348

Rpr hypspad comp dsj & urtp

Surgery - Male Genital

$908

—

54352

Revj prior hypspad repair

Surgery - Male Genital

$1,260

—

54360

Penis plastic surgery

Surgery - Male Genital

$653

—

54380

Repair penis

Surgery - Male Genital

$723

—

54385

Repair penis

Surgery - Male Genital

$840

—

54390

Repair penis and bladder

Surgery - Male Genital

$1,110

—

54400

Insert semi-rigid prosthesis

Surgery - Male Genital

$485

—

54401

Insert self-contd prosthesis

Surgery - Male Genital

$618

—

54405

Insert multi-comp penis pros

Surgery - Male Genital

$729

—

54406

Remove muti-comp penis pros

Surgery - Male Genital

$664

—

54408

Repair multi-comp penis pros

Surgery - Male Genital

$718

—

54410

Remove/replace penis prosth

Surgery - Male Genital

$782

—

54411

Remov/replc penis pros comp

Surgery - Male Genital

$929

—

54415

Remove self-contd penis pros

Surgery - Male Genital

$490

—

54416

Remv/repl penis contain pros

Surgery - Male Genital

$655

—

54417

Remv/replc penis pros compl

Surgery - Male Genital

$812

—

54420

Revision of penis

Surgery - Male Genital

$636

—

54430

Revision of penis

Surgery - Male Genital

$582

—

54435

Revision of penis

Surgery - Male Genital

$384

—

54436001504

OTREXUP 15 MG/0.4 ML AUTO-INJ

Prescription Drug - Brand

$484

—

54436001704

OTREXUP 17.5 MG/0.4 ML AUTOINJ

Prescription Drug - Brand

$477

—

54436002004

OTREXUP 20 MG/0.4 ML AUTO-INJ

Prescription Drug - Brand

$481

—

54436002504

OTREXUP 25 MG/0.4 ML AUTO-INJ

Prescription Drug - Brand

$476

—

54436020004

XYOSTED 100 MG/0.5 ML AUTO-INJ

Prescription Drug - Brand

$317

—

54436025004

XYOSTED 50 MG/0.5 ML AUTO-INJ

Prescription Drug - Brand

$317

—

My Cost List