Medical Procedure Costs

54436027504

XYOSTED 75 MG/0.5 ML AUTO-INJ

Prescription Drug - Brand

$317

—

54436032530

NOCDURNA 27.7 MCG TABLET SL

Prescription Drug - Brand

$16

—

54436035030

NOCDURNA 55.3 MCG TABLET SL

Prescription Drug - Brand

$16

—

54437

Repair corporeal tear

Surgery - Male Genital

$620

—

54450

Preputial stretching

Surgery - Male Genital

$50

—

54482014407

CARNITOR 330 MG TABLET

Prescription Drug - Brand

$1

—

54482014508

CARNITOR 100 MG/ML ORAL SOLN

Prescription Drug - Brand

$0

—

54482014509

CARNITOR 1 GM/10 ML ORAL SOLN

Prescription Drug - Brand

$0

—

54482014801

CARNITOR SF 100 MG/ML ORAL SOL

Prescription Drug - Brand

$0

—

54482014802

CARNITOR SF 1 GM/10 ML SOLN

Prescription Drug - Brand

$1

—

54500

Biopsy of testis

Surgery - Male Genital

$67

—

54505

Biopsy of testis

Surgery - Male Genital

$193

—

54512

Excise lesion testis

Surgery - Male Genital

$490

—

54520

Removal of testis

Surgery - Male Genital

$306

—

54522

Orchiectomy partial

Surgery - Male Genital

$535

—

54530

Removal of testis

Surgery - Male Genital

$469

—

54535

Extensive testis surgery

Surgery - Male Genital

$674

—

54550

Exploration for testis

Surgery - Male Genital

$452

—

54560

Exploration for testis

Surgery - Male Genital

$623

—

54600

Reduce testis torsion

Surgery - Male Genital

$417

—

54620

Suspension of testis

Surgery - Male Genital

$273

—

54640

Orchiopexy ingun/scrot appr

Surgery - Male Genital

$394

—

54643900701

INFUVITE ADULT VIAL

Prescription Drug - Brand

$1

—

54650

Orchiopexy (fowler-stephens)

Surgery - Male Genital

$648

—

54660

Revision of testis

Surgery - Male Genital

$334

—

54670

Repair testis injury

Surgery - Male Genital

$379

—

54680

Relocation of testis(es)

Surgery - Male Genital

$712

—

54690

Laparoscopy orchiectomy

Surgery - Male Genital

$593

—

54692

Laparoscopy orchiopexy

Surgery - Male Genital

$681

—

54700

I&d epdidyms tstis&/scrot sp

Surgery - Male Genital

$200

—

54766009306

RIDAURA 3 MG CAPSULE

Prescription Drug - Brand

$25

—

54766020010

MOTOFEN 1-0.025 MG TABLET

Prescription Drug - Brand

$7

—

54766059010

IMURAN 50 MG TABLET

Prescription Drug - Brand

$9

—

54766077060

NAFTIN 1% GEL

Prescription Drug - Brand

$7

—

54766077260

NAFTIN 2% GEL

Prescription Drug - Brand

$11

—

54766090753

BRISDELLE 7.5 MG CAPSULE

Prescription Drug - Brand

$7

—

54800

Biopsy of epididymis

Surgery - Male Genital

$111

—

54830

Remove epididymis lesion

Surgery - Male Genital

$348

—

54838000870

MULTI-DELYN LIQUID

Prescription Drug - Generic

$0

—

54838001070

CENTAMIN LIQUID

Prescription Drug - Generic

$0

—

54838010440

CHILDREN'S SILFEDRINE LIQ

Prescription Drug - Generic

$0

—

54838010780

SILACE 60 MG/15 ML SYRUP

Prescription Drug - Generic

$0

—

54838011540

PEDIATRIC COUGH-COLD LIQUID

Prescription Drug - Generic

$0

—

54838011680

SILACE 50 MG/5 ML LIQUID

Prescription Drug - Generic

$0

—

54838011740

SILTUSSIN SA 100 MG/5 ML SYR

Prescription Drug - Generic

$0

—

54838012540

BROTAPP LIQUID

Prescription Drug - Generic

$0

—

54838013340

SILTUSSIN DM DAS LIQUID

Prescription Drug - Generic

$0

—

54838013580

SILADRYL 12.5 MG/5 ML LIQUID

Prescription Drug - Generic

$0

—

54838013670

BROTAPP DM LIQUID

Prescription Drug - Generic

$0

—

54838013840

DIABETIC SILTUSSIN DAS-NA LIQ

Prescription Drug - Generic

$0

—

My Cost List