Medical Procedure Costs

57844015101

ORAP 1 MG TABLET

Prescription Drug - Brand

$2

—

57844018701

ORAP 2 MG TABLET

Prescription Drug - Brand

$2

—

57894003001

REMICADE 100 MG VIAL

Prescription Drug - Brand

$1,136

—

57894006003

STELARA 45 MG/0.5 ML SYRINGE

Prescription Drug - Brand

$29,842

—

57894006103

STELARA 90 MG/ML SYRINGE

Prescription Drug - Brand

$29,795

—

57894007001

SIMPONI 50 MG/0.5 ML SYRINGE

Prescription Drug - Brand

$12,977

—

57894007002

SIMPONI 50 MG/0.5 ML PEN INJEC

Prescription Drug - Brand

$12,975

—

57894007102

SIMPONI 100 MG/ML PEN INJECTOR

Prescription Drug - Brand

$7,446

—

57894015012

ZYTIGA 250 MG TABLET

Prescription Drug - Brand

$88

—

57894064001

TREMFYA 100 MG/ML SYRINGE

Prescription Drug - Brand

$14,770

—

57894064011

TREMFYA 100 MG/ML ONE-PRESS

Prescription Drug - Brand

$14,766

—

57894065102

TREMFYA 200 MG/2 ML PEN

Prescription Drug - Brand

$7,350

—

58100

Biopsy of uterus lining

Surgery - Female Genital

$55

—

58110

Bx done w/colposcopy add-on

Surgery - Female Genital

$35

—

58120

Dilation and curettage

Surgery - Female Genital

$210

—

58140

Myomectomy abdom method

Surgery - Female Genital

$813

—

58145

Myomectomy vag method

Surgery - Female Genital

$499

—

58146

Myomectomy abdom complex

Surgery - Female Genital

$1,015

—

58150

Total hysterectomy

Surgery - Female Genital

$933

—

58151007893

CARDURA XL 4 MG TABLET

Prescription Drug - Brand

$7

—

58151008388

CELEBREX 100 MG CAPSULE

Prescription Drug - Brand

$10

—

58151008488

CELEBREX 200 MG CAPSULE

Prescription Drug - Brand

$16

—

58151010493

DETROL LA 4 MG CAPSULE

Prescription Drug - Brand

$13

—

58151011010

DILANTIN 100 MG CAPSULE

Prescription Drug - Generic

$0

—

58151011801

DILANTIN 30 MG CAPSULE

Prescription Drug - Brand

$1

—

58151012593

EFFEXOR XR 37.5 MG CAPSULE

Prescription Drug - Brand

$18

—

58151012693

EFFEXOR XR 75 MG CAPSULE

Prescription Drug - Brand

$20

—

58151012793

EFFEXOR XR 150 MG CAPSULE

Prescription Drug - Brand

$22

—

58151014293

INSPRA 25 MG TABLET

Prescription Drug - Brand

$14

—

58151015577

LIPITOR 10 MG TABLET

Prescription Drug - Brand

$13

—

58151015677

LIPITOR 20 MG TABLET

Prescription Drug - Brand

$19

—

58151015777

LIPITOR 40 MG TABLET

Prescription Drug - Brand

$19

—

58151015877

LIPITOR 80 MG TABLET

Prescription Drug - Brand

$19

—

58151023677

LYRICA 25 MG CAPSULE

Prescription Drug - Brand

$10

—

58151023788

LYRICA 50 MG CAPSULE

Prescription Drug - Brand

$10

—

58151023888

LYRICA 75 MG CAPSULE

Prescription Drug - Brand

$10

—

58151023988

LYRICA 100 MG CAPSULE

Prescription Drug - Brand

$10

—

58151024088

LYRICA 150 MG CAPSULE

Prescription Drug - Brand

$10

—

58151024177

LYRICA 200 MG CAPSULE

Prescription Drug - Brand

$10

—

58151024277

LYRICA 300 MG CAPSULE

Prescription Drug - Brand

$10

—

58151024377

LYRICA 225 MG CAPSULE

Prescription Drug - Brand

$10

—

58151028101

NEURONTIN 100 MG CAPSULE

Prescription Drug - Brand

$3

—

58151028301

NEURONTIN 400 MG CAPSULE

Prescription Drug - Brand

$9

—

58151028401

NEURONTIN 600 MG TABLET

Prescription Drug - Brand

$14

—

58151028501

NEURONTIN 800 MG TABLET

Prescription Drug - Brand

$17

—

58151031094

NITROSTAT 0.4 MG TABLET SL

Prescription Drug - Brand

$2

—

58151035377

NORVASC 2.5 MG TABLET

Prescription Drug - Brand

$9

—

58151035488

NORVASC 5 MG TABLET

Prescription Drug - Brand

$9

—

58151035588

NORVASC 10 MG TABLET

Prescription Drug - Brand

$12

—

58151036756

RELPAX 20 MG TABLET

Prescription Drug - Brand

$78

—

My Cost List