Medical Procedure Costs

63032010150

OLUX-E 0.05% FOAM

Prescription Drug - Brand

$9

—

63035

Lamot dcmprn nrv rt ea addl

Surgery - Nervous

$206

—

63040

Laminotomy single cervical

Surgery - Nervous

$1,288

—

63042

Laminotomy single lumbar

Surgery - Nervous

$1,220

—

63044019801

IFEREX 150 FORTE CAPSULE

Prescription Drug - Generic

$0

—

63044020361

IFEREX 150 CAPSULE

Prescription Drug - Generic

$0

—

63044062201

RENO CAPS SOFTGEL

Prescription Drug - Generic

$0

—

63044063321

HEMATOGEN FORTE SOFTGEL

Prescription Drug - Generic

$0

—

63044063510

TRICON CAPSULE

Prescription Drug - Generic

$0

—

63044401101

VITAMIN D3 10,000 UNIT SOFTGEL

Prescription Drug - Generic

$1

—

63045

Lam facetec & foramot crv

Surgery - Nervous

$1,250

—

63046

Lam facetec & foramot thrc

Surgery - Nervous

$1,184

—

63047

Lam facetec & foramot lumbar

Surgery - Nervous

$1,065

—

63048

Lam facetec &foramot ea addl

Surgery - Nervous

$187

—

63050

Cervical laminoplsty 2/> seg

Surgery - Nervous

$1,401

—

63051

C-laminoplasty w/graft/plate

Surgery - Nervous

$1,575

—

63052

Lam facetc/frmt arthrd lum 1

Surgery - Nervous

$230

—

63053

Lam factc/frmt arthrd lum ea

Surgery - Nervous

$205

—

63055

Decompress spinal cord thrc

Surgery - Nervous

$1,553

—

63056

Decompress spinal cord lmbr

Surgery - Nervous

$1,405

—

63057

Decompress spine cord add-on

Surgery - Nervous

$288

—

63064

Decompress spinal cord thrc

Surgery - Nervous

$1,686

—

63066

Decompress spine cord add-on

Surgery - Nervous

$188

—

63075

Neck spine disk surgery

Surgery - Nervous

$1,288

—

63076

Neck spine disk surgery

Surgery - Nervous

$217

—

63077

Spine disk surgery thorax

Surgery - Nervous

$1,312

—

63078

Spine disk surgery thorax

Surgery - Nervous

$189

—

63081

Remove vert body dcmprn crvl

Surgery - Nervous

$1,660

—

63082

Remove vertebral body add-on

Surgery - Nervous

$237

—

63085

Remove vert body dcmprn thrc

Surgery - Nervous

$1,820

—

63086

Remove vertebral body add-on

Surgery - Nervous

$171

—

63087

Remov vertbr dcmprn thrclmbr

Surgery - Nervous

$2,264

—

63088

Remove vertebral body add-on

Surgery - Nervous

$234

—

63090

Remove vert body dcmprn lmbr

Surgery - Nervous

$1,822

—

63091

Remove vertebral body add-on

Surgery - Nervous

$158

—

63101

Remove vert body dcmprn thrc

Surgery - Nervous

$2,217

—

63102

Remove vert body dcmprn lmbr

Surgery - Nervous

$2,174

—

63103

Remove vertebral body add-on

Surgery - Nervous

$263

—

63162051012

NORTEMP 160 MG/5 ML SUSP

Prescription Drug - Generic

$0

—

63162051830

NORTEMP 80 MG/0.8 ML DROP

Prescription Drug - Generic

$0

—

63170

Incise spinal cord tract(s)

Surgery - Nervous

$1,576

—

63172

Drainage of spinal cyst

Surgery - Nervous

$1,399

—

63173

Drainage of spinal cyst

Surgery - Nervous

$1,697

—

63185

Incise spine nrv half segmnt

Surgery - Nervous

$1,237

—

63190

Incise spine nrv >2 segmnts

Surgery - Nervous

$1,125

—

63191

Incise spine accessory nerve

Surgery - Nervous

$1,377

—

63197

Lam w/cordotomy 1stg thrc

Surgery - Nervous

$1,684

—

63200

Release spinal cord lumbar

Surgery - Nervous

$1,535

—

63250

Revise spinal cord vsls crvl

Surgery - Nervous

$2,834

—

63251

Revise spinal cord vsls thrc

Surgery - Nervous

$2,905

—

My Cost List