Medical Procedure Costs

23630

Optx gr hmrl tbrs fx int fix

Surgery - Musculoskeletal

$734

—

23635011501

XARTEMIS XR 7.5-325 MG TABLET

Prescription Drug - Brand

$2

—

23635031015

PENNSAID 1.5% SOLUTION

Prescription Drug - Brand

$2

—

23635040801

EXALGO ER 8 MG TABLET

Prescription Drug - Brand

$12

—

23635041201

EXALGO ER 12 MG TABLET

Prescription Drug - Brand

$19

—

23635041601

EXALGO ER 16 MG TABLET

Prescription Drug - Brand

$25

—

23635043201

EXALGO ER 32 MG TABLET

Prescription Drug - Brand

$50

—

23635050860

AMITIZA 8 MCG CAPSULE

Prescription Drug - Brand

$6

—

23635052460

AMITIZA 24 MCG CAPSULE

Prescription Drug - Brand

$6

—

23635058110

ROXICODONE 15 MG TABLET

Prescription Drug - Brand

$5

—

23635058210

ROXICODONE 30 MG TABLET

Prescription Drug - Brand

$11

—

23650

Cltx sho dslc w/mnpj wo anes

Surgery - Musculoskeletal

$368

—

23655

Cltx sho dslc w/mnpj w/anes

Surgery - Musculoskeletal

$419

—

23660

Optx acute shoulder dislc

Surgery - Musculoskeletal

$551

—

23665

Cltx sho dslc fx gr hmrl tbr

Surgery - Musculoskeletal

$417

—

23670

Optx sho dislc fx

Surgery - Musculoskeletal

$818

—

23675

Cltx sho dislc neck fx mnpj

Surgery - Musculoskeletal

$511

—

23680

Optx sho dislc neck fx fixj

Surgery - Musculoskeletal

$865

—

23700

Mnpj anes sho jt fixj aprats

Surgery - Musculoskeletal

$185

—

23800

Arthrodesis glenohumeral jt

Surgery - Musculoskeletal

$947

—

23802

Arthrd glenohumeral jt w/grf

Surgery - Musculoskeletal

$1,182

—

23900

Interthoracoscplr amputation

Surgery - Musculoskeletal

$1,257

—

23920

Disarticulation shoulder

Surgery - Musculoskeletal

$1,034

—

23921

Disarticulation sho sec clsr

Surgery - Musculoskeletal

$459

—

23930

I&d upr a/e dp absc/hmtma

Surgery - Musculoskeletal

$205

—

23931

I&d upr a/e bursa

Surgery - Musculoskeletal

$159

—

23935

Inc dp opn b1 crtx hum/elbw

Surgery - Musculoskeletal

$495

—

24000

Arthrt elbw expl drg/rmvl fb

Surgery - Musculoskeletal

$461

—

24006

Arthrt elbw capsl exc rls

Surgery - Musculoskeletal

$664

—

24065

Biopsy arm/elbow soft tissue

Surgery - Musculoskeletal

$149

—

24066

Biopsy arm/elbow soft tissue

Surgery - Musculoskeletal

$416

—

24071

Exc arm/elbow les sc 3 cm/>

Surgery - Musculoskeletal

$392

—

24073

Ex arm/elbow tum deep 5 cm/>

Surgery - Musculoskeletal

$653

—

24075

Exc arm/elbow les sc < 3 cm

Surgery - Musculoskeletal

$321

—

24076

Ex arm/elbow tum deep < 5 cm

Surgery - Musculoskeletal

$521

—

24077

Rad rescj tum tiss a/e <5cm

Surgery - Musculoskeletal

$958

—

24079

Rad rescj tum tiss a/e 5 cm+

Surgery - Musculoskeletal

$1,226

—

24090041004

NITROMIST 400 MCG SPRAY

Prescription Drug - Brand

$99

—

24090047188

INDERAL LA 80 MG CAPSULE

Prescription Drug - Brand

$20

—

24090047388

INDERAL LA 120 MG CAPSULE

Prescription Drug - Brand

$24

—

24100

Arthrt elbw synovial bx only

Surgery - Musculoskeletal

$411

—

24101

Arthrt elbw jt expl bx rmvl

Surgery - Musculoskeletal

$483

—

24102

Arthrt elbow w/synovectomy

Surgery - Musculoskeletal

$579

—

24105

Excision olecranon bursa

Surgery - Musculoskeletal

$358

—

24110

Exc/curtg b1 cst/b9 tum hum

Surgery - Musculoskeletal

$566

—

24115

Exc/crtg b1 cst/tum hum agrf

Surgery - Musculoskeletal

$693

—

24116

Exc/crtg b1 cst/tum hum algr

Surgery - Musculoskeletal

$798

—

24120

Exc/crtg b1 cst/b9 tum rds

Surgery - Musculoskeletal

$507

—

24125

Exc/crtg b1 cst/tum rds agrf

Surgery - Musculoskeletal

$595

—

24126

Exc/crtg b1 cst/tum rds algr

Surgery - Musculoskeletal

$618

—

My Cost List