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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | HYSTERECTOMY - ABDOMINAL TOTAL HYSTERECTOMY | 35653-01[1268] | 400103 | 3565301 | Y | 15,000.00 | |
3 | HYSTERECTOMY - VAGINAL HYSTERECTOMY + REPAIR | 35657-00[1269] | 400104 | 3565700 | Y | 14,000.00 | |
3 | HYSTERECTOMY - VAGINAL RADICAL | 35667-01[1269] | 400105 | 3566701 | Y | 18,000.00 | |
3 | HYSTEROSCOPY (DIAGNOSTIC)1 | 35630-00[1259] | 400106 | 3563000 | Y | 3,465.00 | |
3 | HYSTEROSCOPY W/ BIOPSY1 | 35630-00[1259] | 400107 | 3563000 | Y | 3,960.00 | |
0 | I & D BY COLPOTOMY - G A | 35572-00 | 400108 | 2,000.00 | |||
0 | I & D OF PYOMETRA | 400109 | 3552000 | 2,000.00 | |||
3 | IMPLANTATIONELECTRONIC UTERAL STIMULATOR | 90355-00[1069] | 400110 | 9035500 | Y | 15,000.00 | |
0 | INCIS OF IMPERFORATE HYMEN | 35509-001 | 400111 | 2,400.00 | |||
0 | INSERTION OF IUCD (EXC DEV )GA | 90355-00[1096] | 400112 | 9035500 | 1,900.00 | ||
2 | ANTERIOR COLPOPERINEORRHAPHY (COMPLICATED) | 35570-00[1283] | 400009 | 3557000 | Y | 7,500.00 | |
1 | BILATERAL LIGATION and DIVISION OF FALLPIAN | 8-00[1257]35688-00[ | 400010 | 3568800 | Y | 4,950.00 |
HYSTERECTOMY - ABDOMINAL TOTAL HYSTERECTOMY
15,000.00
HYSTERECTOMY - VAGINAL HYSTERECTOMY + REPAIR
14,000.00
HYSTERECTOMY - VAGINAL RADICAL
18,000.00
HYSTEROSCOPY (DIAGNOSTIC)1
3,465.00
HYSTEROSCOPY W/ BIOPSY1
3,960.00
I & D BY COLPOTOMY - G A
2,000.00
I & D OF PYOMETRA
2,000.00
IMPLANTATIONELECTRONIC UTERAL STIMULATOR
15,000.00
INCIS OF IMPERFORATE HYMEN
2,400.00
INSERTION OF IUCD (EXC DEV )GA
1,900.00
ANTERIOR COLPOPERINEORRHAPHY (COMPLICATED)
7,500.00
BILATERAL LIGATION and DIVISION OF FALLPIAN
4,950.00
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