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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
3 | INCISIONAL HERNIA REPAIR (LEVEL I I I )1 | 30403-01[996] | 370133 | 3040301 | Y | 11,385.00 | |
3 | INSERTION OF GASTRIC BALLOON (ENDOCOPIC)1 | 90950-00[889] | 370134 | 9095000 | Y | 10,000.00 | |
0 | Insulin S.Test | 370135 | 86337 | 2,000.00 | |||
3 | INTESTINAL VOLVULOUS | 370136 | 4391201 | Y | 12,000.00 | ||
0 | Intravenous Immunoglobulin or Monoclonal Antibodies | 370137 | 79403 | 800 | |||
3 | LAPAROSCOPIC APPENDECTOMY (OMPLICATED) | 30572-00[926] | 370138 | 3057200 | Y | 12,000.00 | |
3 | LAPAROSCOPIC GASTRIC BANDING1 | 30511-01[889] | 370139 | 3051101 | Y | 27,720.00 | |
3 | LAPAROSCOPIC HERNIOTOMY | 370140 | Y | 12,000.00 | |||
3 | LAPAROSCOPIC LYSIS OF ADHESIONS OF OVARY and FALLOPIAN TUBE1 | 35694-02[1249] | 370141 | 3569402 | Y | 12,000.00 | |
3 | LAPAROSCOPIC LYSIS OF PERITONEAL ADHESIONS1 | 30393-00[986] | 370142 | 3039300 | Y | 12,000.00 | |
3 | LAPAROSCOPIC REPAIR OF DIAPHRAGMATIC HERNIA | 30601-00[998] | 370143 | 3060100 | Y | 15,048.00 | |
(OR |
INCISIONAL HERNIA REPAIR (LEVEL I I I )1
11,385.00
INSERTION OF GASTRIC BALLOON (ENDOCOPIC)1
10,000.00
Insulin S.Test
2,000.00
INTESTINAL VOLVULOUS
12,000.00
Intravenous Immunoglobulin or Monoclonal Antibodies
800
LAPAROSCOPIC APPENDECTOMY (OMPLICATED)
12,000.00
LAPAROSCOPIC GASTRIC BANDING1
27,720.00
LAPAROSCOPIC HERNIOTOMY
12,000.00
LAPAROSCOPIC LYSIS OF ADHESIONS OF OVARY and FALLOPIAN TUBE1
12,000.00
LAPAROSCOPIC LYSIS OF PERITONEAL ADHESIONS1
12,000.00
LAPAROSCOPIC REPAIR OF DIAPHRAGMATIC HERNIA
15,048.00
(OR
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