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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | PLAIN X-RAY OF OTHER PARTS(1V) | 240370 | 110 | ||||
0 | PLAIN X-RAY OF OTHER PARTS(2V) | 240371 | 220 | ||||
0 | POST THERAPY DOTA Y-90 SCAN | 240372 | 800 | ||||
0 | POST THERAPY Y-90 THERASPHER SCAN | 240373 | 800 | ||||
0 | PROCEDURE REPORT AMD IMAGES PER EXAM ON CD | 240374 | 24 | ||||
0 | PULMONARY ANGIO - BILATERAL | 240375 | 75743 | 2,300.00 | |||
0 | PULMONARY ANGIO - UNILATERAL | 240376 | 75741 | 1,500.00 | |||
0 | Systemic Shunt | 240377 | 37183 | 20,000.00 | |||
0 | RADIONUCLIDE RX 10MCI I131 | 240378 | 1,280.00 | ||||
0 | RADIONUCLIDE RX 15MCI I131 | 240379 | 1,440.00 | ||||
0 | RADIONUCLIDE RX 5MCI I131 | 240380 | 880 | ||||
0 | RADIONUCLIDE RX 8MCI I131 | 240381 | 1,040.00 |
PLAIN X-RAY OF OTHER PARTS(1V)
110
PLAIN X-RAY OF OTHER PARTS(2V)
220
POST THERAPY DOTA Y-90 SCAN
800
POST THERAPY Y-90 THERASPHER SCAN
800
PROCEDURE REPORT AMD IMAGES PER EXAM ON CD
24
PULMONARY ANGIO - BILATERAL
2,300.00
PULMONARY ANGIO - UNILATERAL
1,500.00
Systemic Shunt
20,000.00
RADIONUCLIDE RX 10MCI I131
1,280.00
RADIONUCLIDE RX 15MCI I131
1,440.00
RADIONUCLIDE RX 5MCI I131
880
RADIONUCLIDE RX 8MCI I131
1,040.00
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