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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | CT OF OTHER ORGANS | 60100-00[1951] | 240189 | 76380 | 1,000.00 | ||
0 | CT OF OTHER ORGANS W/ CONTRAST | 240190 | 76380 | 1,300.00 | |||
0 | CT-CORONAL STUDY - LIMITED PNS | 240191 | 76380 | 700 | |||
0 | CYSTOGRAM | 61397-00[2014] | 240192 | 78740 | 410 | ||
0 | DIALYSIS LINE INSERTION | 240193 | 36810 | 4,160.00 | |||
0 | DIRECT CT PORTOGRAM WITH & W/OUT CONTRAST | 240194 | 78220 | 2,000.00 | |||
0 | DISKOGRAM | 240195 | 62290 | 1,200.00 | |||
0 | DOPLR STUDY-PEN ART W/I.C. INJ | 240196 | 560 | ||||
0 | DOPPLER FLOW TRACING ONLY | 240197 | 93892 | 240 | |||
0 | DOPPLER ULTRASOUND OF TESTIS | 240198 | 76870 | 480 | |||
0 | DOTA THERAPY | 240199 | 2,400.00 | ||||
0 | E.V.L.T LASER ABLATION FOR LOWER LIMB VARICOSE | 240200 | 36479 | 12,000.00 |
CT OF OTHER ORGANS
1,000.00
CT OF OTHER ORGANS W/ CONTRAST
1,300.00
CT-CORONAL STUDY - LIMITED PNS
700
CYSTOGRAM
410
DIALYSIS LINE INSERTION
4,160.00
DIRECT CT PORTOGRAM WITH & W/OUT CONTRAST
2,000.00
DISKOGRAM
1,200.00
DOPLR STUDY-PEN ART W/I.C. INJ
560
DOPPLER FLOW TRACING ONLY
240
DOPPLER ULTRASOUND OF TESTIS
480
DOTA THERAPY
2,400.00
E.V.L.T LASER ABLATION FOR LOWER LIMB VARICOSE
12,000.00
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