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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | COMBINED CT-SCAN FOR THREE (3) AREAS W/O | 240124 | 70450 | 3,440.00 | |||
CONTRAST | |||||||
0 | ANGIOGRAM - VERTEBRAL ARTERY (UNILATERAL) | 240025 | 2,800.00 | ||||
0 | ANKLE - ADDITIONAL VIEW | 240026 | 73600 | 90 | |||
0 | ANKLE (COMPLETE) - 3V | 240027 | 73610 | 230 | |||
0 | ANKLE (LIMITED) | 240028 | 73600 | 190 | |||
0 | ANTEGRADE DJ STENTING BILATERAL | 240029 | 74425 | 10,000.00 | |||
0 | ANTEGRADE DJ STENTING UNILATERAL | 240030 | 74425 | 8,000.00 | |||
0 | ANTEGRADE PELVI-URETEROGRAM | 240031 | 74425 | 730 | |||
0 | AORTIC ANGIOGRAM | 59903-03[1990] | 240032 | 75635 | 5,000.00 | ||
0 | AORTIC ARCH ANGIOGRAM | 59903-03[1990] | 240033 | 75600 | 5,000.00 | ||
0 | ARCH ANGIOGRAPHY | 240034 | 75600 | 1,920.00 |
COMBINED CT-SCAN FOR THREE (3) AREAS W/O
3,440.00
CONTRAST
ANGIOGRAM - VERTEBRAL ARTERY (UNILATERAL)
2,800.00
ANKLE - ADDITIONAL VIEW
90
ANKLE (COMPLETE) - 3V
230
ANKLE (LIMITED)
190
ANTEGRADE DJ STENTING BILATERAL
10,000.00
ANTEGRADE DJ STENTING UNILATERAL
8,000.00
ANTEGRADE PELVI-URETEROGRAM
730
AORTIC ANGIOGRAM
5,000.00
AORTIC ARCH ANGIOGRAM
5,000.00
ARCH ANGIOGRAPHY
1,920.00
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