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Days
BS Description E
ICD
IOS BS
CPT
PACKAGE
Price
Center
0
VARICOCELE LIGATION LAP(BILAT)
30635-00[1187]
630100
3063500
5,600.00
0
VARICOCELE LIGATION LAP(UNIL)
30635-00[1187]
630101
3063500
4,500.00
0
ABDOMINOPLASTY - MEDIUM
90675-001
640001
9,700.00
0
ABDOMINOPLASTY (SMALL)
90675-001
640002
6,500.00
0
ABDOMINOPLASTY(LARGE)+LIPOSUCT
90675-001
640003
12,300.00
0
ABDOMINOPLASTY(LARGE)+PLICATION
90675-001
640004
11,800.00
0
ABSCESS I&D UNDER GA (MEDIUM)
90675-001
640005
2,600.00
0
BREAST ASYMMETRY
45521-031
640006
11,600.00
0
BREAST AUGMENTATION EXCL.IMPLANT
45528-001
640007
7,700.00
0
BREAST REDUCTION
45521-011
640008
12,900.00
0
BURN DRESSING - LARGE
90676-001
640009
220
0
BURN DRESSING - LARGE (GA)
90676-001
640010
2,900.00
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