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$2491.23
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Sanford Bismarck Medical Center Menu
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Treatment Room - Spinal Tap For Diagnosis (1021396) | $1,162.00 |
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Treatment Room - Simple Wound Repair Of The Scalp, Neck, Underarms, Trunk, Arms, Or Legs (1024468) | $348.00 |
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Treatment Room - Simple Wound Repair Of The Scalp, Neck, Underarms, Trunk, Arms, Or Legs (1021689) | $298.00 |
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Treatment Room - Simple Wound Repair Of The Face, Ears, Eyelids, Nose, Lips, Or Mucous Membranes (1025524) | $258.00 |
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Treatment Room - Simple Control Of Nose Bleed (1024003) | $221.00 |
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Treatment Room - Separation Of Nail Plate From Nail Bed (1008218) | $249.00 |
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Treatment Room - Separation Of Nail Plate From Nail Bed (1008219) | $63.00 |
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Treatment Room - Reopening Of Recent Abdominal Incision (1028261) | $3,788.00 |
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Treatment Room - Removal Of Tissue From Wounds, Per Session (1007044) | $265.00 |
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Treatment Room - Removal Of Tissue From 6 Or More Finger Or Toe Nails (1008217) | $202.00 |
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Treatment Room - Removal Of Tissue Beneath The Skin, Initial Amount (1005208) | $597.00 |
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Treatment Room - Removal Of Tissue Beneath The Skin, Initial Amount (1021370) | $597.00 |
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Treatment Room - Removal Of Skin Suture With Change Of Bladder Tube (1004332) | $451.00 |
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Treatment Room - Removal Of Skin Of Finger Or Toe Nail (1021371) | $477.00 |
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Treatment Room - Removal Of Muscle Or Muscle Tissue, Initial Amount (1005209) | $839.00 |
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Treatment Room - Removal Of Inflamed Or Infected Skin, Up To 10 Percent Of Body Surface (1003848) | $767.00 |
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Treatment Room - Removal Of Foreign Body, Stone, Or Stent From Bladder Canal Or Bladder Using Endoscope (1026305) | $2,635.00 |
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Treatment Room - Removal Of Fluid From Chest Cavity With Insertion Of Indwelling Catheter, Accessed Through The Skin (1027646) | $2,099.00 |
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Treatment Room - Removal Of Central Vein Catheter Beneath The Skin (1021385) | $1,517.00 |
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Treatment Room - Removal Of 2 To 4 Non-Cancerous Thickened Skin Growths (1008211) | $237.00 |
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Treatment Room - Open Insertion Of Drainage Catheter Into Lung Lining (1021380) | $1,265.00 |
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Treatment Room - Negative Pressure Wound Therapy, Surface Area Less Than Or Equal To 50 Square Centimeters, Per Session (1002928) | $249.00 |
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Treatment Room - Negative Pressure Wound Therapy Surface Area Less Than Or Equal To 50 Square Centimeters Per Session (1024491) | $126.00 |
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Treatment Room - Miscellaneous Procedure On Skin, Tissue Beneath The Skin, Or Mucous Membrane (1025603) | $250.00 |
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Treatment Room - Medical Case Manager Visit (1027668) | $131.00 |
N/A
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Treatment Room - Maternity Care And Delivery Procedure (1027895) | $248.00 |
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Treatment Room - Manipulation Of Broken Forearm Without Incision (1028197) | $2,680.00 |
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Treatment Room - Insertion Of Temporary Bladder Catheter (1021393) | $265.00 |
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Treatment Room - Insertion Of Indwelling Bladder Catheter (1021671) | $267.00 |
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Treatment Room - Insertion Of Indwelling Bladder Catheter (1021394) | $242.00 |
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Treatment Room - Insertion Of Catheter Into An Artery In Navel, Newborn (1025439) | $146.00 |
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Treatment Room - Insertion Of Catheter In Central Vein, Access Via Arm, Leg, Or Neck Vein, 5+ Years (1021383) | $2,181.00 |
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Treatment Room - Insertion Of Catheter In Central Vein, 5+ Years (1021381) | $1,966.00 |
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Treatment Room - Insertion Dilator Device Into Cervix (1024297) | $481.00 |
N/A
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Treatment Room - Injections Of Trigger Points In 3 Or More Muscles (1021374) | $559.00 |
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Treatment Room - Injections Of Trigger Points In 1 Or 2 Muscles (1021373) | $532.00 |
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Treatment Room - Injections Of Tendon Sheath, Ligament, Or Muscle Membrane (1021372) | $541.00 |
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Treatment Room - Injection Of Chemical Agent To Destroy Other Peripheral Nerve Or Nerve Branch (1024090) | $1,636.00 |
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Treatment Room - Injection Of Chemical Agent To Destroy Nerves Of Arm Or Leg Muscle(S) (1021143) | $1,165.00 |
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Treatment Room - Injection Of Chemical Agent To Destroy Neck Muscle Nerves On One Side Of Neck (1021141) | $724.00 |
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Treatment Room - Injection Of Chemical Agent To Destroy Facial And Neck Muscle Nerves On Both Sides Of Face (1024089) | $735.00 |
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Treatment Room - Injection Of Carpal Tunnel (1024084) | $534.00 |
N/A
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Treatment Room - Injection Of Blood Or Blood Clot Into Spinal Canal (1021397) | $1,410.00 |
N/A
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Treatment Room - Injection Of Anesthesia Or Steroid Into Thigh Nerve (1021399) | $1,162.00 |
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Treatment Room - Injection Of Anesthesia Or Steroid Into Other Peripheral Nerve (1021400) | $987.00 |
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Treatment Room - Injection Of Anesthesia Or Steroid Into Occipital Cranial Nerve (1021398) | $631.00 |
N/A
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Treatment Room - Incision Of Tissue Connecting Tongue And Floor Of Mouth (1025197) | $1,778.00 |
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Treatment Room - Incision Of Engorged External Hemorrhoid (1021391) | $389.00 |
N/A
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Treatment Room - Incision And Drainage Of Roof Of Mouth Or Its Soft Tissue Projection (1028227) | $355.00 |
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Treatment Room - Incision And Drainage Of Abscess In Scrotal Sac Of Testicle (1028179) | $2,676.00 |
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Treatment Room - Implantation, Revision, Or Repositioning Of Catheter In Spinal Canal For Medication Administration (1024086) | $8,084.00 |
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Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1028030) | $278.00 |
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Treatment Room - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (1009264) | $127.00 |
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Treatment Room - Emergent Insertion Of Breathing Tube Into Windpipe (1027181) | $450.00 |
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Treatment Room - Dressing Change Or Removal Of Burn Tissue Small Area (1010689) | $264.00 |
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Treatment Room - Drainage Of Tonsil Abscess (1027450) | $292.00 |
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Treatment Room - Drainage Of Finger Abscess (1027864) | $249.00 |
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Treatment Room - Drainage Of Abscess, Simple Or Single (1010690) | $349.00 |
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Treatment Room - Drainage Of Abscess, Cyst, Or Blood Accumulation Under The Jaw Bone (1027645) | $3,758.00 |
N/A
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Treatment Room - Dilation Of Bladder Canal Using Endoscope (1026647) | $2,842.00 |
N/A
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Treatment Room - Diagnostic Exam Of Voice Box Using Endoscope (1024007) | $3,528.00 |
N/A
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Treatment Room - Diagnostic Exam Of Voice Box Using Endoscope (1021378) | $390.00 |
N/A
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Treatment Room - Diagnostic Exam Of Nasal Passages Using Endoscope (1021376) | $326.00 |
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Treatment Room - Diagnostic Exam Of Anus And Cell Collection Using Endoscope (1023390) | $222.00 |
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Treatment Room - Control Of Nasal Bleeding Using Endoscope (1011583) | $2,934.00 |
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Treatment Room - Closure Of Permanent Windpipe Opening Or Abnormal Drainage Tract (1028224) | $4,365.00 |
N/A
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Treatment Room - Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist With Manipulation (1021682) | $1,986.00 |
N/A
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Treatment Room - Change Of Breathing Tube In Windpipe (1021377) | $277.00 |
N/A
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Treatment Room - Bladder Irrigation Or Instillation (1024363) | $413.00 |
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Treatment Room - Biopsy Of Uterine Lining (1022217) | $411.00 |
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Treatment Room - Biopsy Of Lining Of Vagina (1027863) | $992.00 |
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Treatment Room - Aspiration Or Injection Of Medium Joint Or Joint Capsule (1021375) | $505.00 |
N/A
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Treatment Room - Aspiration Or Injection Of Large Joint Or Joint Capsule With Ultrasound Guidance (1024808) | $1,337.00 |
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Treatment Room - Aspiration Or Injection Of Large Joint Or Joint Capsule (1011679) | $573.00 |
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Treatment Room - Aspiration Of Voice Box Using Endoscope (1026782) | $3,705.00 |
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Treatment Room - Application Of Long Leg Cast (1024006) | $481.00 |
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Treatment Room - Adjustment Of Band Around Stomach (1024010) | $245.00 |
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Trauma Response - Trauma Alert (1024059) | $983.00 |
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Trauma Response - Trauma Activation Alert/evaluation (1027812) | $1,008.00 |
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Trauma Response - Trauma Activation (1006879) | $4,225.00 |
N/A
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Trauma Response - Hospital Critical Care Service (1027813) | $5,499.00 |
N/A
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Trauma Response - Hospital Critical Care Service (1013443) | $5,364.00 |
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Trauma Response - Full Trauma Activation (1027810) | $5,499.00 |
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Therapeutic Services - Therapeutic Removal Of Whole Blood To Correct Blood Level Imbalance (1004588) | $323.00 |
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Therapeutic Services - Refilling And Maintenance Of Portable Pump (1004360) | $493.00 |
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Therapeutic Services - Refilling And Maintenance Of Implantable Spinal Or Brain Drug Delivery Pump Or Reservoir Requiring Skill Of Qualified Professional (1013388) | $443.00 |
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Therapeutic Services - Refilling And Maintenance Of Implantable Pump Or Reservoir For Drug Delivery (1021552) | $450.00 |
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Therapeutic Services - Mechanical Separation Of Plasma From From Opening Blood (1005256) | $2,318.00 |
N/A
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Therapeutic Services - Mechanical Separation Of Plasma And Abnormal Antibodies From Blood (1010054) | $6,668.00 |
N/A
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Therapeutic Services - Irrigation Of Implanted Venous Access Drug Delivery Device (1004718) | $177.00 |
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Therapeutic Services - Insertion Of Needle Into Vein, Patient 3 Years Or Older (1008910) | $50.00 |
N/A
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Telemedicine - Fee For Remote Healthcare Service (1009851) | $63.00 |
N/A
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Speech Therapy - Treatment Of Swallowing Or Oral Feeding Function (1002861) | $323.00 |
N/A
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Speech Therapy - Treatment Of Speech, Language, Voice, Communication, Or Hearing Processing Disorder, Individual (1002858) | $281.00 |
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Speech Therapy - Therapeutic Services For Use Of Speech-Generating Device With Programming And Modification (1008114) | $389.00 |
N/A
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Speech Therapy - Therapeutic Services For Use Of Non-Speech-Generating Device With Programming (1008111) | $286.00 |
N/A
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Speech Therapy - Standardized Thought Processing Testing With Interpretation And Report, Per Hour Of Qualified Professional Time (1006830) | $362.00 |
N/A
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Speech Therapy - Fluoroscopic And Video Recorded Motion Evaluation Of Swallowing Function (1002872) | $408.00 |
N/A
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Speech Therapy - Evaluation Of Swallowing Function (1002860) | $343.00 |
N/A
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Speech Therapy - Evaluation Of Speech Sound Production With Evaluation Of Language Comprehension And Expression (1021038) | $598.00 |
N/A
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Speech Therapy - Evaluation Of Speech Sound Production (1021037) | $350.00 |
N/A
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Speech Therapy - Evaluation Of Speech Fluency (1021036) | $350.00 |
N/A
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Speech Therapy - Evaluation For Use Or Fitting Of Voice Prosthetic Device To Supplement Oral Speech (1008110) | $228.00 |
N/A
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Speech Therapy - Developmental Screening (1008119) | $121.00 |
N/A
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Speech Therapy - Behavioral And Qualitative Analysis Of Voice And Resonance (1021039) | $350.00 |
N/A
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Speech Therapy - Assessment Of Expressive And Receptive Speech With Interpretation And Report, Per Hour (1008115) | $365.00 |
N/A
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Room & Board - Semi-Private Psychiatric (1009228) | $1,655.00 |
N/A
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Room & Board - Semi-Private Pediatric (1006792) | $1,437.00 |
N/A
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Room & Board - Semi-Private Obstetrical (1013950) | $1,437.00 |
N/A
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Room & Board - Semi-Private (1008184) | $1,437.00 |
N/A
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Room & Board - Psychiatric Intensive Care (1024011) | $2,016.00 |
N/A
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Room & Board - Private Pediatric (1006596) | $2,359.00 |
N/A
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Room & Board - Pediatric Intensive Care (1006597) | $2,967.00 |
N/A
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Room & Board - Newborn Level Iv (1007951) | $2,967.00 |
N/A
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Room & Board - Newborn Level Iii (1007950) | $2,359.00 |
N/A
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Room & Board - Newborn Level Ii (1010103) | $1,773.00 |
N/A
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Room & Board - Newborn Level I (1006605) | $1,101.00 |
N/A
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Room & Board - Intensive Care (1000441) | $2,967.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Subsequent Day (1003244) | $918.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Subsequent Day (1003237) | $918.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Subsequent Day (1006725) | $918.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Subsequent Day (1003234) | $918.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Initial Day (1003235) | $1,078.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Initial Day (1003236) | $1,078.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Initial Day (1007481) | $1,078.00 |
N/A
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Respiratory Services - Ventilation Management In Hospital - Initial Day (1006724) | $1,078.00 |
N/A
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Respiratory Services - Test For Exercise-Induced Lung Stress (1027651) | $308.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009222) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011525) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1009221) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011850) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006731) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011526) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1004474) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1006717) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1011849) | $89.00 |
N/A
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Respiratory Services - Respiratory Inhaled Aerosol Treatment To Relieve Airway Obstruction, First Hour (1004608) | $171.00 |
N/A
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Respiratory Services - Respiratory Inhaled Aerosol Treatment To Relieve Airway Obstruction, Each Additional Hour (1003292) | $97.00 |
N/A
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Respiratory Services - Procedure To Improve Lung Function, Each 15 Minutes (1007808) | $79.00 |
N/A
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Respiratory Services - Procedure To Improve Lung Function, 2+ Patients (1005465) | $70.00 |
N/A
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Respiratory Services - Physical Performance Test Or Measurement With Report, Each 15 Minutes (1008258) | $121.00 |
N/A
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Respiratory Services - Overnight Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1002093) | $242.00 |
N/A
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Respiratory Services - Multiple Measurements Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003267) | $210.00 |
N/A
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Respiratory Services - Multiple Measurements Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003249) | $210.00 |
N/A
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Respiratory Services - Multiple Measurements And Graphic Recordings Of The Amount And Speed Of Breathed Air, Before And Following Medication Administration (1003330) | $428.00 |
N/A
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Respiratory Services - Measurement Of Oxygen Saturation In Blood Using Ear Or Finger Device (1003265) | $74.00 |
N/A
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Respiratory Services - Measurement Of Lung Diffusing Capacity (1003337) | $311.00 |
N/A
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Respiratory Services - Measurement And Graphic Recording Of Total And Timed Exhaled Air Capacity (1003239) | $201.00 |
N/A
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Respiratory Services - Measurement And Graphic Recording Of The Amount And Speed Of Breathed Air, Before And Following Medication Administration (1001533) | $366.00 |
N/A
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Respiratory Services - Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003254) | $155.00 |
N/A
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1006722) | $553.00 |
N/A
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1020782) | $516.00 |
N/A
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1020785) | $516.00 |
N/A
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1020784) | $411.00 |
N/A
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1006723) | $411.00 |
N/A
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Respiratory Services - Initiation And Management Of Continuous Positive Airway Pressure (Cpap) Assistance By Mask Or Breathing Tube (1020783) | $411.00 |
N/A
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Respiratory Services - Inhaled Pneumonia Treatment (1004609) | $548.00 |
N/A
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Respiratory Services - Exercise Test For Spasm Of Lung Airways (1027650) | $568.00 |
N/A
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Respiratory Services - Emergent Insertion Of Breathing Tube Into Windpipe (1004631) | $450.00 |
N/A
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Respiratory Services - Determination Of Lung Volumes Using Plethysmography (Instrumentation) (1003336) | $301.00 |
N/A
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Respiratory Services - Demonstration Or Evaluation Of Patient Use Of Aerosol Generator, Nebulizer, Metered Dose Inhaler Or Intermittent Positive Pressure Breathing (Ippb) Device (1011524) | $102.00 |
N/A
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Respiratory Services - Demonstration Or Evaluation Of Patient Use Of Aerosol Generator, Nebulizer, Metered Dose Inhaler Or Intermittent Positive Pressure Breathing (Ippb) Device (1004614) | $102.00 |
N/A
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Respiratory Services - Demonstration Or Evaluation Of Patient Use Of Aerosol Generator, Nebulizer, Metered Dose Inhaler Or Intermittent Positive Pressure Breathing (Ippb) Device (1001534) | $102.00 |
N/A
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Respiratory Services - Demonstration Or Evaluation Of Patient Use Of Aerosol Generator, Nebulizer, Metered Dose Inhaler Or Intermittent Positive Pressure Breathing (Ippb) Device (1011848) | $102.00 |
N/A
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Respiratory Services - Demonstration Or Evaluation Of Patient Use Of Aerosol Generator, Nebulizer, Metered Dose Inhaler Or Intermittent Positive Pressure Breathing (Ippb) Device (1004705) | $102.00 |
N/A
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Respiratory Services - Demonstration Or Evaluation Of Manual Maneuvers To Chest Wall To Assist Movement Of Lung Secretions (1003278) | $155.00 |
N/A
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Respiratory Services - Administration Of Medication Through Breathing Tube (1022022) | $237.00 |
N/A
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Recovery - Respiratory Inhaled Pressure Or Nonpressure Treatment To Relieve Airway Obstruction Or For Sputum Specimen (1021219) | $89.00 |
N/A
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Recovery - Post Anesthesia Services Each Additional 15 Minutes (1011823) | $238.00 |
N/A
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Recovery - Post Anesthesia Services (1001874) | $219.00 |
N/A
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Recovery - Phase 1 Major 15 Minutes (1024082) | $109.00 |
N/A
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Recovery - Iv Injection First Drug (1021227) | $160.00 |
N/A
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Recovery - Iv Injection Each Additional New Drug (1021228) | $152.00 |
N/A
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Recovery - Iv Infusion First Hour (1021223) | $607.00 |
N/A
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Recovery - Injection Into Muscle Or Under Skin (1021229) | $121.00 |
N/A
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Recovery - Additional Iv Injection Of Same Drug (1021230) | $153.00 |
N/A
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Radiopharmaceuticals - Thallium (Radioactive Imaging Agent) (1003568) | $197.00 |
N/A
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Radiopharmaceuticals - Technetium Sulfur Colloid (Radioactive Imaging Agent) (1003542) | $715.00 |
N/A
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Radiopharmaceuticals - Technetium Succimer (Radioactive Imaging Agent) (1005445) | $1,651.00 |
N/A
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Radiopharmaceuticals - Technetium Sestamibi (Radioactive Imaging Agent) (1003575) | $495.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Pyrophosphate (Radioactive Imaging Agent) (1005437) | $196.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Pertechnetate (Radioactive Imaging Agent) (1007530) | $60.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Pentetate (Radioactive Imaging Agent) (1005438) | $624.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Pentetate (Radioactive Imaging Agent) (1010432) | $624.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Mertiatide (Radioactive Imaging Agent) (1005454) | $1,351.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Medronate (Radioactive Imaging Agent) (1009453) | $80.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Mebrofenin (Radioactive Imaging Agent) (1005436) | $140.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Macroaggregated Albumin (Radioactive Imaging Agent) (1005439) | $1,584.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium Labeled Blood Cells (Radioactive Imaging Agent) (1005452) | $440.00 |
N/A
|
|
||
Radiopharmaceuticals - Technetium - Full Cost Recovery Add-On (1027777) | $10.00 |
N/A
|
|
||
Radiopharmaceuticals - Radium Dichloride (Radioactive Therapy Agent) (1020842) | $418.00 |
N/A
|
|
||
Radiopharmaceuticals - Iodine I-131 Sodium Iodide (Radioactive Therapy Agent) (1003576) | $103.00 |
N/A
|
|
||
Radiopharmaceuticals - Iodine I-123 Sodium Iodide (Radioactive Imaging Agent) (1006808) | $2,089.00 |
N/A
|
|
||
Radiopharmaceuticals - Iodine I-123 Sodium Iodide (Radioactive Imaging Agent) (1007048) | $258.00 |
N/A
|
|
||
Radiopharmaceuticals - Iodine I-123 Ioflupane (Radioactive Imaging Agent) (1012691) | $4,623.00 |
N/A
|
|
||
Radiopharmaceuticals - Indium Labeled White Blood Cells (Radioactive Imaging Agent) (1013454) | $5,766.00 |
N/A
|
|
||
Radiopharmaceuticals - Indium In-111 Pentetreotide (Radioactive Imaging Agent) (1005455) | $8,848.00 |
N/A
|
|
||
Radiopharmaceuticals - Indium In-111 Pentetate (Radioactive Imaging Agent) (1005443) | $4,225.00 |
N/A
|
|
||
Radiopharmaceuticals - Fluorodeoxyglucose F-18 (Radioactive Imaging Agent) (1005446) | $1,001.00 |
N/A
|
|
||
Radiation Therapy - Special Radiation Therapy Procedure (1002114) | $301.00 |
N/A
|
|
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