Procedures & surgery prices at San Luis Valley Health Regional Medical Center

Alamosa, CO · every code in this section with a posted price and a Medicare benchmark.

243 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abd paracentesis (49082) $125.95 $229 0.1×
Abd paracentesis w/imaging (49083) $715.82 $1,301.50 0.7×
Acne surgery (10040) $175.45 $319 0.8×
Amnioinfusion (59070) $515.90 $938 1.6×
App skn sub grft t/a/l area/<100scm /<1st 25 scm (15271) $1,578.50 $2,870 2.0×
Application finger splint static (29130) $155.10 $282 1.1×
Application of long leg splint (thigh to ankle or toes) (29505) $136.95 $249 0.8×
Application of short arm splint (forearm to hand); static (29125) $210.10 $382 1.5×
Application of short leg cast (below knee to toes); (29405) $235.40 $428 0.8×
Application of short leg splint (calf to foot) (29515) $66 $120 0.4×
Application of vein wound compression bandages on lower leg ankle and foot|BILATERAL PROCEDURE |SERV DELIV PERSONALLY… (29581) $137.50 $250 0.8×
Application, cast; shoulder to hand (long arm) (29065) $235.40 $428 0.8×
Apply long arm splint (29105) $182.60 $332 1.1×
Arthrocentesis aspir&/inj interm jt/burs w/o us (20605) $255.20 $464 0.8×
Arthrocentesis aspir&/inj major jt/bursa w/o us (20610) $311.85 $567 1.0×
Arthrocentesis aspir&/inj major jt/bursa w/us (20611) $254.10 $462 0.8×
Arthrocentesis aspir&/inj small jt/bursa w/o us (20600) $254.10 $462 0.8×
Aspirate pleura w/o imaging (32554) $212.30 $386 0.3×
Aspiration and/or injection of ganglion cyst(s) any location (20612) $254.10 $462 0.8×
Avulsion of nail plate, partial or complete, simple; single (11730) $104.50 $190 0.5×
Biopsy bone trocar/needle deep (20225) $299.75 $545 0.2×
Biopsy external ear (69100) $45.65 $83 0.2×
Biopsy lip (40490) $206.25 $375 0.8×
Biopsy liver needle percutaneous (47000) $1,644.50 $2,990 0.9×
Biopsy of cervix (57500) $73.15 $133 0.1×
Biopsy of tongue; anterior two-thirds Age Under 21 (41100) $440.55 $801 0.8×
Biopsy of uterus lining (58100) $61.60 $112 0.3×
Biopsy vestibule mouth (40808) $440.55 $801 0.8×
Bladder irrigation (51700) $259.60 $472 1.0×
Bx breast 1st lesion strtctc (19081) $2,122.45 $3,859 1.2×
Bx breast 1st lesion us imag (19083) $2,046.55 $3,721 1.2×
Cast short arm (29075) $235.40 $428 0.8×
Change Cystostomy Tube Simple (51705) $60.50 $110 0.2×
Chemical cauterization of granulation tissue (17250) $175.45 $319 0.8×
Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) Age Under 21 (54160) $282.70 $514 0.4×
Closed treatment of calcaneal fracture; without manipulation (28400) $334.40 $608 1.3×
Closed treatment of carpal bone fracture; without manipulation (25630) $201.30 $366 0.8×
Closed treatment of carpal scaphoid (navicular) fracture; without manipulation (25622) $200.75 $365 0.8×
Closed treatment of clavicular fracture; without manipulation (23500) $201.02 $365.50 0.8×
Closed treatment of distal fibular fracture (lateral malleolus); without manipulation (27786) $201.02 $365.50 0.8×
Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each (26750) $201.30 $366 0.8×
Closed treatment of fracture great toe, phalanx or phalanges; without manipulation (28490) $335.50 $610 1.3×
Closed treatment of fracture, phalanx or phalanges, other than great toe w/o manipulation each (28510) $201.02 $365.50 0.8×
Closed treatment of humeral shaft fracture; without manipulation (24500) $158.40 $288 0.6×
Closed treatment of medial malleolus fracture; without manipulation (27760) $200.75 $365 0.8×
Closed treatment of metacarpal fracture, single; with manipulation, each bone (26605) $219.45 $399 0.8×
Closed treatment of metacarpal fracture, single; without manipulation, each bone (26600) $221.92 $403.50 0.9×
Closed treatment of patellar fracture, without manipulation (27520) $210.65 $383 0.8×
Closed treatment of phalangeal shaft fracture, proximal/middle phalanx with manipulation each (26725) $497.75 $905 1.9×
Closed treatment of phalangeal shaft fx, proximal/middle phalanx w/o manipulation, each (26720) $201.30 $366 0.8×
Closed treatment of post hip arthroplasty dislocation; requiring general anesthesia (27266) $2,061.95 $3,749 1.2×
Closed treatment of proximal fibula or shaft fracture; without manipulation (27780) $200.75 $365 0.8×
Closed treatment of proximal humeral fracture; without manipulation (23600) $201.02 $365.50 0.8×
Closed treatment of radial and ulnar shaft fractures; without manipulation (25560) $201.30 $366 0.8×
Closed treatment of radial head or neck fracture; without manipulation (24650) $201.30 $366 0.8×
Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation (24640) $219.45 $399 0.8×
Closed treatment of shoulder dislocation, with manipulation; without anesthesia (23650) $446.05 $811 1.7×
Closed treatment of tibial fracture, proximal (plateau); without manipulation (27530) $201.30 $366 0.8×
Closed treatment of ulnar fracture, proximal end; without manipulation (24670) $162.80 $296 0.6×
Closed treatment of ulnar shaft fracture; without manipulation (25530) $201.30 $366 0.8×
Closed treatment of ulnar styloid fracture (25650) $219.45 $399 0.8×
Closed tx bimalleolar ankle fracture w/manj (27810) $1,091.75 $1,985 0.6×
Closed tx bimalleolar ankle fracture w/o manip (27808) $201.30 $366 0.8×
Closed tx metatarsal fracture w/o manipulation (28470) $201.30 $366 0.8×
Closed tx patellar dislocation w/o anesthesia (27560) $212.85 $387 0.8×
CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ TechFee (25565) $1,354.65 $2,463 0.8×
Closed tx scapular fracture w/o manipulation (23570) $201.30 $366 0.8×
Closed tx supra/transcondylar humeral fx, w/wo intercondylar extension; w/o manip (24530) $219.45 $399 0.8×
Closed tx vert fx w/o manj (22310) $218.90 $398 0.8×
Cltx dstl radial fx/epiphysl sep w/o manj (25600) $237.32 $431.50 0.9×
Cltx dstl rdl fx/epiphysl sep w/manj when perf (25605) $1,283.70 $2,334 0.8×
Cltx fem fx dstl end medial/lat condyle w/o manj (27508) $201.30 $366 0.8×
Cltx greater humeral tuberosity fx w/o mnpj (23620) $201.30 $366 0.8×
Cltx humeral condylar fx medial/lat w/o manj (24576) $218.90 $398 0.8×
CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES TechFee (26700) $394.90 $718 1.5×
CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ TechFee (27752) $2,631.75 $4,785 1.6×
Cltx trimalleolar ankle fx w/manipulation (27818) $970.20 $1,764 0.6×
Cltx trimalleolar ankle fx w/o manipulation (27816) $200.75 $365 0.8×
Collect blood from catheter venous nos (36592) $80.85 $147 0.6×
Collect blood from implant venous access device (36591) $107.80 $196 0.8×
Colposcopy entire vagina w/cervix if present (57420) $66.55 $121 0.2×
Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage Age… (57454) $78.65 $143 0.2×
Colposcopy vulva (56820) $50.60 $92 0.2×
Complex uroflowmetry (51741) $135.85 $247 0.6×
Contrast injection perq radiologic eval gi tube (49465) $500.50 $910 2.0×
Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method (30903) $113.30 $206 0.8×
Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method (30901) $96.25 $175 0.7×
Core needle bx lung/mediastinum perq w/img (32408) $1,368.95 $2,489 0.8×
Ctrl nsl hemrrg pst nasal packs&/cautery 1st (30905) $109.45 $199 0.8×
Cystoscopy and treatment (52310) $182.05 $331 0.1×
Cystourethroscopy (52000) $559.35 $1,017 0.8×
Debridement of nail(s) by any method(s); 1 to 5 (11720) $54.45 $99 0.9×
Debridement of nail(s) by any method(s); 6 or more (11721) $54.45 $99 0.9×
DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/< TechFee (11042) $337.15 $613 0.8×
Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm… (11044) $1,368.95 $2,489 0.8×
Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm… (11043) $637.45 $1,159 0.8×
Declot vascular device (36593) $97.35 $177 0.3×
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions… (17000) $175.45 $319 0.8×
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions… (17004) $337.15 $613 0.8×
Destruction benign lesions up to 14 (17110) $175.45 $319 0.8×
Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17261) $170.50 $310 0.8×
Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement),… (17264) $337.15 $613 0.8×
Diagnostic lumbar spinal puncture w/fluor or CT (62328) $419.10 $762 0.6×
Drainage of scrotum (54700) $1,744.05 $3,171 0.8×
Drainage of tonsil abscess (42700) $206.25 $375 0.8×
Ed proc insert intraosseous IV (36680) $354.20 $644 0.8×
Ed proc insj temp ndwellg bladder catheter complicated (51703) $383.90 $698 2.8×
Ed proc remve fb nasal- hospital (30300) $68.75 $125 0.5×
Ed prof artl pnxr w/drawal bld dx (36600) $129.80 $236 0.9×
Ed prof burn - large - hospital (16030) $343.75 $625 0.8×
Ed prof burn medium - hospital (16025) $216.70 $394 1.0×
Ed prof burn small - hospital (16020) $216.70 $394 1.0×
Ed prof catheterization/straight (51701) $97.35 $177 0.7×
Ed prof closed tx post hip arthroplasty (27265) $364.10 $662 1.4×
Ed prof drain dental abscess-hospital (41800) $224.40 $408 1.6×
Ed prof insert foley cath simple (51702) $121.55 $221 0.9×
Ed prof insert non tunnel cv cath >5 (36556) $1,832.60 $3,332 0.6×
Ed prof int lac 7.6-12.5cm bd - hospital (12034) $215.60 $392 0.5×
Ed prof interphalangeal dislocation- hospital (26770) $339.90 $618 1.3×
Ed prof naso/oro-gastric tube plmt req phys&fluor gdn (43752) $263.45 $479 0.6×
Er inj anesthetic agent, peripheral nerve or branch (64450) $145.75 $265 0.2×
Evac subungual hematoma (11740) $20.90 $38 0.1×
Exc f/e/e/n/l mal+mrg 1.1-2 (11642) $605.55 $1,101 0.8×
Exc h-f-nk-sp b9+marg 0.5/< (11420) $1,368.95 $2,489 0.8×
Exc tr-ext b9+marg 0.5 < cm (11400) $605.55 $1,101 0.8×
Exc tr-ext b9+marg 1.1-2 cm (11402) $605.55 $1,101 0.8×
Excision Mal Lesion Trunk/Arm/Leg 1.1-2.0 Cm (11602) $235.95 $429 0.6×
Excision Mal Lesion Trunk/Arm/Leg 2.1-3.0 Cm (11603) $605.55 $1,101 0.8×
Excision Mal Lesion Trunk/Arm/Leg 3.1-4.0 Cm (11604) $605.55 $1,101 0.8×
Excision malignant lesion f/e/e/n/l >4.0 cm (11646) $2,113.65 $3,843 0.7×
Excision Malignant Lesion S/N/H/F/G 1.1-2.0 Cm (11622) $605.55 $1,101 0.8×
Excision Malignant Lesion S/N/H/F/G 3.1-4.0 Cm (11624) $1,368.95 $2,489 0.8×
Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair (40812) $1,371.87 $2,494.31 0.8×
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet,… (11423) $1,368.95 $2,489 0.8×
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11401) $337.15 $613 0.8×
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11403) $605.55 $1,101 0.8×
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised… (11406) $1,368.95 $2,489 0.8×
Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm Age Under… (11644) $2,098.25 $3,815 1.2×
Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm Age… (11626) $2,305.05 $4,191 0.8×
Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm Age Under 21 (11606) $1,368.95 $2,489 0.8×
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11442) $605.55 $1,101 0.8×
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11441) $86.90 $158 0.1×
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose,… (11440) $605.55 $1,101 0.8×
Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm (21555) $1,368.95 $2,489 0.8×
Fine needle aspiration bx w/us gdn 1st lesion (10005) $875.05 $1,591 1.2×
Fluid pressure muscle (20950) $652.30 $1,186 0.9×
Guide cathet fluid drainage (10030) $2,094.95 $3,809 2.8×
Hemorrhoidectomy internal rubber band ligations (46221) $507.38 $922.50 0.5×
I&d abscess simple/single (10060) $194.70 $354 0.9×
I&d hematoma/seroma/fluid (10140) $256.85 $467 0.1×
I&d pilonidal cyst simple (10080) $73.15 $133 0.1×
Incise external hemorrhoid (46083) $96.80 $176 0.4×
INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE TechFee (10061) $273.90 $498 0.6×
Incision and drainage of Bartholin's gland abscess (56420) $326.70 $594 1.5×
Incision and drainage of vulva or perineal abscess (56405) $273.90 $498 0.9×
Incision and drainage, perianal abscess, superficial (46050) $1,619.20 $2,944 1.7×
Incision and removal of foreign body, subcutaneous tissues; simple (10120) $337.15 $613 0.8×
Incision of eardrum with insertion of eardrum tube under local or topical anesthesia|BILATERAL PROCEDURE (69433) $449.35 $817 0.8×
Incisional biopsy skin single lesion (11106) $401.50 $730 0.5×
Infectious disease (Bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 22… (0202U) $748 $1,360 1.8×
Initial treatment, first degree burn, when no more than local treatment is required (16000) $170.50 $310 0.8×
Inj,Anes Agent,Femoral Nerve,Single (64447) $168.85 $307 0.2×
Injection aa&/strd trigeminal nerve each branch (64400) $73.15 $133 0.2×
Injection therapeutic carpal tunnel (20526) $254.10 $462 0.8×
Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or… (62325) $188.10 $342 0.2×
Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) (20552) $254.10 $462 0.8×
Injection(s); single or multiple trigger point(s), 3 or more muscle(s) (20553) $254.10 $462 0.8×
Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia) (20550) $317.90 $578 1.0×
Injection, anesthetic agent; sphenopalatine ganglion Age Under 21 (64505) $235.40 $428 0.7×
Injection, intralesional; up to and including 7 lesions (11900) $175.45 $319 0.8×
Insert cervical dilator (59200) $297 $540 0.9×
Insert drug implant device (11981) $109.45 $199 0.8×
Insert pessary/other device (57160) $36.85 $67 0.2×
Insertion picc w/o img gdn 5 yr/> (36569) $1,364.55 $2,481 0.8×
Insertion picc w/rs&i 5 yr/> (36573) $1,562 $2,840 0.9×
Intubation endotracheal (31500) $207.90 $378 0.8×
Laryngoscopy flex diagnostic (31575) $160.05 $291 0.8×
Lumbar puncture (62270) $608.30 $1,106 0.8×
Meas post-voiding residual urine&/bladder cap (51798) $52.52 $95.50 0.8×
Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) Age Under 21 (31231) $160.05 $291 0.8×
Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure) Age Under 21 (31237) $1,101.65 $2,003 0.6×
Needle insertion w/o injection 1 or 2 muscles (20560) $57.75 $105 1.9×
Needle insertion w/o injection 3 or more muscles (20561) $64.35 $117 2.1×
Neuroeltrd stim post tibial (64566) $45.65 $83 0.1×
Njx cholangio prq w/img gid rs&i existing access (47531) $435.05 $791 0.1×
Njx dx/ther sbst intrlmnr lmbr/sac w/img gdn (62323) $1,419.55 $2,581 1.9×
Njx dx/ther sbst intrlmnr lmbr/sac w/o img gdn (62326) $485.10 $882 0.5×
Non stress test (59025) $364.10 $662 1.7×
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions (11056) $175.45 $319 0.8×
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion (11055) $175.45 $319 0.8×
Perq dev breast 1st strtctc (19283) $970.20 $1,764 1.3×
Perq dev breast 1st us imag (19285) $425.70 $774 0.6×
Perq drainage pleura insert cath w/o imaging (32556) $227.70 $414 0.1×
Perq replacement gtube not req revj gstrst trc (43762) $229.35 $417 0.9×
Punch biopsy skin single lesion (11104) $642.20 $1,167.63 1.5×
Puncture aspiration of abscess, hematoma, bulla, or cyst (10160) $196.90 $358 0.5×
Puncture aspiration of cyst of breast (19000) $661.65 $1,203 0.9×
Removal impacted cerumen irrigation/lvg unilat (69209) $38.78 $70.50 0.6×
Removal impacted cerumen requiring instrumentation, unilateral (69210) $54.18 $98.50 0.9×
Removal implant superficial (20670) $1,368.95 $2,489 0.8×
Removal of foreign body, external eye; conjunctival superficial (65205) $42.90 $78 0.3×
Removal of foreign body, external eye; corneal, without slit lamp (65220) $55 $100 0.1×
Removal of iud (58301) $273.90 $498 0.9×
Removal of nail bed (11750) $257.95 $469 0.6×
Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions (11200) $175.45 $319 0.8×
Removal, non-biodegradable drug delivery implant (11982) $263.45 $479 0.6×
Removal/revision of cast (29700) $235.40 $428 0.8×
Repair complex f/c/c/m/n/ax/g/h/f 1.1-2.5 cm (13131) $311.30 $566 0.7×
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM TechFee (13132) $343.20 $624 0.8×
Repair complex scalp/arm/leg 2.6-7.5 cm (13121) $510.40 $928 1.2×
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.5 CM/< (12051) $207.90 $378 0.5×
REPAIR INTERMEDIATE F/E/E/N/L and /MUC 2.6-5.0 CM (12052) $337.15 $613 0.8×
Repair intermediate n/h/f/xtrnl gent 2.6-7.5 cm (12042) $337.15 $613 0.8×
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/< TechFee (12031) $337.15 $613 0.8×
REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM TechFee (12032) $237.05 $431 0.6×
Repair Intermediate Wounds Of Scalp, Underarms, Truck And/or Extremities Over 30.0cm (12037) $278.85 $507 0.1×
Repair of nail bed (11760) $510.40 $928 0.7×
Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm (13151) $520.85 $947 0.7×
Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm (13152) $510.40 $928 0.7×
RMVL FB XTRNL AUDITORY CANAL W/O ANES TechFee (69200) $52.80 $96 0.4×
RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP TechFee (65222) $109.45 $199 0.8×
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/< TechFee (12011) $63.80 $116 0.3×
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM TechFee (12013) $86.35 $157 0.4×
SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM TechFee (12014) $175.45 $319 0.8×
SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM TechFee (12015) $175.45 $319 0.8×
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/< TechFee (12001) $115.78 $210.50 0.5×
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM TechFee (12007) $178.20 $324 0.8×
Simple rpr scalp/neck/ax/genit/trunk 7.6-12.5cm (12004) $246.95 $449 1.2×
SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM TechFee (12002) $246.95 $449 1.2×
SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM TechFee (12005) $138.05 $251 0.3×
Smpl rpr scalp/neck/ax/genit/trunk 20.1-30.0cm (12006) $163.90 $298 0.4×
Strapping unna boot (29580) $137.50 $250 0.8×
Sub grft f/s/n/h/f/g/m/d <100sq cm 1st 25 sq cm (15275) $1,668.70 $3,034 2.1×
Tangential biopsy skin single lesion (11102) $175.45 $319 0.4×
Tenotomy percutaneous toe single tendon (28010) $1,354.65 $2,463 0.8×
Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance (32555) $1,146.75 $2,085 1.7×
Transfusion, blood or blood components (36430) $330 $600 0.7×
Treatment of bladder lesion (51720) $163.90 $298 0.2×
Treatment of closed elbow dislocation; without anesthesia (24600) $455.40 $828 1.8×
Trimming of nondystrophic nails, any number (11719) $54.45 $99 0.9×
Vasectomy (55250) $256.30 $466 0.1×
Venipuncture (36415) $15.40 $28 1.6×
Version cephalic external (59412) $485.10 $882 0.1×