Surgical - Bozeman HealthSurgical PROCEDURE NAME UNIT PRICE INJ PSEUDOANEURYSM EXTREMITY PERC $390.00 TPM INSERTION $1,288.00 REPOSITION PPM DEFIB LEAD $3,540.00 INTRO CATH RT HRT

Surgical

PROCEDURE NAME UNIT PRICE

INS PICC WO PORT WO IMAG <5 $1,555.00

INSERT CATH CENTRAL VENOUS PERIPH WO IMAG >5 YRS $1,595.00

SURG FINE NDL ASPIR BX WO GDN 1ST LESION $116.00

SURG FINE NDL ASPIR BX W US GDN 1ST LESION $1,826.00

SURG FINE NDL ASPIR BX W US GDN EA ADDL LESION $1,977.00

SURG FINE NDL ASPIR BX W FLURO GDN 1ST LESION $1,826.00

SURG FINE NDL ASPIR BX W FLURO GDN EA ADDL LESION $1,977.00

SURG FINE NDL ASPIR BX W CT GDN 1ST LESION $1,826.00

SURG FINE NDL ASPIR BX W CT GDN EA ADDL LESION $1,977.00

SURG US GUIDE CRYO ABD WALL LESION $12,194.00

BRONCH REVISE PREV STENT $8,108.00

TRACHEOBRONCHOSCOPY $1,019.00

SURG BRONCH W PLCMT FIDUCIAL MRKR SNGL OR MULT $8,108.00

BRONCHOSCOPY BRONCH STENTS $8,108.00

BRONCHOSCOPY W CATH PLACMT $2,157.00

BRONCH WTHERP ASP TRACH $1,662.00

BRONCHOSC WASP TRANSBRONCH $4,317.00

BRONCH W ASP TREE INITIAL $2,157.00

BRONCHOSC WBX TRANSBRONCH SGL $4,317.00

BRONCH W/ PLACE TRACHEAL STENT $8,108.00

BRONCH W/ DESTR TUM RELIEF STENOSIS NOT EXC $4,317.00

SURG INJ FEMORAL NERVE $741.00

SURG INJ ANES OTHER PERIPHERAL NERVE BRANCH $322.00

TAP BLOCK UNILATERAL BY INJECTION $195.00

SURG CHG PICC INCL IMAGING $1,453.00

SURG INJ ANES AGENT INTERCOSTAL NERVE EA ADDL LVL $552.00

SURG ARTHROCENTESIS ASP INJ INTRM JNT BURSA WO US GUID $468.00

VENIPUNCTURE < AGE 3 $27.00

SURG INJ INTERCOSTAL NERVE SINGLE LEVEL $371.00

SURG INJ SINUS TRACT THERAPEUTIC $1,883.00

ARTHRO ASP INJ JT BURSA INTERMED W US $1,132.00

SURG RPLC G TUBE PERC WO IMG OR ENDO GDN NO REVISION $486.00

SURG TANGENTIAL BX SKIN SINGLE LESION $927.00

SURG PUNCH BX SKIN SINGLE LESION $927.00

SURG INCISIONAL BX SKIN SINGLE LESION $1,650.00

SURG TANGENTIAL BX SKIN EA SEP OR ADDL LESION $973.00

SURG PUNCH BX SKIN EA SEP OR ADDL LESION $973.00

SURG INCISIONAL BX SKIN EA SEP OR ADDL LESION $1,731.00

SURG DILAT EXIST TRACT PERC ENDOUROLOGIC PX INC IMAG GD $3,654.00

DILAT EXIST TRACT PERC ENDOUROLOGIC PX INC IMAG GD NEW ACCESS$6,147.00

SURG INSERT PICC WO PORT W/IMAGING < 5 YR $1,303.00

SURG INSERT PICC WO PORT W/IMAGING > 5 YR $2,297.00

INJ CONTRAST KNEE ARTHROGRAPHY CT MRI $291.00

SURG RMVL ECCR IOL INSRT CMPLX $3,666.00

SURG CILIARY BODY DESTRUCT CYCLOPHOTOCOAGULATION ENDOSCOPIC$3,043.00

SNIP INCISION OF LACRIMAL PUNCTUM $302.00

Bozeman Health Deaconess HospitalPage 1 of 13 2020 Pricing

Surgical


SURG EXTRACTION CATARACT PHACOEMULSIFICATION W INTRAOCULAR LENS BILATERAL$7,332.00

REMOV CORNEAL EPITHELIUM WWO CHEMOCAUTERIZATION $1,400.00

SURG RPR ECTROPION EXC TARSAL WEDGE $3,141.00

VITRECTOMY MECHANICAL PARS PLANA APPRCH $6,307.00

SUTURE OF IRIS $3,322.00

REPAIR LACERATIONS $3,295.00

REMOVAL OF SKIN TAGS MULTIPLE $307.00

OR CASE LEVEL 3&4 $2,294.00

ABLATION RF BONE TUMOR W IMAGING $7,967.00

SURG VENOGRAM INJ $193.00

SURG VENA CAVA NON-SEL CA $426.00

SURG SEL 1ST ORDER VENOUS $570.00

SURG SEL 2ND ORDER VENOUS $645.00

SURG PULM ART CATH SEL $1,898.00

SURG PULM ART SUP SEL $2,658.00

SURG INTRO NDLE OR EXT CATH UPPER OR LOWER EXT ART $1,643.00

SURG INTROCATH AORTA $2,300.00

SURG SEL 1ST ORD AD $677.00

SURG INITIAL 2ND ORDER AD $764.00

SURG INITIAL 3RD ORDER AD $907.00

SURG SEL EA ADD 2ND 3RDAD $684.00

SURG SEL CATH 1ST ORD-BD $727.00

SURG INITIAL 2ND ORDER BD $762.00

SURG INITIAL 3RD ORDER BD $906.00

SURG SEL EA ADD 2ND 3RDBD $551.00

SURG CHECK CVAP PATENCY $464.00

SURG VENOUS ORGAN BLD SU $570.00

SURG INS NT CENT CVA >5 $1,416.00

SURG INS TUN CVA >5 $3,092.00

SURG INS TUN CVA WPORT $4,308.00

SURG CHG TUN CVA $2,213.00

SURG REML TUN CVA $652.00

SURG PERICATH CVA STRIP $1,992.00

SURG MECH REML INTRLUM OBSTR $536.00

SURG REPOSITION CV PICC $480.00

SURG INSRT INTRHEP PORTO $1,868.00

SURG REV INTRHEP PORTO $12,040.00

INS VENA CAVA FILTER $11,128.00

SURG RETROGRADE URETHRAI $237.00

SURG TRNSCTH INTRACRANIAL EMBO $4,206.00

SURG TRNSCTH EXTRACRANIAL EMBO $3,738.00

INJ TRNFRM EPID CERV THOR 1LVL $342.00

INJ TRNFRM CER THOR EA ADDL $277.00

INJ TRNFRM EPID LUM SNGL 1LVL $342.00

INJ TRNFRM EPID LUM SAC EA ADD $218.00

INTRO CATH VEIN $92.00


Surgical


INJ PSEUDOANEURYSM EXTREMITY PERC $390.00

TPM INSERTION $1,288.00

REPOSITION PPM DEFIB LEAD $3,540.00

INTRO CATH RT HRT MAIN PA $2,003.00

THROMB ONLY ART NON COR $8,202.00

THROMB ONLY ART ADDL $2,681.00

THROMB W INTERVENTION $980.00

THROMB ONLY VENOUS $7,784.00

THROMB ONLY V REPEAT TX $6,556.00

CRYOABLATION RENAL TUMOR(S) UNILAT $17,740.00

ABD PARACENTESIS W IMAGING $1,214.00

SURG INSERT PVA WPORT >5 $4,158.00

RMVL TUNNEL CVAD W SQ PORT $990.00

INJ FACET JNT CER THOR 1 LVL $369.00


INJ FACET JNT LUM SACRAL 1 LVL $373.00


PTA ILIAC INIT $11,735.00

STNT PTA ILIAC INIT $11,903.00

PTA ILIAC IPSILAT EA ADD $11,735.00

STNT PTA ILIAC IPSILAT EA ADD $11,903.00

PTA FEM POP ART $11,903.00

ATH PTA FEM POP ART $25,269.00

STNT PTA FEM POP ART $25,269.00

STNT ATH PTA FEM POP ART $43,763.00

PTA TIB PRNL ART INIT $11,903.00

ATH PTA TIB PRNL ART INIT $25,269.00

STNT PTA TIB PRNL ART INIT $25,269.00

STNT ATH PTA TIB PRNL ART INIT $43,763.00

PTA TIB PRNL ART EA ADD $11,903.00

ATH PTA TIB PRNL ART EA ADD $25,269.00

STNT PTA TIB PRNL ART EA ADD $11,903.00

STNT ATH PTA TIB PRNL EA ADD $11,903.00

INS CATH RENAL ART 1ST UNILAT $1,105.00

INS CATH RENAL ART 1ST BILAT $1,435.00

CHEST TUBE INSERTION $811.00

INS CATH RENAL ART 2ND+ UNILAT $7,726.00

PICC LINE INSERTION $1,519.00

INS CATH RENAL ART 2ND+ BILAT $8,039.00

NONSEL THORACIC AORTA W ANGIO $3,981.00

SEL CAR INNOM UNI EXTRACR WAN $2,455.00

SURG SEL CATH CAROTID INNOM ART UNIL W ANG INCL S&I $2,455.00

SURG SEL CATH INT CAROTID UNIL W ANG INTRACRN ART INCL S&I $2,455.00

SEL SUBCLAVIAN IMMOM UNI WAN $5,384.00

SEL VERTEBRAL ART UNI WANGIO $1,868.00

SEL XTRNL CAROTID UNI WANGIO $1,868.00


Surgical


SEL EA ADD INTRACRANIAL UNI $856.00

FOREIGN BODY RETRIEVAL PERC $3,884.00

THROM THPY ART NON-COR INT DAY $1,399.00

THROM THPY VENOUS INF INT DY $1,235.00

THROM THPY INFS NON-COR SUB DY $864.00

THROM NON COR SUB DY CATH RMV $507.00

EMBOL POP TIB PERON LEG $6,235.00

THROMB VEIN-ILIAC FEMPOP $6,465.00

THROMBECTOMY DIR WCATH $6,235.00

SELECT CATH PLACE BILAT $1,435.00

REMOVE INTRAVAS VC FILTER $4,786.00

TRANSCATH BIOPSY $803.00

EMBOLECT ART AXILLAR ARM $6,235.00

EMBOLECT ARTERY INC FEMPOP BIL $6,235.00

STNT ANGIO OPEN PERC INT ARTERY $1,754.00

STNT ANGIO OPEN PERC ADDL ARTERY $819.00

STNT ANGIO OPEN PERC INT VEIN $1,229.00

STNT ANGIO OPEN PERC ADDL VEIN $571.00

EMBOL OCCL VENOUS NOT HEMORRHAGE $14,598.00

EMBOL OCCL ARTERIAL NOT HEMORR TUMR $24,587.00

EMBOL OCCL TUMORS ORGAN $31,040.00

EMBOL OCCL ART VEN HEMORR LYMP EXTRAV $21,734.00

INTRO NDL CATH ART CAR VER BIL $1,862.00

INJ THROMBIN PSEUDOANEURYSM $390.00

KYPHOPLASTY PERC THORACIC WIMG $20,730.00

KYPHOPLASTY PERC LUMBAR WIMG $23,065.00

EMBO THROMBOLECTOMY RADIAL OR ULNAR ART BY INCISION $6,235.00

INSERT PERIPH VEN ACCESS DEV WPORT <5 YEARS OF AGE $4,158.00

THROMBOLYSIS CEREBRAL IV INFUSION $1,213.00

EXCHANGE INTRAOCULAR LENS $2,697.00

SURG INTRO DIALYSIS CIRCUIT W ANGIO $2,843.00

SURG INTRO DIALYSIS CIRCUIT W ANGIO & ANGIOPLASTY $3,426.00

SURG THROMBECTOMY DIALYSIS CIRCUIT $4,980.00

SURG THROMBECTOMY DIALYSIS CIRCUIT W ANGIOPLASTY $3,408.00

SURG ANGIOPLASTY INITIAL ARTERY OCCLUSIVE DISEASE $7,283.00

SURG ANGIOPLASTY INITIAL ARTERY OCCLUSIVE DISEASE ADDL ART $1,175.00

SURG ANGIOPLASTY VEIN INITIAL $7,283.00

ESOPHAGOSCOPY $992.00

FEEDING TUBE INSERT REM'L $339.00

ESOPHAGOSCOPY WBX $1,331.00

UPPER ENDOSCOPY WITH SCLEROTHERAPY $1,749.00

POUCHOSCOPY $970.00

POUCHOSCOPY W BIOPSY $1,293.00

SURG ANGIOPLASTY VEIN ADDL VEIN $1,838.00

ABD PARACENTESIS WO IMAGING $557.00

SURG BLOOD PATCH $744.00


Surgical


THORACENTESIS WO IMAGING $1,037.00

PUNCTURE ASPIRATION ABCESS HEM $357.00

BONE BX SUP $645.00

BIOP BONE TROCAR NDL DEEP $2,040.00

SURG INJ SINUS TRACT DIAGNOSTIC $441.00

SURG BIOP PLEU PERC NEEDLE $568.00

BIOPSY LUNG PERCUTANEOUS NDL $1,723.00

CT BIOPSY LIVER $1,474.00

BX LIVER NEEDLE BIOPSY $1,399.00

ABLATION RF LIVER TUMOR 1 OR MORE $15,042.00

SURG NDLE BIOPSY PANCREA $2,006.00

SURG RENAL BIOP PERC NDLE TRO $2,264.00

SURG RENAL CYST ASPIRATION $357.00

SURG ARTHROCENTESIS ASP INJ MJR JNT BURSA WO US GUID $226.00

DIAG BONE MARROW BIOPSY 38221 $251.00

CRYOABLATION LIVER $22,760.00

BIOPSY MUSCLE PERC NEEDLE $898.00

ABLATION RF RENAL TUMOR 1 OR MORE UNI $10,372.00

RF ABLATION PULM TUMOR 1 OR MORE UNI $7,777.00

DIAGNOSTIC BONE MARROW BIOPSY $251.00

PL DEV MKR RAD THPY ABD PEL PE $1,651.00

INJ CELIAC PLEXUS $313.00

DRAIN FLUID COL CATH SFT TISSUE PERC $2,799.00

VERTEBROPLASTY PERC INJ EA ADDL WIMG $2,754.00

KYPHOPLASTY PERC EA ADDL WIMG $12,519.00

SCLEROTHERAPY FLUID COLLECTION PERQ $2,616.00

SURG DX BONE MARROW BX AND ASPIRATION $380.00

BRONCHOSCOPY WASH BRUSH $2,157.00

BX BREAST W DVC MR GUIDE 1ST LSN $575.00

PL LOC DVC BREAST 1ST LSN MR GUID $1,164.00

PL LOC DVC BREAST ADDL LSN MR GUID $923.00

NM INJ PROC SENTINEL NODE $114.00

INJ TRNFRM EPID CERV THOR 1LVL $679.00

INJ TRNFRM CER THOR EA ADDL $550.00

INJ TRNFRM EPID LUM SNGL 1LVL $679.00

INJ TRNFRM EPID LUM SAC EA ADD $437.00

SURG INJ SI JOINT UNILAT $591.00

INJ FACET JNT CERVICAL/THORACIC 1 LEVEL $809.00

INJ FACET JNT CERVICAL/THORACIC 2 LEVELS $809.00

INJ FACET JNT CERVICAL/THORACIC 3 LEVELS $887.00

INJ FACET JTN LUMBAR/SACRAL 1 LEVEL $809.00

INJ FACET JTN LUMBAR/SACRAL 2 LEVELS $809.00

PERC INTRADISC ELECTROTHERMAL ANNULOPLASTY 1 LEVEL $806.00

INJ TRANSFORAMINAL EPIDURAL W IMG LUM/SAC 1 LEVEL $453.00

INJ TRANSFORAMINAL EPIDURAL W IMG LUMSAC EA ADD LVL $453.00

INJ SACROILIAC JNT W IMAGING $295.00


Surgical


INJ TRANSFORAMINAL EPIDURAL W IMG CERV/THOR 1 LEVEL $809.00

INJ ANES STELLATE GANGLION CERV SYMPATHETIC $809.00

INJ TRANSFORAMINAL EPIDURAL W IMG CERV/THOR EA ADD LVL $679.00

NERVE ABLATION LUMBAR/SACRAL 1 LEVEL $680.00

NERVE ABLATION LUMBAR/SACRAL 1 LEVEL $1,021.00

NERVE ABLATION LUMBAR/SACRAL EA ADD LEVEL $674.00

NERVE ABLATION CERVICAL/THORACIC 1 LEVEL $680.00

NERVE ABLATION CERVICAL/THORACIC 1 LEVEL $1,021.00

NERVE ABLATION CERVICAL/THORACIC EA ADD LEVEL $674.00

DECLOTTING VASCULAR DEVICE $317.00

INJ JNT MAJOR $213.00

INJ DISCOGRAPHY LUMBAR/SACRAL EA LEVEL $794.00

SURG INJ SI JOINT UNILAT $1,180.00

HIP ARTHROGRAPH INJ $574.00

SURG ARTHROCENTESIS ASP INJ MJR JNT BURSA WO US GUID $453.00









INJ ANES AGENT LUMBAR THORACIC $1,112.00

INJ SINGLE TENDON INSERTION $160.00

DESTROY CERV THOR FACET JNT $447.00

DESTROY CERV THOR FACET JNT $897.00

DESTROY C TH FACET JNT ADDL $298.00

DESTROY C TH FACET JNT ADDL $595.00

DESTROY LUMB SAC FACET JNT $447.00

DESTROY LUMB SAC FACET JNT $897.00

DESTROY L S FACET JNT ADDL $298.00

DESTROY L S FACET JNT ADDL $595.00

TENOTOMY ELBOW LAT MEDIAL PERCUTANEOUS $4,304.00

TAP BLOCK BILATERAL BY INJECTION $401.00

TENOTOMY PERCUTANEOUS ACHILLES TENDON $2,884.00

SURG INJ IL NDL CATH CERV THOR W GUID $899.00

SURG INJ IL NDL CATH LUMB SACR W GUID $709.00

SURG INJ IL NDL CATH LUMB SACR WO GUID $525.00

PL DEV MKR RAD THPY PROST $2,203.00

BIOPSY BONE $635.00

SURG CHEST TB PLACE OPEN PROC $665.00

SURG PLEURAL CATH INS PERM TUN $840.00

SURG REML PLEURAL TUN CATH $677.00

SURG SCLEROSIS FLUID COLL ABD $1,243.00

SURG CHG CENTRAL CVA $778.00


Surgical


SURG G-TUBE PLMT $4,071.00

SURG G CECOSTOMY TUBE CHANGE $2,277.00

SURG REPL CHG GJ TUBE $2,079.00

SURG REPL CHG J TUBE $2,071.00

SURG INTRO LONG GI TUBE $232.00

SURG GB DRAIN PERC CHOLE $1,250.00

SURG DILTN BIL STRIC WO $1,083.00

BIOPSY ABDOMEN RETRO PERC NDL $612.00

BREAST RECONSTRUCTION $601.00

SURG INS PERITONEAL PORT $4,293.00

SURG RMVL PERITONEAL TUN CATH $1,392.00

SURG ABCS DRAN CATH CHG $2,117.00

BIOPSY THYROID PERC CORE NDL $419.00

CTCISTRNL LAT CER PUN WIN $513.00

SURG DSC INJ LMBR EA LEV $734.00

SURG DISC INJ C T EA LEV $1,072.00

SURG DISC ASPIRATION $948.00

SURG CYSTOGRAPHY INJ $185.00

HYSTERO INJ $379.00

SURG SPINAL PUNCTURE LUMBAR DIAG $360.00

SURG INJ MYELOGRAPHY AND OR CT LUMBAR $320.00

SHOULDER ARTHRO INJ $897.00

SURG INJ SIALOGRAPHY $180.00

ELBOW ARTHROGRAP INJ $268.00

WRIST ARTHR INJ $324.00

NASOGSTRIC TUBE PLMT STM $415.00

SURG R&R URETERAL STNT PERQ $4,279.00

SURG REM'L URETRL STENT $2,499.00

SURG R&R NPHROURETR STNT $2,077.00

SURG REM'L NEPH TUBE FLO $1,133.00

R&R STNT CHG IL $244.00

SURG J TUBE PLMT PERC $3,474.00

SURG CNTRST INJ ASSMT ABSCESS OR CYST VIA DRG CATH TUBE $528.00

BIOPSY LYMPH NODE $625.00

SURG SCLEROSIS LYMPHOCELE $223.00

SURG CONVERT G TO GJ TUBE $2,909.00

SURG MECH REML OBST G GJ J TBE $2,384.00

SURG INJ G J GJ TUBE $586.00

INJ SINGLE TENDON LIGAMENT $236.00

ASP BLADDER W INSERT SUPR CATH $1,077.00

PUNCT ASP HYDROCELE TUNICA $423.00

SURG ARTHROCENTESIS ASP INJ SM JNT BURSA WO US GUID $414.00

PLCMNT PERITONEAL CATH TUN $5,163.00

LYSE CHEST FIBRIN INIT DAY $811.00

THORACENTESIS W IMAGING $2,435.00

PLEUR DRAIN PLACEMENT W IMAGING $345.00


Surgical


ASP OF GANGLION CYST(S) $405.00

SURG INJ ANKLE ARTHROGRAPHY $326.00

REPOS INTRAVAS VC FILTER $3,884.00

INJ AIR CONTRAS PERI CAV $140.00

INJ URETER PYELOGRAPHY $225.00

INJ URETER PYELOGRAPHY $225.00

SPINAL PUNC THERAPEUTIC $343.00

INJECT ANES GANGLION SPHENOPALATINE $378.00

DESTRUCTION CELIAC PLEXUS $1,132.00

UNLIST PROC NERVOUS SYS $509.00

DRAIN FLUID COL CATH VISCERAL PERC $3,138.00

DRAIN FLUID COL CATH RETRO PERITON PERC $3,137.00

PL LOC DVC BREAST 1ST LSN MAMMO GUID $431.00

PL LOC DVC BREAST ADDL LSN MAMMO GUID $226.00

PL LOC DVC BREAST 1ST LSN STEREO GUID $436.00

PL LOC DVC BREAST ADDL LSN STEREO GUID $272.00

ADJUST GASTRIC BAND $811.00

BIOPSY TISSUE NECK THORAX $949.00

ARTHROCENT ASP INJ JT BURSA SMALL W US $250.00

ARTHROCENT ASP INJ JT BURSA MAJOR W US $414.00

VERTEBROPLASTY PERC INJ CERVIOTHOR W IMG $4,304.00

VERTEBROPLASTY PERC INJ LUMBOSACRAL WIMG $3,978.00

SURG CERV MYELOGRAPHY LUMB INJ INCL S&I $882.00

SURG THOR MYELOGRAPHY LUMB INJ INCL S&I $1,618.00

SURG LUMB MYELOGRAPHY LUMB INJ INCL S&I $869.00

SURG MYELOGRAPHY LUMB INJ 2 + REGIONS INCL S&I $903.00

INJ PROC/PLACE CONTRAST/CHAIN URETHROCYSTOGRAPHY $185.00

CYSTO/URETERO TX URETERAL STRICTURE $676.00

CYSTOURETHROSCOPY W/URETERAL CATH $242.00

PNEUMONOSTOMY OPEN DRAINAGE ABSCESS/CYST $1,959.00

INCISION AND REMOVAL FOREIGN BODY SUBQ SIMPLE $261.00

VENIPUNCTURE NON ROUTINE >3YRS $27.00

SURG INJ CHOLANGIOGRAPHY PERC COMPL DX INCL IMG GUID INCL S&I $1,340.00

INJ CHOLANGIOGRAM NEW ACCESS PERQ $2,945.00

PLMT BILIARY DRAINAGE CATH EXTERNAL PERQ $4,807.00

PLMT BILIARY DRAINAGE CATH INTERNAL-EXT PERQ $4,741.00

CONVERT EXT BIL DRG CATH TO INTERNAL-EXT PERQ $3,973.00

EXCHANGE BILIARY DRAINAGE CATH PERQ $2,932.00

REMOVAL BILIARY DRAINAGE CATH PERQ $1,451.00

PLMT BILE DUCT STENT(S) EXISTING ACCESS PERQ $16,166.00

PLMT BILE DUCT STENT(S) NEW ACCESS WO CATH PERQ $17,669.00

PLMT BILE DUCT STENT(S) NEW ACCESS W CATH PERQ $18,376.00

PLMT ACCESS BIL TREE SM BOWEL NEW ACCESS PERQ $4,243.00

BALLOON DILATE EA BILIARY DUCT AMPULLA PERQ $1,856.00

ENDOLUMINAL BX BILIARY TREE SINGLE MULTIPLE PERQ $4,778.00

REMOVAL CALCULI DUCT GALLBLADDER PERQ $2,918.00


Surgical


INJ NEPHROSTOGRAM URETEROGRAM NEW ACCESS $1,874.00

INJ NEPHROSTOGRAM URETEROGRAM EXIST ACCESS $339.00

PLMT NEPHROSTOMY CATHETER PERQ $3,025.00

PLMT NEPHROURETERAL CATHETER PERQ NEW ACCESS $3,087.00

CONVERT NEPHROSTOMY CATHETER PERQ VIA EXIST $3,235.00

BRONCHOSCOPY TRNSBRONC BX $1,128.00

BRONCHOSCOPY WASH BRUSH $846.00

EXCHANGE NEPHROSTOMY CATH PERQ $1,697.00

ENDOLUMINAL BX URETER RENAL PELVIS NON ENDO $1,901.00

PLMT URETERAL STENT PERQ PRE EXIST TRACT $3,802.00

PLMT URETERAL STENT PERQ NEW ACCESS WO SEP CATH $4,190.00

PLMT URETERAL STENT PERQ NEW ACCESS W SEP CATH $5,108.00

BALLOON DILATE URETERAL STRICTURE $2,750.00

PLACE LOCALIZ DEV SOFT TISSUE W GUIDE 1ST LES $835.00

SURG INJ IL NDL CATH CERV THOR WO GUID $378.00

ART CATH MON TRANS SEP PROC $174.00

BRONCH WALVEOLAR LAVAGE $585.00

BRONCH WREMOVAL FGN BDY $1,832.00

SURG BRONCH DX W CELL WASH IF PERF $846.00

BRONCH WITH ENDOBRONCHIAL BX $1,832.00

BRONCH RIGID/FLEX EBUS SAMPLING 1 OR 2 NODE $3,282.00

BRONCH RIGID/FLEX EBUS SAMPLING 3 OR MORE NODES $3,489.00

BRONCH RIGID/FLEX EBUS INTERVEN PERIPH LES $525.00

BRONCH W NEEDLE ASP SINGLE LOBE $3,919.00

BONY SPUR EXCISION $3,001.00

BUNIONECTOMY $2,744.00

FOREIGN BODY RMVL $1,019.00

HAMMER TOES $3,001.00

PTERYGIUM PTOSIS $3,379.00

VITRECTOMY $6,569.00

BLEPHAROPLASTY $2,002.00

CATARACT W PHACO $3,666.00

GANGLION EXCISION $1,534.00

TRABECULECTOMY $3,379.00

AMPUTATION MINOR $2,306.00

DISCISSION CATARACT LASER SURG $1,171.00

EXTRACAP CATARACT REMVL WINS $3,666.00

OR CASE LEVEL 1 $2,550.00

RPR ECTROPION EXTENSIVE $2,004.00

RPR ECTROPION EXTENSIVE $4,005.00

EXC EYELID LESION $2,007.00

RPR ENTROPION EXTENSIVE $2,004.00

RPR ENTROPION EXTENSIVE $4,008.00

REMOVE SKIN TAG <15 $259.00

NASAL ENDOSCOPY DIAGNOSTIC $600.00

NASAL ENDOSCOPY DIAGNOSTIC $1,199.00


Surgical


CONJUNSTIVOPLASTY $2,564.00

CONTROL HEMORRHAGE $403.00

ECTROPION $2,037.00

INSERT ANT SEGMENT DRAIN INTIAL $5,968.00

REMOVE FB EXT EYE CORNEAL WO SLIT LAMP $1,000.00

EXCISION OR TRANSPOSITION OF PTERYGIUM WO GRAFT $1,540.00

KERATOPLASTY ANTERIOR LAMELLAR $3,585.00

KERATOPLASTY PENETRATING $3,973.00

KEROTOPLASTY PENETRATING APHAKIA $3,975.00

KEROTOPLASTY PENETRATING PSEUDOPHAKIA $3,972.00

KEROTOPLASTY ENDOTHELIAL $3,711.00

REMOVE IMPLANTED MATERIAL ANT SEGMENT OF EYE $3,379.00

INJ ANT CHAMBER OF EYE AIR OR LIQUID $1,653.00

FISTULIZATION SCL GLAUC TRABCTOMY AB EXTERNO NO PREV SURG $3,379.00

FISTULA SCL GLAUC TRABCTOMY AB EXTERNO PREV SURG TRMA $3,379.00

REV RPR OP WND ANT SEG EARLY LATE MAJOR OR MINOR $1,653.00

IRIDOTOMY IRIDECTOMY BY LASER $1,050.00

IRIDOTOMY IRIDECTOMY BY LASER $2,098.00

REPOSITION IOL PROSTHESIS WINCISION $3,281.00

REMOVE LENS MATERIAL ASP TECHNIQUE 1 OR MORE STAGES $2,316.00

INSERT IOL PROSTHESIS SECONDARY $3,666.00

REMOVE VITREOUS ANT APPROACH PARTIAL $2,145.00

INJ VITREOUS SUBS PARS PLANA OR LIMBAL APPR WWO ASP $2,088.00

SEVER VITREOUS STRANDS FACE ADH SHEETS MEM OPAC LASER $1,050.00

EXCISION CHALAZION SINGLE $557.00

EXCISION OF CHALAZION GEN ANES REQ HOSP SNGL OR MULT $2,004.00

EXCISION EYELID LESION SIMPLE CLOSURE OR NO CLOSURE $1,342.00

REPAIR BROW PTOSIS $2,683.00

REPAIR BROW PTOSIS $5,364.00

REPAIR BLEPHAROPTOSIS LEVATOR RESEC OR ADVNC INT APPROACH $2,004.00

REPAIR BLEPHAROPTOSIS LEVATOR RESEC OR ADVNC INT APPROACH $4,008.00

REPAIR BLEPHAROPTOSIS CONJ-TARSO-MULLER LEVATOR RESECT $2,004.00

REPAIR BLEPHAROPTOSIS CONJ-TARSO-MULLER LEVATOR RESECT $4,008.00

REDUCTION OVERCORRECTION OF PTOSIS $1,454.00

REPAIR ENTROPION SUTURE $2,004.00

REPAIR ENTROPION EXCISION TARSAL WEDGE $2,004.00

EXC RPR EYELID WMARGIN TARSUS CONJ CANTHUS FULL THICK $2,007.00

EXCISION LESION CONJUNCTIVA UP TO 1 CM $1,745.00

SUBCONJUNCTIVAL INJECTION $114.00

BIOPSY LACRIMAL GLAND $2,004.00

PLASTIC REPAIR OF CANALICULI $2,675.00

PROBING NASOLACRIMAL DUCT W GEN ANES $4,005.00

PROBING NASOLACRIMAL DUCT W GEN ANES $2,004.00

PROBING NASOLACRIMAL DUCT INS TUBE STENT $2,004.00

OPTH EXAM EVAL GEN ANESTHESIA COMPLETE $1,745.00

TRANSPLANT AMNIOTIC MEMBRANE CORNEA $2,135.00


Surgical


REMOVE SUSTURE UNDER ANES OTHER THAN LOCAL SAME SURGEON $141.00

RPR LAC W TISSUE GLUE CORNEA AND OR SCLERA $1,851.00

REMOVE CORNEAL EPITHELIUM W APPL CHELATING AGENT $1,177.00

PLCMNT AMNIOTIC MEMBRANE OCULAR SURFACE WO SUTURES $4,426.00

PLCMNT AMNIOTIC MEMBRANCE OCULAR SURFACE SINGLE LAYER SUTURE$3,890.00

REPAIR ECTROPION VIA SUTURE $951.00

REPAIR ECTROPION BILATERAL $4,074.00

BLEPHAROPLASTY BILATERAL $4,005.00

CORRECTION PTOSIS BILATERAL $4,074.00

INJECTION VITREOUS SUBSTITUTE FLUID GAS EXCHANGE $2,088.00

KERATOPLASTY CT ENDOTHELIAL $3,711.00

BIOPSY OF CONJUNCTIVA $643.00

DESTRUCTION LESION CONJUNCTIVA $586.00

KERATECTOMY $2,143.00

RECON EYELID FULL THICKNESS UP TO TWO THIRDS LID 1 STG 1ST STG $2,665.00

RECON EYELID FULL THICKNESS UP TO TWO THIRDS LID 1 STG 1ST STG $5,330.00

IRIDECTOMY PERIPHERAL $1,277.00

EXC LESION CORNEA XCP PTERY $1,792.00

TEMP CLOSURE EYELID BY SUTURE $291.00

RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR $2,275.00

RECONSTRUCT EYELID FULL THICKNESS TOTAL LID LOWER 1 STAGE FIRST STAGE$2,665.00

RECONSTRUCT EYELID FULL THICKNESS TOTAL LID LOWER 1 STAGE FIRST STAGE$5,330.00

EXC RPR EYELID > ONE QUARTER LID MARGIN $2,665.00

EXC RPR EYELID > ONE QUARTER LID MARGIN $5,330.00

CANTHOPLASTY (RECONSTRUCT CANTHUS) $2,665.00

CANTHOPLASTY (RECONSTRUCT CANTHUS) $5,330.00

CORRECTION LAGOPHTHALMOS WIMPLANT UPPER EYELID LID LOAD $2,665.00

CORRECTION LAGOPHTHALMOS WIMPLANT UPPER EYELID LID LOAD $5,330.00

CORRECTION LID RETRACTION $2,665.00

CORRECTION LID RETRACTION $5,330.00

ENUCLEATION EYE WIMPLANT MUSCLES ATTACHED TO IMPLANT $4,633.00

ENUCLEATION EYE WIMPLANT MUSCLES ATTACHED TO IMPLANT $9,265.00

EVISCERATION OCULAR CONTENTS WIMPLANT $4,633.00

EVISCERATION OCULAR CONTENTS WIMPLANT $9,265.00

LAT CANTHOPEXY $2,200.00

LAT CANTHOPEXY $4,400.00

MOHS MICRO TECH STAGE 1 SPECIMEN $75.00

MOHS ADDL STAGE 5 TISS BLKS HEAD $529.00

MOHS MICRO TECH STAGE 1 HEAD $1,315.00

GRAFT DERMA-FAT-FASCIA $3,996.00

FULL THICKNESS GRFT FREE WCLOSURE DONOR SITE NOSE EARS EYELIDS LIPS 2$2,444.00

ADJ TISSUE XFER REARRANGE EYELIDS NOSE EARS LIPS DEFECT 10 SQ CM <$2,444.00

DACRYOCYSTORHINOSTOMY (FISTULIZATION LACRIMAL SAC TO NASAL CAVITY)$4,633.00

DACRYOCYSTORHINOSTOMY (FISTULIZATION LACRIMAL SAC TO NASAL CAVITY)$9,265.00

SURG PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX $547.00

INSERT ANTERIOR SEGMENT AQUEOUS DRAIN DEVICE, INTO SUPRACILIARY SPACE$6,569.00


Surgical


INS DRAIN, W/O EXTRAOCULAR RESERVOIR, INT APPROACH SUBJ SPACE; INIT$5,912.00

TRAN DIL AQ OUT CAN WO RET DE $5,422.00

GONIOTOMY $3,043.00

CONJUNCTIVAL FLAP TOTAL GUNDERSON THIN FLAP PURSE STRING FLAP$2,666.00

BLEPHAROPLASTY LOWER EYELID $2,445.00

BLEPHAROPLASTY LOWER EYELID $4,890.00

BLEPHAROPLASTY LOWER EYELID WEXTNSV HERNIATED FAT PAD $2,445.00

BLEPHAROPLASTY LOWER EYELID WEXTNSV HERNIATED FAT PAD $4,890.00

DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION $519.00

RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS $2,898.00

RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS $2,898.00

SKIN FULL GRFT FACE/GENIT/HF $2,328.00

EXC LESN SCLERA $2,539.00

PHAKIC IOL, VISIAN LENS $1,709.00

REFRACTIVE LENS EXCHANGE WMONO LENS, REG LENS $1,874.00

REFRACTIVE LENS EXCHANGE W/ TORIC LENS, EACH EYE $2,310.00

REFRACTIVE LENS EXCHANGE W/MULTIFOCAL OR SYMFONY LENS, EACH EYE$2,751.00

PLACEMENT AMNIOTIC MEMBRANE USING TISSUE GLUE $1,340.00

EXC LESN CONJUNCTIVA > 1 CM $2,997.00

ANT SEG INSERT DRAIN WO RS $6,569.00

RPR IRIS CILIARY BODY (AS IRIDODIALYSIS) $3,189.00

RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT $3,189.00

AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT $5,972.00

STROBOSCOPIC EVALUATION 31579 $732.00

ESOPHAGOSCOPY W ABLATION $1,105.00





OR ROOM 15 MIN $1,160.00

OR CASE LEVEL 1 ADDL 15 MIN $1,160.00

OR CASE LEVEL 2 ADDL 15 MIN $1,251.00

REMOVE TONSILS AND ADENOIDS > 12 YEARS $3,212.00

TYMPANOSTOMY W/VENT TUBE REQUIRE ANES $2,221.00

OR EMERGENT CASE $3,189.00

OR EMERGENT CASE ADDITIONAL MINUTES $1,448.00

INJECTION SUBCONJUCTIVAL $116.00

INSTILLATION AGENT FOR PLEURODESIS $758.00

AMNIOCENTESIS ANY METHD $226.00

PUBS $624.00

PUNCTURE ASPIR BREAST CYST $217.00

PUNCTURE ASP BREAST EACH ADDL $181.00

INSERT TUN CATH WO PORT<5 $4,815.00

BIOP SALIVARY GLAND NDLE $392.00

ASP INJ THYROID CYST $399.00

BX BREAST W DVC US GUIDE 1ST LSN $239.00


Surgical


BX BREAST W DVC US GUIDE ADDL LSN $113.00

PL LOC DVC BREAST 1ST LSN US GUID $626.00

PL LOC DVC BREAST ADDL LSN US GUID $526.00

BX LYMPH NODES(S) SUPERFICIAL OPEN $1,020.00

ABLATION FIBROADENOMA CRYO W US EA $5,858.00

DRN OVARIAN CYST VAG $949.00

SURG DRAIN HEMATOMA SEROMA $179.00

INCI REMOVE FORGN BODY COMPLIC $516.00

EXC LESN BGN TRUNK ARM <0.5CM $440.00


Documents

Surgical - Bozeman HealthSurgical PROCEDURE NAME UNIT PRICE INJ PSEUDOANEURYSM EXTREMITY PERC $390.00 TPM INSERTION $1,288.00 REPOSITION PPM DEFIB LEAD $3,540.00 INTRO CATH RT HRT