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Cost Estimator
Spanish Valley Clinic
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Cash Pricing
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Misc.
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Select a Service
Select a service.
You may need to get a specific service code from your provider.
Code
Description
Acromio/clavicular canvas&we
Cervical Foam Collar
Cervical, Flexible, Nonadjustable (Foam Collar)
CTLSO kyphosis pad
Elbow orthosis, double upright, arm cuffs, free motion
High compress bndge, elast/knit/wov, load resist >=1.35
Knee Immobilizer
Lt compres band <3”/yd
MCL Brace
Slings
Splint
Splint Roll 2" Ortho Glass Per Inch
WHO, w/o joints, soft interface, straps, cstm fab, fit/adjst
11302
Shaving of epidermal or dermal lesion, single lesion, trunk,
19081
Sterotactic BX Breast
29581
WOUND APPLY MULTILAYER COMPRESS BELOW CHARGE
36415
Bill Only Venous Draw
36430
IP BLOOD TRANSFUSION 2 Hr Charge
36430
IP BLOOD TRANSFUSION 3 Hr Charge
36430
IP BLOOD TRANSFUSION 4 Hr Charge
70160
Nasal Bones 3 View Complete
85610
PT/INR POC
85610
PT/INR POC
90460
IMMUNIZATION ADMIN, INITIAL (18 AND UNDER)
90636
Hep A-Hep B
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