Medical City Surgery Center - Southlake

Provider Information

Services

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,750

• Breast MRI

  SSP RA011

  up to

  $293

• Bronchoscopy

  SSP PU000

  up to

  $2,286

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,786

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,535

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,613

• Colonoscopy

  SSP GA002

  up to

  $1,539

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,367

• CT

  SSP RA001

  up to

  $490

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $498

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $948

• Fetal MRI

  SSP RA006

  up to

  $377

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $647

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $670

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $4,928

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $3,215

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $8,023

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $4,907

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $3,602

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $4,996

• MRI with Contrast

  SSP RA007

  up to

  $504

• MRI without Contrast

  SSP RA005

  up to

  $409

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $1,326

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $7,453

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $4,733

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $2,513

• Ultrasound

  SSP RA008

  up to

  $206

• X-Ray

  SSP RA000

  up to

  $128