Addison Gilbert Hospital

Provider Information

Services

• Breast MRI

  SSP RA011

  up to

  $1,859

• Breast Ultrasound

  SSP RA012

  up to

  $537

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,266

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,360

• Colonoscopy

  SSP GA002

  up to

  $3,010

• CT

  SSP RA001

  up to

  $2,220

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,053

• MRI with Contrast

  SSP RA007

  up to

  $2,665

• MRI without Contrast

  SSP RA005

  up to

  $2,842

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,199

• Ultrasound

  SSP RA008

  up to

  $978

• X-Ray

  SSP RA000

  up to

  $801