Amery Hospital & Clinic

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $12,038

• Breast MRI

  SSP RA011

  up to

  $2,552

• Breast Ultrasound

  SSP RA012

  up to

  $812

• Bronchoscopy

  SSP PU000

  up to

  $20,061

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,625

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,737

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $3,225

• Colonoscopy

  SSP GA002

  up to

  $4,754

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,856

• CT

  SSP RA001

  up to

  $3,137

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,753

• Delivery - Cesarean

  SSP OB002

  up to

  $35,428

• Delivery - Vaginal

  SSP OB001

  up to

  $33,535

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,927

• Fetal MRI

  SSP RA006

  up to

  $1,481

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,744

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $983

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $9,539

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $8,863

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $20,240

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,883

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $12,944

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $14,943

• Mammogram

  SSP RA010

  up to

  $590

• MRI with Contrast

  SSP RA007

  up to

  $5,880

• MRI without Contrast

  SSP RA005

  up to

  $4,035

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,371

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $16,736

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $5,787

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $5,549

• Ultrasound

  SSP RA008

  up to

  $1,239

• X-Ray

  SSP RA000

  up to

  $704