Ascension NE Wisconsin - St Elizabeth Campus

Provider Information

Services

• Breast MRI

  SSP RA011

  up to

  $2,808

• Breast Ultrasound

  SSP RA012

  up to

  $493

• Bronchoscopy

  SSP PU000

  up to

  $2,672

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,300

• CT

  SSP RA001

  up to

  $1,319

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,579

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,589

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,558

• Mammogram

  SSP RA010

  up to

  $712

• MRI with Contrast

  SSP RA007

  up to

  $2,162

• MRI without Contrast

  SSP RA005

  up to

  $1,947

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,377

• Ultrasound

  SSP RA008

  up to

  $719

• X-Ray

  SSP RA000

  up to

  $384