Ascension Saint Thomas Rutherford Westlawn Hospital

Provider Information

Services

• Breast Ultrasound

  SSP RA012

  up to

  $173

• Bronchoscopy

  SSP PU000

  up to

  $1,861

• Colonoscopy

  SSP GA002

  up to

  $1,261

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,261

• CT

  SSP RA001

  up to

  $1,007

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,946

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,093

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,268

• Mammogram

  SSP RA010

  up to

  $244

• MRI with Contrast

  SSP RA007

  up to

  $1,516

• MRI without Contrast

  SSP RA005

  up to

  $1,147

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,537

• Ultrasound

  SSP RA008

  up to

  $366

• X-Ray

  SSP RA000

  up to

  $292