Baylor Scott & White Medical Center - Sunnyvale

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $9,686

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $3,560

• Breast Ultrasound

  SSP RA012

  up to

  $216

• Bronchoscopy

  SSP PU000

  up to

  $4,847

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,943

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,983

• Colonoscopy

  SSP GA002

  up to

  $3,429

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,983

• CT

  SSP RA001

  up to

  $2,846

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,568

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,983

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,104

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $2,668

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $14,396

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $10,658

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $10,142

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $15,088

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $9,686

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $16,436

• Mammogram

  SSP RA010

  up to

  $150

• MRI with Contrast

  SSP RA007

  up to

  $2,609

• MRI without Contrast

  SSP RA005

  up to

  $4,385

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,904

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $20,528

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $2,983

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $9,174

• Ultrasound

  SSP RA008

  up to

  $619

• X-Ray

  SSP RA000

  up to

  $617