Baystate Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $4,100

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,689

• Breast MRI

  SSP RA011

  up to

  $924

• Breast Ultrasound

  SSP RA012

  up to

  $423

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,814

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,561

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,733

• Colonoscopy

  SSP GA002

  up to

  $3,497

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,104

• CT

  SSP RA001

  up to

  $937

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,155

• Delivery - Cesarean

  SSP OB002

  up to

  $17,270

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,928

• Fetal MRI

  SSP RA006

  up to

  $606

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $700

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $2,335

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $8,802

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $5,411

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $10,696

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $5,375

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $4,604

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $8,918

• MRI with Contrast

  SSP RA007

  up to

  $937

• MRI without Contrast

  SSP RA005

  up to

  $713

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,930

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $10,246

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,225

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,794

• Ultrasound

  SSP RA008

  up to

  $395

• X-Ray

  SSP RA000

  up to

  $352