Boone County Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $10,516

• Breast MRI

  SSP RA011

  up to

  $4,059

• Breast Ultrasound

  SSP RA012

  up to

  $954

• Bronchoscopy

  SSP PU000

  up to

  $15,399

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,516

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,496

• Colonoscopy

  SSP GA002

  up to

  $4,272

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,664

• CT

  SSP RA001

  up to

  $3,022

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $4,482

• Delivery - Cesarean

  SSP OB002

  up to

  $8,311

• Delivery - Vaginal

  SSP OB001

  up to

  $8,432

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,002

• Fetal MRI

  SSP RA006

  up to

  $1,713

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,528

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $975

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $7,687

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $6,568

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $6,383

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $5,387

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $6,653

• Mammogram

  SSP RA010

  up to

  $666

• MRI with Contrast

  SSP RA007

  up to

  $7,700

• MRI without Contrast

  SSP RA005

  up to

  $5,441

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,450

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $12,311

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $6,057

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,413

• Ultrasound

  SSP RA008

  up to

  $1,374

• X-Ray

  SSP RA000

  up to

  $733