Boone Memorial Health

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $7,378

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $3,594

• Breast MRI

  SSP RA011

  up to

  $1,316

• Breast Ultrasound

  SSP RA012

  up to

  $526

• Bronchoscopy

  SSP PU000

  up to

  $4,243

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,674

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,645

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,435

• Colonoscopy

  SSP GA002

  up to

  $3,233

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,215

• CT

  SSP RA001

  up to

  $1,931

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,326

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,072

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $3,009

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,160

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $12,239

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $7,939

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $9,760

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $7,866

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $12,593

• Mammogram

  SSP RA010

  up to

  $408

• MRI with Contrast

  SSP RA007

  up to

  $2,883

• MRI without Contrast

  SSP RA005

  up to

  $2,025

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,160

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $16,310

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $11,115

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $6,460

• Ultrasound

  SSP RA008

  up to

  $1,186

• X-Ray

  SSP RA000

  up to

  $378