Cheshire Medical Center

Provider Information

Services

• Breast MRI

  SSP RA011

  up to

  $1,289

• Breast Ultrasound

  SSP RA012

  up to

  $127

• Bronchoscopy

  SSP PU000

  up to

  $894

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,109

• Colonoscopy

  SSP GA002

  up to

  $1,426

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,261

• CT

  SSP RA001

  up to

  $1,032

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $941

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,036

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $532

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $798

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $1,270

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $1,872

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $1,333

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $2,217

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $1,703

• Mammogram

  SSP RA010

  up to

  $153

• MRI with Contrast

  SSP RA007

  up to

  $2,297

• MRI without Contrast

  SSP RA005

  up to

  $1,424

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,618

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $3,332

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $1,150

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $1,212

• Ultrasound

  SSP RA008

  up to

  $408

• X-Ray

  SSP RA000

  up to

  $197