Childrens Hospital Los Angeles

Provider Information

Services

• Breast Ultrasound

  SSP RA012

  up to

  $412

• Bronchoscopy

  SSP PU000

  up to

  $556

• Colonoscopy

  SSP GA002

  up to

  $10,636

• CT

  SSP RA001

  up to

  $2,274

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,511

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $11,561

• Fetal MRI

  SSP RA006

  up to

  $2,073

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $464

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $88

• MRI with Contrast

  SSP RA007

  up to

  $3,562

• MRI without Contrast

  SSP RA005

  up to

  $2,849

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $1,098

• Ultrasound

  SSP RA008

  up to

  $636

• X-Ray

  SSP RA000

  up to

  $622