Childrens Mercy Adele Hall Campus

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $799

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $487

• Breast Ultrasound

  SSP RA012

  up to

  $713

• Bronchoscopy

  SSP PU000

  up to

  $743

• Carpal Tunnel Repair

  SSP NU002

  up to

  $732

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $1,422

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $549

• Colonoscopy

  SSP GA002

  up to

  $757

• Colonoscopy via Stoma

  SSP GA000

  up to

  $488

• CT

  SSP RA001

  up to

  $3,517

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $4,726

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $513

• Fetal MRI

  SSP RA006

  up to

  $2,853

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $135

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,895

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $809

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $1,135

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $1,455

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $2,428

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $1,183

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $1,288

• MRI with Contrast

  SSP RA007

  up to

  $1,993

• MRI without Contrast

  SSP RA005

  up to

  $1,766

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $679

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $1,525

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $413

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $432

• Ultrasound

  SSP RA008

  up to

  $378

• X-Ray

  SSP RA000

  up to

  $792