Delta Community Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $7,693

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,799

• Breast MRI

  SSP RA011

  up to

  $6,018

• Breast Ultrasound

  SSP RA012

  up to

  $2,554

• Bronchoscopy

  SSP PU000

  up to

  $1,326

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,041

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,264

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,695

• Colonoscopy

  SSP GA002

  up to

  $4,321

• CT

  SSP RA001

  up to

  $2,359

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,175

• Delivery - Cesarean

  SSP OB002

  up to

  $14,874

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,137

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,016

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,570

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $5,573

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $4,902

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $15,213

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,064

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $7,244

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $9,487

• Mammogram

  SSP RA010

  up to

  $502

• MRI with Contrast

  SSP RA007

  up to

  $1,675

• MRI without Contrast

  SSP RA005

  up to

  $1,371

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $5,666

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $18,297

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $4,949

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $5,061

• Ultrasound

  SSP RA008

  up to

  $1,295

• X-Ray

  SSP RA000

  up to

  $1,709