Elmore Community Hospital

Provider Information

Services

• Breast Ultrasound

  SSP RA012

  up to

  $128

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,992

• Colonoscopy

  SSP GA002

  up to

  $1,415

• CT

  SSP RA001

  up to

  $554

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $442

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,112

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $413

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $4,235

• Mammogram

  SSP RA010

  up to

  $196

• MRI with Contrast

  SSP RA007

  up to

  $1,508

• MRI without Contrast

  SSP RA005

  up to

  $1,045

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,099

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,892

• Ultrasound

  SSP RA008

  up to

  $228

• X-Ray

  SSP RA000

  up to

  $280