Fayette Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $2,716

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,506

• Breast MRI

  SSP RA011

  up to

  $2,849

• Breast Ultrasound

  SSP RA012

  up to

  $466

• Bronchoscopy

  SSP PU000

  up to

  $2,970

• Carpal Tunnel Repair

  SSP NU002

  up to

  $2,389

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,798

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,433

• Colonoscopy

  SSP GA002

  up to

  $2,801

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,474

• CT

  SSP RA001

  up to

  $2,346

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,978

• Delivery - Cesarean

  SSP OB002

  up to

  $13,361

• Delivery - Vaginal

  SSP OB001

  up to

  $8,680

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,142

• Fetal MRI

  SSP RA006

  up to

  $1,181

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,571

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $2,438

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $12,478

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $2,816

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $18,721

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,855

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $3,681

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $12,978

• Mammogram

  SSP RA010

  up to

  $371

• MRI with Contrast

  SSP RA007

  up to

  $2,801

• MRI without Contrast

  SSP RA005

  up to

  $1,959

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,185

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $15,227

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $2,333

• Ultrasound

  SSP RA008

  up to

  $534

• X-Ray

  SSP RA000

  up to

  $345