FHN Memorial Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $4,431

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,181

• Breast MRI

  SSP RA011

  up to

  $3,422

• Breast Ultrasound

  SSP RA012

  up to

  $671

• Bronchoscopy

  SSP PU000

  up to

  $1,818

• Carpal Tunnel Repair

  SSP NU002

  up to

  $2,558

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,674

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $999

• Colonoscopy

  SSP GA002

  up to

  $1,865

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,816

• CT

  SSP RA001

  up to

  $4,045

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $7,170

• Delivery - Cesarean

  SSP OB002

  up to

  $42,597

• Delivery - Vaginal

  SSP OB001

  up to

  $33,468

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,254

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,115

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,242

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $1,385

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $2,183

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $3,605

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $5,595

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $4,973

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $4,343

• Mammogram

  SSP RA010

  up to

  $390

• MRI with Contrast

  SSP RA007

  up to

  $6,464

• MRI without Contrast

  SSP RA005

  up to

  $4,991

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $1,542

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $4,990

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $1,274

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $1,362

• Ultrasound

  SSP RA008

  up to

  $924

• X-Ray

  SSP RA000

  up to

  $652