Pascack Valley Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $10,606

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $3,208

• Breast MRI

  SSP RA011

  up to

  $2,519

• Breast Ultrasound

  SSP RA012

  up to

  $487

• Bronchoscopy

  SSP PU000

  up to

  $6,986

• Carpal Tunnel Repair

  SSP NU002

  up to

  $5,284

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $7,773

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,610

• Colonoscopy

  SSP GA002

  up to

  $4,281

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,214

• CT

  SSP RA001

  up to

  $1,585

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,871

• Delivery - Cesarean

  SSP OB002

  up to

  $53,738

• Delivery - Vaginal

  SSP OB001

  up to

  $39,420

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,148

• Fetal MRI

  SSP RA006

  up to

  $1,000

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,865

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $2,045

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $12,353

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $8,790

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $15,030

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $8,091

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $12,018

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $16,083

• Mammogram

  SSP RA010

  up to

  $631

• MRI with Contrast

  SSP RA007

  up to

  $2,183

• MRI without Contrast

  SSP RA005

  up to

  $4,487

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,304

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $17,457

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,375

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $7,674

• Ultrasound

  SSP RA008

  up to

  $1,377

• X-Ray

  SSP RA000

  up to

  $816