Heritage Valley Beaver

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $943

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $858

• Breast MRI

  SSP RA011

  up to

  $500

• Breast Ultrasound

  SSP RA012

  up to

  $106

• Bronchoscopy

  SSP PU000

  up to

  $903

• Carpal Tunnel Repair

  SSP NU002

  up to

  $646

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $548

• Colonoscopy

  SSP GA002

  up to

  $528

• Colonoscopy via Stoma

  SSP GA000

  up to

  $245

• CT

  SSP RA001

  up to

  $402

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,098

• Delivery - Cesarean

  SSP OB002

  up to

  $12,900

• Delivery - Vaginal

  SSP OB001

  up to

  $9,028

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $700

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $435

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $840

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $2,731

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $2,042

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $1,076

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $1,507

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $1,883

• Mammogram

  SSP RA010

  up to

  $161

• MRI with Contrast

  SSP RA007

  up to

  $910

• MRI without Contrast

  SSP RA005

  up to

  $471

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $849

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $1,588

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $937

• Ultrasound

  SSP RA008

  up to

  $131

• X-Ray

  SSP RA000

  up to

  $122