HonorHealth Mountain Vista Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $8,941

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,837

• Breast MRI

  SSP RA011

  up to

  $1,997

• Bronchoscopy

  SSP PU000

  up to

  $6,082

• Carpal Tunnel Repair

  SSP NU002

  up to

  $7,740

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $8,354

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $3,340

• Colonoscopy

  SSP GA002

  up to

  $7,402

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,396

• CT

  SSP RA001

  up to

  $5,351

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $5,350

• Delivery - Cesarean

  SSP OB002

  up to

  $35,832

• Delivery - Vaginal

  SSP OB001

  up to

  $12,978

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,950

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,962

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $683

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $19,302

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $17,870

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $20,131

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $10,206

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $20,104

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $15,970

• Mammogram

  SSP RA010

  up to

  $725

• MRI without Contrast

  SSP RA005

  up to

  $3,014

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,400

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $22,537

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $9,622

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $10,508

• Ultrasound

  SSP RA008

  up to

  $1,848

• X-Ray

  SSP RA000

  up to

  $467