Hospital of the University of Pennsylvania

Provider Information

Services

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,890

• Breast MRI

  SSP RA011

  up to

  $1,392

• Breast Ultrasound

  SSP RA012

  up to

  $237

• Bronchoscopy

  SSP PU000

  up to

  $4,224

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $10,540

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,914

• Colonoscopy

  SSP GA002

  up to

  $4,889

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,766

• CT

  SSP RA001

  up to

  $784

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $620

• Delivery - Cesarean

  SSP OB002

  up to

  $22,056

• Delivery - Vaginal

  SSP OB001

  up to

  $15,452

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $4,316

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,197

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $4,526

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $8,571

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $9,002

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $5,969

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $7,998

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $7,627

• Mammogram

  SSP RA010

  up to

  $228

• MRI with Contrast

  SSP RA007

  up to

  $1,020

• MRI without Contrast

  SSP RA005

  up to

  $808

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $5,047

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $10,604

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $6,565

• Ultrasound

  SSP RA008

  up to

  $765

• X-Ray

  SSP RA000

  up to

  $184