Houston Methodist Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $8,499

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $4,871

• Breast MRI

  SSP RA011

  up to

  $2,458

• Breast Ultrasound

  SSP RA012

  up to

  $1,593

• Bronchoscopy

  SSP PU000

  up to

  $5,262

• Carpal Tunnel Repair

  SSP NU002

  up to

  $8,459

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $6,400

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $4,885

• Colonoscopy

  SSP GA002

  up to

  $4,705

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,509

• CT

  SSP RA001

  up to

  $2,466

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,954

• Delivery - Cesarean

  SSP OB002

  up to

  $19,178

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $4,141

• Fetal MRI

  SSP RA006

  up to

  $2,248

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $3,985

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $4,961

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $10,512

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $10,348

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $10,135

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $10,926

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $8,981

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $10,632

• MRI with Contrast

  SSP RA007

  up to

  $2,459

• MRI without Contrast

  SSP RA005

  up to

  $2,336

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,649

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $9,701

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $6,041

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $6,097

• Ultrasound

  SSP RA008

  up to

  $1,560

• X-Ray

  SSP RA000

  up to

  $1,524