HSHS St Vincent Childrens Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $6,996

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,849

• Breast MRI

  SSP RA011

  up to

  $3,068

• Breast Ultrasound

  SSP RA012

  up to

  $546

• Bronchoscopy

  SSP PU000

  up to

  $2,970

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,428

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $8,360

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $14,838

• Colonoscopy

  SSP GA002

  up to

  $3,948

• CT

  SSP RA001

  up to

  $2,092

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,550

• Delivery - Cesarean

  SSP OB002

  up to

  $21,026

• Delivery - Vaginal

  SSP OB001

  up to

  $12,513

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $6,597

• Fetal MRI

  SSP RA006

  up to

  $2,233

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,250

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $4,906

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $14,942

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $9,698

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $15,794

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,358

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $8,313

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $11,409

• Mammogram

  SSP RA010

  up to

  $370

• MRI with Contrast

  SSP RA007

  up to

  $2,914

• MRI without Contrast

  SSP RA005

  up to

  $2,657

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,779

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $4,715

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $5,079

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $6,257

• Ultrasound

  SSP RA008

  up to

  $770

• X-Ray

  SSP RA000

  up to

  $583