Jasper Memorial Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $57,475

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,213

• Breast MRI

  SSP RA011

  up to

  $5,456

• Breast Ultrasound

  SSP RA012

  up to

  $249

• Bronchoscopy

  SSP PU000

  up to

  $5,843

• Carpal Tunnel Repair

  SSP NU002

  up to

  $12,561

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $6,554

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $3,197

• Colonoscopy

  SSP GA002

  up to

  $4,971

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,624

• CT

  SSP RA001

  up to

  $3,567

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,337

• Delivery - Cesarean

  SSP OB002

  up to

  $34,598

• Delivery - Vaginal

  SSP OB001

  up to

  $21,766

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $4,275

• Fetal MRI

  SSP RA006

  up to

  $1,883

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,352

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,582

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $26,722

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $16,212

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $67,063

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $17,732

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $21,862

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $17,991

• Mammogram

  SSP RA010

  up to

  $245

• MRI with Contrast

  SSP RA007

  up to

  $4,943

• MRI without Contrast

  SSP RA005

  up to

  $3,648

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $6,270

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $35,941

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $9,248

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $13,171

• Ultrasound

  SSP RA008

  up to

  $1,448

• X-Ray

  SSP RA000

  up to

  $983