Kings Daughters Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $3,858

• Breast MRI

  SSP RA011

  up to

  $3,654

• Breast Ultrasound

  SSP RA012

  up to

  $338

• Bronchoscopy

  SSP PU000

  up to

  $4,516

• Carpal Tunnel Repair

  SSP NU002

  up to

  $14,378

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,205

• Colonoscopy

  SSP GA002

  up to

  $3,466

• CT

  SSP RA001

  up to

  $2,108

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,260

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,265

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,729

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $17,561

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $12,947

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $11,385

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,213

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $10,169

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $8,904

• Mammogram

  SSP RA010

  up to

  $410

• MRI with Contrast

  SSP RA007

  up to

  $4,180

• MRI without Contrast

  SSP RA005

  up to

  $2,161

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,903

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $13,532

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $5,626

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $5,733

• Ultrasound

  SSP RA008

  up to

  $1,080

• X-Ray

  SSP RA000

  up to

  $610