Logan Regional Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $2,910

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,892

• Breast MRI

  SSP RA011

  up to

  $2,485

• Breast Ultrasound

  SSP RA012

  up to

  $592

• Bronchoscopy

  SSP PU000

  up to

  $3,442

• Carpal Tunnel Repair

  SSP NU002

  up to

  $7,491

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $7,241

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,723

• Colonoscopy

  SSP GA002

  up to

  $8,526

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,065

• CT

  SSP RA001

  up to

  $1,310

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,363

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $7,726

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,254

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,268

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $10,985

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $12,344

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $12,137

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $13,080

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $18,940

• Mammogram

  SSP RA010

  up to

  $489

• MRI with Contrast

  SSP RA007

  up to

  $983

• MRI without Contrast

  SSP RA005

  up to

  $1,971

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,487

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $28,460

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $8,874

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $9,219

• Ultrasound

  SSP RA008

  up to

  $545

• X-Ray

  SSP RA000

  up to

  $501