Logansport Memorial Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $23,506

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $15,860

• Breast MRI

  SSP RA011

  up to

  $1,625

• Breast Ultrasound

  SSP RA012

  up to

  $725

• Bronchoscopy

  SSP PU000

  up to

  $8,476

• Carpal Tunnel Repair

  SSP NU002

  up to

  $15,826

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,534

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $15,810

• Colonoscopy

  SSP GA002

  up to

  $6,796

• Colonoscopy via Stoma

  SSP GA000

  up to

  $6,508

• CT

  SSP RA001

  up to

  $1,645

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,605

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,052

• Fetal MRI

  SSP RA006

  up to

  $1,132

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,335

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $764

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $17,675

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $18,498

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $19,109

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $8,366

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $23,942

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $17,795

• Mammogram

  SSP RA010

  up to

  $462

• MRI with Contrast

  SSP RA007

  up to

  $1,623

• MRI without Contrast

  SSP RA005

  up to

  $1,221

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,694

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $18,428

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $27,687

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $10,589

• Ultrasound

  SSP RA008

  up to

  $689

• X-Ray

  SSP RA000

  up to

  $644