M Health Fairview St Johns Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $7,839

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $4,014

• Breast MRI

  SSP RA011

  up to

  $3,254

• Breast Ultrasound

  SSP RA012

  up to

  $483

• Bronchoscopy

  SSP PU000

  up to

  $6,323

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,088

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,730

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $3,948

• Colonoscopy

  SSP GA002

  up to

  $4,602

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,186

• CT

  SSP RA001

  up to

  $1,543

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,518

• Delivery - Cesarean

  SSP OB002

  up to

  $32,234

• Delivery - Vaginal

  SSP OB001

  up to

  $21,870

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,008

• Fetal MRI

  SSP RA006

  up to

  $1,516

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,663

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $979

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $13,608

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $8,481

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $18,778

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $12,293

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $8,499

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $13,857

• Mammogram

  SSP RA010

  up to

  $1,512

• MRI with Contrast

  SSP RA007

  up to

  $1,530

• MRI without Contrast

  SSP RA005

  up to

  $1,624

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,943

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $18,199

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $13,549

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $7,596

• Ultrasound

  SSP RA008

  up to

  $430

• X-Ray

  SSP RA000

  up to

  $382