Mahaska Health Partnership

Provider Information

Services

• Breast Ultrasound

  SSP RA012

  up to

  $381

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,625

• Colonoscopy

  SSP GA002

  up to

  $1,027

• Colonoscopy via Stoma

  SSP GA000

  up to

  $688

• CT

  SSP RA001

  up to

  $2,380

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,623

• Delivery - Cesarean

  SSP OB002

  up to

  $18,719

• Delivery - Vaginal

  SSP OB001

  up to

  $12,434

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,084

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,016

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $666

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $2,836

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $1,993

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $1,113

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $2,263

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $2,366

• Mammogram

  SSP RA010

  up to

  $318

• MRI with Contrast

  SSP RA007

  up to

  $3,910

• MRI without Contrast

  SSP RA005

  up to

  $3,740

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,499

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $3,509

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $940

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $980

• Ultrasound

  SSP RA008

  up to

  $381

• X-Ray

  SSP RA000

  up to

  $1,003