MaineHealth Maine Medical Center Portland

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $25,840

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,487

• Breast MRI

  SSP RA011

  up to

  $2,698

• Breast Ultrasound

  SSP RA012

  up to

  $659

• Bronchoscopy

  SSP PU000

  up to

  $5,036

• Carpal Tunnel Repair

  SSP NU002

  up to

  $5,929

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $10,933

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,507

• Colonoscopy

  SSP GA002

  up to

  $6,891

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,502

• CT

  SSP RA001

  up to

  $1,933

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,530

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,444

• Fetal MRI

  SSP RA006

  up to

  $1,282

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $707

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,678

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $23,425

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $12,448

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $26,468

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $19,711

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $24,794

• Mammogram

  SSP RA010

  up to

  $831

• MRI with Contrast

  SSP RA007

  up to

  $2,692

• MRI without Contrast

  SSP RA005

  up to

  $1,812

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $5,540

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $41,902

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,995

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $16,276

• Ultrasound

  SSP RA008

  up to

  $1,874

• X-Ray

  SSP RA000

  up to

  $904