Margaret Mary Health

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $1,154

• Breast MRI

  SSP RA011

  up to

  $3,354

• Breast Ultrasound

  SSP RA012

  up to

  $766

• Bronchoscopy

  SSP PU000

  up to

  $889

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,525

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $6,486

• Colonoscopy

  SSP GA002

  up to

  $1,559

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,198

• CT

  SSP RA001

  up to

  $3,799

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,747

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $909

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,408

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $684

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $1,284

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $3,793

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $2,074

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $2,107

• Mammogram

  SSP RA010

  up to

  $600

• MRI with Contrast

  SSP RA007

  up to

  $4,146

• MRI without Contrast

  SSP RA005

  up to

  $2,754

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,123

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $3,167

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $730

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $762

• Ultrasound

  SSP RA008

  up to

  $1,238

• X-Ray

  SSP RA000

  up to

  $723