Mayo Clinic Health System - Lake City

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $10,121

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $3,423

• Breast MRI

  SSP RA011

  up to

  $4,027

• Breast Ultrasound

  SSP RA012

  up to

  $994

• Bronchoscopy

  SSP PU000

  up to

  $5,294

• Carpal Tunnel Repair

  SSP NU002

  up to

  $6,026

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $10,716

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $6,481

• Colonoscopy

  SSP GA002

  up to

  $4,701

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,052

• CT

  SSP RA001

  up to

  $3,816

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,980

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,309

• Fetal MRI

  SSP RA006

  up to

  $2,424

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,105

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,732

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $37,235

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $27,764

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $54,849

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $21,518

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $10,684

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $44,833

• Mammogram

  SSP RA010

  up to

  $1,033

• MRI with Contrast

  SSP RA007

  up to

  $4,283

• MRI without Contrast

  SSP RA005

  up to

  $4,444

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,765

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $46,176

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $14,329

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $10,493

• Ultrasound

  SSP RA008

  up to

  $1,007

• X-Ray

  SSP RA000

  up to

  $933