MercyOne Des Moines Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $26,393

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,479

• Breast MRI

  SSP RA011

  up to

  $2,929

• Breast Ultrasound

  SSP RA012

  up to

  $865

• Bronchoscopy

  SSP PU000

  up to

  $3,060

• Carpal Tunnel Repair

  SSP NU002

  up to

  $5,173

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $7,905

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,567

• Colonoscopy

  SSP GA002

  up to

  $3,906

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,333

• CT

  SSP RA001

  up to

  $2,764

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $4,055

• Delivery - Cesarean

  SSP OB002

  up to

  $22,929

• Delivery - Vaginal

  SSP OB001

  up to

  $25,242

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,157

• Fetal MRI

  SSP RA006

  up to

  $4,172

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,731

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $916

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $19,074

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $13,561

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $13,939

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $10,488

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $16,283

• Mammogram

  SSP RA010

  up to

  $588

• MRI with Contrast

  SSP RA007

  up to

  $5,941

• MRI without Contrast

  SSP RA005

  up to

  $3,945

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $8,833

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $23,307

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,422

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $8,309

• Ultrasound

  SSP RA008

  up to

  $1,168

• X-Ray

  SSP RA000

  up to

  $645