MercyOne Genesis Dewitt Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $17,477

• Breast MRI

  SSP RA011

  up to

  $2,938

• Breast Ultrasound

  SSP RA012

  up to

  $996

• Bronchoscopy

  SSP PU000

  up to

  $2,985

• Carpal Tunnel Repair

  SSP NU002

  up to

  $5,848

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,840

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,521

• Colonoscopy

  SSP GA002

  up to

  $4,227

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,954

• CT

  SSP RA001

  up to

  $3,295

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $5,072

• Delivery - Cesarean

  SSP OB002

  up to

  $13,268

• Delivery - Vaginal

  SSP OB001

  up to

  $13,999

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,866

• Fetal MRI

  SSP RA006

  up to

  $2,788

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,450

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,638

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $12,760

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $10,901

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $6,591

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $8,943

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $11,043

• Mammogram

  SSP RA010

  up to

  $633

• MRI with Contrast

  SSP RA007

  up to

  $6,275

• MRI without Contrast

  SSP RA005

  up to

  $4,387

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,953

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $17,715

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $5,022

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $5,659

• Ultrasound

  SSP RA008

  up to

  $1,218

• X-Ray

  SSP RA000

  up to

  $806