MercyOne West Des Moines Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $19,328

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,308

• Breast MRI

  SSP RA011

  up to

  $2,181

• Breast Ultrasound

  SSP RA012

  up to

  $872

• Bronchoscopy

  SSP PU000

  up to

  $2,966

• Carpal Tunnel Repair

  SSP NU002

  up to

  $6,238

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $6,349

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,274

• Colonoscopy

  SSP GA002

  up to

  $7,819

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,419

• CT

  SSP RA001

  up to

  $3,564

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $5,710

• Delivery - Cesarean

  SSP OB002

  up to

  $13,108

• Delivery - Vaginal

  SSP OB001

  up to

  $13,830

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,494

• Fetal MRI

  SSP RA006

  up to

  $3,062

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,764

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $820

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $13,985

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $11,998

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $10,176

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $9,838

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $12,035

• Mammogram

  SSP RA010

  up to

  $561

• MRI with Contrast

  SSP RA007

  up to

  $9,002

• MRI without Contrast

  SSP RA005

  up to

  $5,679

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $5,176

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $18,925

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $5,498

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $6,168

• Ultrasound

  SSP RA008

  up to

  $1,170

• X-Ray

  SSP RA000

  up to

  $646