Methodist Fremont Health

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $7,652

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $138

• Breast MRI

  SSP RA011

  up to

  $2,178

• Breast Ultrasound

  SSP RA012

  up to

  $155

• Bronchoscopy

  SSP PU000

  up to

  $4,501

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,501

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,504

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,434

• Colonoscopy

  SSP GA002

  up to

  $1,140

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,140

• CT

  SSP RA001

  up to

  $2,244

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,016

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,117

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $565

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $228

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $4,501

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $4,501

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $4,501

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $4,501

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $4,501

• Mammogram

  SSP RA010

  up to

  $263

• MRI with Contrast

  SSP RA007

  up to

  $3,075

• MRI without Contrast

  SSP RA005

  up to

  $2,506

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $1,476

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $3,898

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $3,700

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,168

• Ultrasound

  SSP RA008

  up to

  $595

• X-Ray

  SSP RA000

  up to

  $506