Methodist Olive Branch Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $13,386

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $359

• Breast MRI

  SSP RA011

  up to

  $1,859

• Breast Ultrasound

  SSP RA012

  up to

  $254

• Bronchoscopy

  SSP PU000

  up to

  $2,907

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,133

• Colonoscopy

  SSP GA002

  up to

  $1,472

• Colonoscopy via Stoma

  SSP GA000

  up to

  $843

• CT

  SSP RA001

  up to

  $1,135

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,269

• Delivery - Cesarean

  SSP OB002

  up to

  $7,689

• Delivery - Vaginal

  SSP OB001

  up to

  $7,905

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,984

• Fetal MRI

  SSP RA006

  up to

  $464

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $486

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $2,285

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $8,511

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $8,914

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $20,157

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $4,343

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $11,739

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $7,753

• Mammogram

  SSP RA010

  up to

  $254

• MRI with Contrast

  SSP RA007

  up to

  $1,859

• MRI without Contrast

  SSP RA005

  up to

  $1,364

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $1,192

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $20,819

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $4,405

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $4,938

• Ultrasound

  SSP RA008

  up to

  $303

• X-Ray

  SSP RA000

  up to

  $421