Northern Light Mercy Hospital - Fore River Campus

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $7,185

• Breast MRI

  SSP RA011

  up to

  $1,763

• Breast Ultrasound

  SSP RA012

  up to

  $577

• Bronchoscopy

  SSP PU000

  up to

  $2,876

• Colonoscopy

  SSP GA002

  up to

  $4,453

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,385

• CT

  SSP RA001

  up to

  $1,745

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,153

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $4,099

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,434

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,071

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $655

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $442

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $1,803

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $2,641

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $1,325

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $1,341

• Mammogram

  SSP RA010

  up to

  $468

• MRI with Contrast

  SSP RA007

  up to

  $2,574

• MRI without Contrast

  SSP RA005

  up to

  $1,865

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,797

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $2,026

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $774

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $839

• Ultrasound

  SSP RA008

  up to

  $666

• X-Ray

  SSP RA000

  up to

  $453