Ochsner Hospital for Children

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $14,483

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $313

• Breast MRI

  SSP RA011

  up to

  $586

• Breast Ultrasound

  SSP RA012

  up to

  $117

• Bronchoscopy

  SSP PU000

  up to

  $855

• Carpal Tunnel Repair

  SSP NU002

  up to

  $8,032

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,988

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $373

• Colonoscopy

  SSP GA002

  up to

  $5,034

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,150

• CT

  SSP RA001

  up to

  $745

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,006

• Delivery - Cesarean

  SSP OB002

  up to

  $49,116

• Delivery - Vaginal

  SSP OB001

  up to

  $6,162

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $636

• Fetal MRI

  SSP RA006

  up to

  $461

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $882

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $313

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $17,125

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $12,944

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $24,314

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,670

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $14,808

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $15,368

• Mammogram

  SSP RA010

  up to

  $103

• MRI with Contrast

  SSP RA007

  up to

  $1,039

• MRI without Contrast

  SSP RA005

  up to

  $726

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $398

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $21,213

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,104

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $7,589

• Ultrasound

  SSP RA008

  up to

  $182

• X-Ray

  SSP RA000

  up to

  $137