OConnor Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $436

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $178

• Breast MRI

  SSP RA011

  up to

  $153

• Breast Ultrasound

  SSP RA012

  up to

  $275

• Bronchoscopy

  SSP PU000

  up to

  $209

• Carpal Tunnel Repair

  SSP NU002

  up to

  $324

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $810

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $178

• Colonoscopy

  SSP GA002

  up to

  $324

• Colonoscopy via Stoma

  SSP GA000

  up to

  $243

• CT

  SSP RA001

  up to

  $1,081

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,566

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $206

• Fetal MRI

  SSP RA006

  up to

  $183

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $85

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $187

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $329

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $351

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $646

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $1,103

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $728

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $594

• Mammogram

  SSP RA010

  up to

  $187

• MRI with Contrast

  SSP RA007

  up to

  $1,232

• MRI without Contrast

  SSP RA005

  up to

  $1,035

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $331

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $544

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $193

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $235

• Ultrasound

  SSP RA008

  up to

  $425

• X-Ray

  SSP RA000

  up to

  $325