Penn State Health Holy Spirit Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $5,038

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,485

• Breast MRI

  SSP RA011

  up to

  $554

• Breast Ultrasound

  SSP RA012

  up to

  $127

• Bronchoscopy

  SSP PU000

  up to

  $2,678

• Carpal Tunnel Repair

  SSP NU002

  up to

  $2,485

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,542

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,485

• Colonoscopy

  SSP GA002

  up to

  $1,831

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,831

• CT

  SSP RA001

  up to

  $427

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $624

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,456

• Fetal MRI

  SSP RA006

  up to

  $289

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,092

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $372

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $9,060

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $5,480

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $11,093

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,666

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $5,038

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $9,060

• Mammogram

  SSP RA010

  up to

  $156

• MRI with Contrast

  SSP RA007

  up to

  $427

• MRI without Contrast

  SSP RA005

  up to

  $375

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,516

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $11,093

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $9,186

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $5,036

• Ultrasound

  SSP RA008

  up to

  $165

• X-Ray

  SSP RA000

  up to

  $165