ProHealth Waukesha Memorial Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $9,427

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,753

• Breast MRI

  SSP RA011

  up to

  $681

• Breast Ultrasound

  SSP RA012

  up to

  $346

• Bronchoscopy

  SSP PU000

  up to

  $8,130

• Carpal Tunnel Repair

  SSP NU002

  up to

  $9,387

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $8,048

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $4,992

• Colonoscopy

  SSP GA002

  up to

  $7,361

• Colonoscopy via Stoma

  SSP GA000

  up to

  $7,131

• CT

  SSP RA001

  up to

  $673

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $829

• Delivery - Cesarean

  SSP OB002

  up to

  $31,260

• Delivery - Vaginal

  SSP OB001

  up to

  $20,308

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $6,688

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $4,820

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,815

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $12,314

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $9,483

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $13,949

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $16,986

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $9,909

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $12,429

• Mammogram

  SSP RA010

  up to

  $339

• MRI with Contrast

  SSP RA007

  up to

  $817

• MRI without Contrast

  SSP RA005

  up to

  $583

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $7,088

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $13,515

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,712

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $7,768

• Ultrasound

  SSP RA008

  up to

  $702

• X-Ray

  SSP RA000

  up to

  $271