Southwest Health Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $971

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $362

• Breast Ultrasound

  SSP RA012

  up to

  $404

• Bronchoscopy

  SSP PU000

  up to

  $238

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,601

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,415

• Colonoscopy

  SSP GA002

  up to

  $2,973

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,606

• CT

  SSP RA001

  up to

  $3,031

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $3,723

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,104

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,563

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $812

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $1,711

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $1,875

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $8,732

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $6,122

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $1,271

• Mammogram

  SSP RA010

  up to

  $464

• MRI with Contrast

  SSP RA007

  up to

  $3,946

• MRI without Contrast

  SSP RA005

  up to

  $3,196

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,441

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $3,449

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $782

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $6,630

• Ultrasound

  SSP RA008

  up to

  $933

• X-Ray

  SSP RA000

  up to

  $782