SSM Health Cardinal Glennon Childrens Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $8,006

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,439

• Breast MRI

  SSP RA011

  up to

  $2,387

• Breast Ultrasound

  SSP RA012

  up to

  $369

• Bronchoscopy

  SSP PU000

  up to

  $4,745

• Carpal Tunnel Repair

  SSP NU002

  up to

  $7,946

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,411

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,305

• Colonoscopy

  SSP GA002

  up to

  $4,769

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,539

• CT

  SSP RA001

  up to

  $2,284

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,276

• Delivery - Cesarean

  SSP OB002

  up to

  $11,663

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,268

• Fetal MRI

  SSP RA006

  up to

  $649

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,272

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,318

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $8,415

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $8,199

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $10,241

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $5,224

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $8,663

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $8,573

• Mammogram

  SSP RA010

  up to

  $437

• MRI with Contrast

  SSP RA007

  up to

  $2,265

• MRI without Contrast

  SSP RA005

  up to

  $767

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,308

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $9,649

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $3,429

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $4,772

• Ultrasound

  SSP RA008

  up to

  $325

• X-Ray

  SSP RA000

  up to

  $281