St Josephs Health Hospital

Provider Information

Services

• Breast MRI

  SSP RA011

  up to

  $4,026

• Breast Ultrasound

  SSP RA012

  up to

  $297

• Bronchoscopy

  SSP PU000

  up to

  $321

• Carpal Tunnel Repair

  SSP NU002

  up to

  $9,519

• Colonoscopy

  SSP GA002

  up to

  $5,433

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,537

• CT

  SSP RA001

  up to

  $15,579

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,998

• Delivery - Cesarean

  SSP OB002

  up to

  $15,838

• Delivery - Vaginal

  SSP OB001

  up to

  $18,448

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $605

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $153

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $682

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $1,021

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $766

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $452

• Mammogram

  SSP RA010

  up to

  $505

• MRI with Contrast

  SSP RA007

  up to

  $1,808

• MRI without Contrast

  SSP RA005

  up to

  $1,687

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,493

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $25,463

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $571

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $838

• Ultrasound

  SSP RA008

  up to

  $672

• X-Ray

  SSP RA000

  up to

  $512