St Louise Regional Hospital

Provider Information

Services

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,896

• Breast MRI

  SSP RA011

  up to

  $1,110

• Breast Ultrasound

  SSP RA012

  up to

  $303

• Bronchoscopy

  SSP PU000

  up to

  $1,285

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,398

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $6,919

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $6,322

• Colonoscopy

  SSP GA002

  up to

  $4,717

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,717

• CT

  SSP RA001

  up to

  $972

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $828

• Delivery - Cesarean

  SSP OB002

  up to

  $52,819

• Delivery - Vaginal

  SSP OB001

  up to

  $35,976

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,665

• Fetal MRI

  SSP RA006

  up to

  $1,110

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,191

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $3,030

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $4,571

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $5,116

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $19,858

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $13,446

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $22,121

• Mammogram

  SSP RA010

  up to

  $244

• MRI with Contrast

  SSP RA007

  up to

  $1,058

• MRI without Contrast

  SSP RA005

  up to

  $616

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $6,621

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $27,432

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $2,458

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $2,556

• Ultrasound

  SSP RA008

  up to

  $555

• X-Ray

  SSP RA000

  up to

  $541