Stonewall Jackson Memorial Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $2,965

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,939

• Breast MRI

  SSP RA011

  up to

  $2,553

• Breast Ultrasound

  SSP RA012

  up to

  $701

• Bronchoscopy

  SSP PU000

  up to

  $11,458

• Carpal Tunnel Repair

  SSP NU002

  up to

  $7,880

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $12,681

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,806

• Colonoscopy

  SSP GA002

  up to

  $9,468

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,327

• CT

  SSP RA001

  up to

  $1,739

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,158

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $8,413

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $3,714

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,459

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $11,620

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $11,312

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $13,410

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $11,970

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $20,075

• Mammogram

  SSP RA010

  up to

  $656

• MRI with Contrast

  SSP RA007

  up to

  $2,101

• MRI without Contrast

  SSP RA005

  up to

  $1,418

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $8,715

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $29,942

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $9,411

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $9,743

• Ultrasound

  SSP RA008

  up to

  $656

• X-Ray

  SSP RA000

  up to

  $628