Thorek Memorial Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $4,613

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,536

• Bronchoscopy

  SSP PU000

  up to

  $4,526

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,564

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,903

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,944

• Colonoscopy

  SSP GA002

  up to

  $3,822

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,385

• CT

  SSP RA001

  up to

  $523

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $634

• Delivery - Cesarean

  SSP OB002

  up to

  $23,855

• Delivery - Vaginal

  SSP OB001

  up to

  $15,497

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,925

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,657

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,588

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $5,377

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $4,705

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $7,497

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $4,721

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $5,246

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $5,515

• Mammogram

  SSP RA010

  up to

  $275

• MRI with Contrast

  SSP RA007

  up to

  $565

• MRI without Contrast

  SSP RA005

  up to

  $396

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,293

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $6,922

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $3,491

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,562

• Ultrasound

  SSP RA008

  up to

  $236

• X-Ray

  SSP RA000

  up to

  $157