TidalHealth Peninsula Regional

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $10,554

• Breast MRI

  SSP RA011

  up to

  $1,999

• Breast Ultrasound

  SSP RA012

  up to

  $718

• Bronchoscopy

  SSP PU000

  up to

  $14,852

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,502

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $8,163

• Colonoscopy

  SSP GA002

  up to

  $8,299

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,839

• CT

  SSP RA001

  up to

  $516

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,195

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,936

• Fetal MRI

  SSP RA006

  up to

  $1,202

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,066

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $11,028

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $8,644

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $20,231

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $8,349

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $17,034

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $10,929

• Mammogram

  SSP RA010

  up to

  $792

• MRI with Contrast

  SSP RA007

  up to

  $1,362

• MRI without Contrast

  SSP RA005

  up to

  $2,334

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,978

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $14,270

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $5,401

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $5,646

• Ultrasound

  SSP RA008

  up to

  $1,106

• X-Ray

  SSP RA000

  up to

  $553