University of Iowa Stead Family Childrens Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $2,909

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,040

• Breast MRI

  SSP RA011

  up to

  $671

• Breast Ultrasound

  SSP RA012

  up to

  $92

• Bronchoscopy

  SSP PU000

  up to

  $1,019

• Carpal Tunnel Repair

  SSP NU002

  up to

  $2,633

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,196

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,125

• Colonoscopy

  SSP GA002

  up to

  $2,346

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,857

• CT

  SSP RA001

  up to

  $2,744

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $539

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,831

• Fetal MRI

  SSP RA006

  up to

  $428

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $349

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,285

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $2,041

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $2,057

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $6,552

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $3,621

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $3,353

• Mammogram

  SSP RA010

  up to

  $97

• MRI with Contrast

  SSP RA007

  up to

  $5,117

• MRI without Contrast

  SSP RA005

  up to

  $3,199

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,300

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $5,555

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $1,025

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $937

• Ultrasound

  SSP RA008

  up to

  $384

• X-Ray

  SSP RA000

  up to

  $195