UNM Childrens Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $2,081

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $152

• Breast MRI

  SSP RA011

  up to

  $760

• Breast Ultrasound

  SSP RA012

  up to

  $181

• Bronchoscopy

  SSP PU000

  up to

  $958

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,859

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,717

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $764

• Colonoscopy

  SSP GA002

  up to

  $1,301

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,407

• CT

  SSP RA001

  up to

  $1,498

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,219

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,084

• Fetal MRI

  SSP RA006

  up to

  $320

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $956

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $428

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $9,524

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $6,516

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $5,420

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $3,872

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $3,446

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $5,420

• Mammogram

  SSP RA010

  up to

  $139

• MRI with Contrast

  SSP RA007

  up to

  $1,632

• MRI without Contrast

  SSP RA005

  up to

  $1,543

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $1,041

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $6,073

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $4,001

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,872

• Ultrasound

  SSP RA008

  up to

  $667

• X-Ray

  SSP RA000

  up to

  $326