UPMC Jameson

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $5,338

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,356

• Breast MRI

  SSP RA011

  up to

  $1,288

• Breast Ultrasound

  SSP RA012

  up to

  $342

• Bronchoscopy

  SSP PU000

  up to

  $1,979

• Carpal Tunnel Repair

  SSP NU002

  up to

  $2,143

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,450

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,045

• Colonoscopy

  SSP GA002

  up to

  $2,393

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,713

• CT

  SSP RA001

  up to

  $1,126

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,000

• Delivery - Cesarean

  SSP OB002

  up to

  $13,439

• Delivery - Vaginal

  SSP OB001

  up to

  $8,731

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,128

• Fetal MRI

  SSP RA006

  up to

  $290

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $773

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,095

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $5,346

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $4,927

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $9,139

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $4,374

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $6,805

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $25,453

• Mammogram

  SSP RA010

  up to

  $405

• MRI with Contrast

  SSP RA007

  up to

  $1,308

• MRI without Contrast

  SSP RA005

  up to

  $1,314

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,216

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $13,717

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $2,911

• Ultrasound

  SSP RA008

  up to

  $365

• X-Ray

  SSP RA000

  up to

  $241