Virginia Gay Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $11,877

• Breast MRI

  SSP RA011

  up to

  $1,459

• Breast Ultrasound

  SSP RA012

  up to

  $813

• Bronchoscopy

  SSP PU000

  up to

  $17,494

• Carpal Tunnel Repair

  SSP NU002

  up to

  $4,062

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,129

• Colonoscopy

  SSP GA002

  up to

  $4,905

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,631

• CT

  SSP RA001

  up to

  $3,220

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $4,006

• Delivery - Cesarean

  SSP OB002

  up to

  $8,016

• Delivery - Vaginal

  SSP OB001

  up to

  $9,385

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,392

• Fetal MRI

  SSP RA006

  up to

  $1,886

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $867

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,695

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $8,710

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $7,474

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,207

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $6,152

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $7,588

• Mammogram

  SSP RA010

  up to

  $681

• MRI with Contrast

  SSP RA007

  up to

  $4,511

• MRI without Contrast

  SSP RA005

  up to

  $3,168

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,735

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $14,080

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $3,449

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,896

• Ultrasound

  SSP RA008

  up to

  $1,035

• X-Ray

  SSP RA000

  up to

  $521