Virtua Our Lady of Lourdes Hospital

Provider Information

Services

• Breast MRI

  SSP RA011

  up to

  $989

• Breast Ultrasound

  SSP RA012

  up to

  $143

• CT

  SSP RA001

  up to

  $770

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $933

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $135

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $139

• Mammogram

  SSP RA010

  up to

  $214

• MRI with Contrast

  SSP RA007

  up to

  $1,314

• MRI without Contrast

  SSP RA005

  up to

  $1,156

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $548

• Ultrasound

  SSP RA008

  up to

  $461

• X-Ray

  SSP RA000

  up to

  $325