Wills Eye Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $3,825

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,059

• Breast MRI

  SSP RA011

  up to

  $561

• Breast Ultrasound

  SSP RA012

  up to

  $270

• Bronchoscopy

  SSP PU000

  up to

  $2,880

• Carpal Tunnel Repair

  SSP NU002

  up to

  $2,072

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,946

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,968

• CT

  SSP RA001

  up to

  $562

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $556

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $684

• Fetal MRI

  SSP RA006

  up to

  $410

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $447

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $6,459

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $4,102

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $9,621

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $6,273

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $4,347

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $6,656

• MRI with Contrast

  SSP RA007

  up to

  $544

• MRI without Contrast

  SSP RA005

  up to

  $545

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,004

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $9,158

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $6,377

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,648

• Ultrasound

  SSP RA008

  up to

  $230

• X-Ray

  SSP RA000

  up to

  $175