Women & Babies Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $10,522

• Breast MRI

  SSP RA011

  up to

  $1,709

• Breast Ultrasound

  SSP RA012

  up to

  $442

• Bronchoscopy

  SSP PU000

  up to

  $8,360

• Carpal Tunnel Repair

  SSP NU002

  up to

  $8,502

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $7,652

• Colonoscopy

  SSP GA002

  up to

  $7,395

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,556

• CT

  SSP RA001

  up to

  $1,293

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $957

• Delivery - Cesarean

  SSP OB002

  up to

  $40,400

• Delivery - Vaginal

  SSP OB001

  up to

  $33,630

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,327

• Fetal MRI

  SSP RA006

  up to

  $1,100

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $894

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $3,211

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $10,011

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $10,262

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $8,971

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $8,072

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $14,456

• Mammogram

  SSP RA010

  up to

  $460

• MRI with Contrast

  SSP RA007

  up to

  $1,502

• MRI without Contrast

  SSP RA005

  up to

  $1,322

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,608

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $13,946

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $6,936

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $7,071

• Ultrasound

  SSP RA008

  up to

  $674

• X-Ray

  SSP RA000

  up to

  $207