Wyoming County Community Health System

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $7,322

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $3,692

• Breast MRI

  SSP RA011

  up to

  $1,410

• Breast Ultrasound

  SSP RA012

  up to

  $329

• Bronchoscopy

  SSP PU000

  up to

  $5,181

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,822

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,497

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $3,664

• Colonoscopy

  SSP GA002

  up to

  $3,240

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,084

• CT

  SSP RA001

  up to

  $861

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $867

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $2,172

• Fetal MRI

  SSP RA006

  up to

  $646

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,572

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,038

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $12,970

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $7,935

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $17,616

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $10,896

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $7,946

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $13,186

• Mammogram

  SSP RA010

  up to

  $240

• MRI with Contrast

  SSP RA007

  up to

  $862

• MRI without Contrast

  SSP RA005

  up to

  $734

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,881

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $17,067

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $12,524

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $7,217

• Ultrasound

  SSP RA008

  up to

  $346

• X-Ray

  SSP RA000

  up to

  $296