Screening Services
Assessment, education and CBE
Assessment, education, pelvic w/pap smear
Screening Mammograms

Diagnostic Services
Diagnostic Mammogram
Short Visit- repeat pap
Ultrasound
Fine Needle Aspiration
Ultrasonic needle localization
Core Biopsy
Incisional Biopsy
Excisional Biopsy
Stereotactic biopsy procedures (includes localization, biopsy, clip placement and specimen radiograph)
Mammographic needle localization
Colposcopy
Colposcopy – directed biopsy
Colonoscopy w/biopsy single or multiple
Colonoscopy w/removal of tumor(s), polyp(s) by hot biopsy forceps or biolpar Cautery
Colonoscopy w/removal of tumors(s), polyp(s) by snare technique
Sigmoidoscopy (when colonoscopy is contraindicated)
Sigmoidoscopy with polypectomy (when colonoscopy is contraindicated)
Flexible sigmoidoscopy w/ biopsy (when colonoscopy is contraindicated)
Radiological exam; colon, barium enema (when colonoscopy is contraindicated
Surgical consultation 2nd opinion

Pre-Operative and Operative Procedures
Chest X-ray
CBC
EKG/ECG
Anesthesiologist
Facility Fee – Core
Facility Fee- Incis/ Excis
Facility Fee- Colonoscopy
Facility Fee- Sigmoidoscopy

Pathology
Pap smear cytology, conventional
Pap smear cytology, thin prep
HPV amplified test
FOBT kit processing
Fluid cytology, other than vaginal/cervical
Surgical pathology, gross & microscopic exam of breast, cervical or colorectal tissue

For coverage amounts please contact:

Fiscal Manager/Program Coordinator
111 Westfall Road
Rochester NY 14620