Cleveland Clinic Martin North Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $2,373

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $5,376

• Breast MRI

  SSP RA011

  up to

  $4,503

• Breast Ultrasound

  SSP RA012

  up to

  $552

• Bronchoscopy

  SSP PU000

  up to

  $5,257

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,496

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $2,055

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $5,376

• Colonoscopy

  SSP GA002

  up to

  $3,947

• Colonoscopy via Stoma

  SSP GA000

  up to

  $5,078

• CT

  SSP RA001

  up to

  $922

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,070

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,033

• Fetal MRI

  SSP RA006

  up to

  $1,230

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,354

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $789

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $1,961

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $11,571

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $4,101

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $15,403

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $2,684

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $3,173

• Mammogram

  SSP RA010

  up to

  $532

• MRI with Contrast

  SSP RA007

  up to

  $1,930

• MRI without Contrast

  SSP RA005

  up to

  $1,230

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $8,133

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $3,678

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $988

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $1,021

• Ultrasound

  SSP RA008

  up to

  $565

• X-Ray

  SSP RA000

  up to

  $552