Clifton Springs Hospital & Clinic

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $3,404

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,072

• Breast MRI

  SSP RA011

  up to

  $536

• Breast Ultrasound

  SSP RA012

  up to

  $259

• Bronchoscopy

  SSP PU000

  up to

  $2,749

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,352

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $5,013

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,718

• Colonoscopy

  SSP GA002

  up to

  $2,234

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,723

• CT

  SSP RA001

  up to

  $578

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $643

• Delivery - Cesarean

  SSP OB002

  up to

  $17,843

• Delivery - Vaginal

  SSP OB001

  up to

  $11,592

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,957

• Fetal MRI

  SSP RA006

  up to

  $593

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,394

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,976

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $4,740

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $3,697

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $4,253

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $4,350

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $4,662

• Mammogram

  SSP RA010

  up to

  $350

• MRI with Contrast

  SSP RA007

  up to

  $575

• MRI without Contrast

  SSP RA005

  up to

  $487

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $3,082

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $4,361

• Ultrasound

  SSP RA008

  up to

  $318

• X-Ray

  SSP RA000

  up to

  $472