Northwestern Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $11,080

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $559

• Breast MRI

  SSP RA011

  up to

  $1,462

• Breast Ultrasound

  SSP RA012

  up to

  $395

• Bronchoscopy

  SSP PU000

  up to

  $7,919

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,973

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,521

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $537

• Colonoscopy

  SSP GA002

  up to

  $9,045

• Colonoscopy via Stoma

  SSP GA000

  up to

  $10,889

• CT

  SSP RA001

  up to

  $2,087

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,163

• Delivery - Cesarean

  SSP OB002

  up to

  $9,555

• Delivery - Vaginal

  SSP OB001

  up to

  $6,856

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $11,858

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $6,307

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $3,884

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $7,109

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $8,791

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $1,332

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $5,488

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $11,400

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $8,771

• Mammogram

  SSP RA010

  up to

  $255

• MRI with Contrast

  SSP RA007

  up to

  $2,666

• MRI without Contrast

  SSP RA005

  up to

  $2,931

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,508

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $12,971

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $4,533

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $5,386

• Ultrasound

  SSP RA008

  up to

  $509

• X-Ray

  SSP RA000

  up to

  $624