Norton Clark Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $13,300

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,083

• Breast MRI

  SSP RA011

  up to

  $2,654

• Breast Ultrasound

  SSP RA012

  up to

  $563

• Bronchoscopy

  SSP PU000

  up to

  $8,834

• Carpal Tunnel Repair

  SSP NU002

  up to

  $6,944

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $8,637

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,289

• Colonoscopy

  SSP GA002

  up to

  $6,095

• Colonoscopy via Stoma

  SSP GA000

  up to

  $3,998

• CT

  SSP RA001

  up to

  $1,689

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $2,856

• Delivery - Cesarean

  SSP OB002

  up to

  $14,720

• Delivery - Vaginal

  SSP OB001

  up to

  $9,563

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $5,797

• Fetal MRI

  SSP RA006

  up to

  $1,199

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,951

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,642

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $20,625

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $13,392

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $29,097

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $13,107

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $16,755

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $18,566

• Mammogram

  SSP RA010

  up to

  $312

• MRI with Contrast

  SSP RA007

  up to

  $3,096

• MRI without Contrast

  SSP RA005

  up to

  $1,788

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $6,877

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $24,309

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $7,114

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $11,174

• Ultrasound

  SSP RA008

  up to

  $1,742

• X-Ray

  SSP RA000

  up to

  $553