Ohio State University Wexner Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $4,684

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,984

• Breast MRI

  SSP RA011

  up to

  $1,362

• Breast Ultrasound

  SSP RA012

  up to

  $322

• Bronchoscopy

  SSP PU000

  up to

  $5,948

• Carpal Tunnel Repair

  SSP NU002

  up to

  $9,095

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $16,577

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,736

• Colonoscopy

  SSP GA002

  up to

  $4,736

• Colonoscopy via Stoma

  SSP GA000

  up to

  $1,676

• CT

  SSP RA001

  up to

  $1,347

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,600

• Delivery - Cesarean

  SSP OB002

  up to

  $16,754

• Delivery - Vaginal

  SSP OB001

  up to

  $21,223

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,562

• Fetal MRI

  SSP RA006

  up to

  $1,384

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,692

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $853

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $18,961

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $10,078

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $8,524

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $9,483

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $10,947

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $24,649

• Mammogram

  SSP RA010

  up to

  $444

• MRI with Contrast

  SSP RA007

  up to

  $1,400

• MRI without Contrast

  SSP RA005

  up to

  $1,476

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,302

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $14,895

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $12,239

• Ultrasound

  SSP RA008

  up to

  $657

• X-Ray

  SSP RA000

  up to

  $496