University Health Lakewood Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $2,235

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $2,173

• Breast MRI

  SSP RA011

  up to

  $574

• Breast Ultrasound

  SSP RA012

  up to

  $258

• Bronchoscopy

  SSP PU000

  up to

  $2,723

• Carpal Tunnel Repair

  SSP NU002

  up to

  $1,694

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,113

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,086

• Colonoscopy

  SSP GA002

  up to

  $2,335

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,124

• CT

  SSP RA001

  up to

  $582

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $677

• Delivery - Cesarean

  SSP OB002

  up to

  $13,060

• Delivery - Vaginal

  SSP OB001

  up to

  $12,288

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,923

• Fetal MRI

  SSP RA006

  up to

  $621

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $872

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $2,026

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $2,324

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $7,703

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $2,784

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $7,747

• Mammogram

  SSP RA010

  up to

  $302

• MRI with Contrast

  SSP RA007

  up to

  $1,048

• MRI without Contrast

  SSP RA005

  up to

  $1,425

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $1,992

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $3,207

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $2,100

• Ultrasound

  SSP RA008

  up to

  $235

• X-Ray

  SSP RA000

  up to

  $617