University of Toledo Medical Center

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $3,398

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,377

• Breast MRI

  SSP RA011

  up to

  $1,333

• Breast Ultrasound

  SSP RA012

  up to

  $737

• Bronchoscopy

  SSP PU000

  up to

  $3,182

• Carpal Tunnel Repair

  SSP NU002

  up to

  $3,357

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $3,300

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $1,715

• Colonoscopy

  SSP GA002

  up to

  $2,663

• Colonoscopy via Stoma

  SSP GA000

  up to

  $2,364

• CT

  SSP RA001

  up to

  $1,304

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,736

• Delivery - Cesarean

  SSP OB002

  up to

  $19,725

• Delivery - Vaginal

  SSP OB001

  up to

  $12,814

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $1,979

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $1,530

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,486

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $5,697

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $3,457

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $7,394

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $4,633

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $3,899

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $5,816

• Mammogram

  SSP RA010

  up to

  $307

• MRI with Contrast

  SSP RA007

  up to

  $1,270

• MRI without Contrast

  SSP RA005

  up to

  $1,396

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $2,565

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $6,944

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $3,010

• Ultrasound

  SSP RA008

  up to

  $865

• X-Ray

  SSP RA000

  up to

  $494