Western Reserve Hospital

Provider Information

Services

• Ankle Repair - Arthroscopic

  SSP MS009

  up to

  $5,636

• Articular Finger Fracture Repair - Surgical

  SSP MS019

  up to

  $1,281

• Breast Ultrasound

  SSP RA012

  up to

  $439

• Bronchoscopy

  SSP PU000

  up to

  $6,256

• Carpal Tunnel Repair

  SSP NU002

  up to

  $5,543

• Cataract Removal with Intraocular Lens Insertion

  SSP OP000

  up to

  $4,972

• Clavicle/Scapula Repair - Non-Surgical

  SSP MS028

  up to

  $2,850

• Colonoscopy

  SSP GA002

  up to

  $4,820

• Colonoscopy via Stoma

  SSP GA000

  up to

  $4,498

• CT

  SSP RA001

  up to

  $1,573

• CT of Abdomen and Pelvis

  SSP RA004

  up to

  $1,800

• Delivery - Cesarean

  SSP OB002

  up to

  $22,724

• Delivery - Vaginal

  SSP OB001

  up to

  $14,762

• Esophagogastroduodenoscopy, Simple

  SSP GA007

  up to

  $3,994

• Fine Needle Aspiration Biopsy with Ultrasound Guidance

  SSP DE003

  up to

  $2,675

• Forearm/Wrist Repair - Non-Surgical

  SSP MS010

  up to

  $1,327

• Hernia Repair - Laparoscopic

  SSP GA010

  up to

  $6,616

• Hernia Repair - Non-Laparoscopic

  SSP GA011

  up to

  $5,632

• Hip Repair - Arthroscopic

  SSP MS008

  up to

  $8,947

• Hysteroscopy with Surgical Procedure

  SSP RE003

  up to

  $6,158

• Knee Repair - Arthroscopic

  SSP MS006

  up to

  $6,237

• Laparoscopic Surgery of Ovaries and/or Fallopian Tubes

  SSP RE004

  up to

  $6,814

• Mammogram

  SSP RA010

  up to

  $489

• MRI with Contrast

  SSP RA007

  up to

  $971

• MRI without Contrast

  SSP RA005

  up to

  $976

• Percutaneous Breast Biopsy

  SSP DE000

  up to

  $4,535

• Shoulder Repair, Complex - Arthroscopic

  SSP MS005

  up to

  $8,119

• Tonsil and Adenoid Removal (Child Under 12)

  SSP EN000

  up to

  $4,464

• Tonsil and/or Adenoid Removal

  SSP EN004

  up to

  $4,525

• Ultrasound

  SSP RA008

  up to

  $1,171

• X-Ray

  SSP RA000

  up to

  $1,014