Aetna "Select Provider" Listing - High-Tech Radiology Toledo - January, 2013

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1 Aetna "Select Provider" Listing - High-Tech Radiology Maumee St. Luke's Hospital , Monclova Road Phone: Bay Park Community Memorial Hosptial , Bay Park Drive, OH Phone: Mercy St. Charles Hospital , Navarre Avenue, OH Phone: Sylvania Flower Hospital , Harroun Road Phone: Medical Imaging , Monroe Street, Suite 7 Phone: Svcs: MR, OMR Imaging Central, LLC , West Central Avenue, OH Phone: / Fax: Svcs: MR, OMR, PET Mercy St. Anne Hospital , West Sylvania Avenue, OH Phone: Mercy St. Vincent Medical Center , Cherry Street, OH Phone: Svcs: MR, CNM, CT PDI, LLC , Woodley Avenue, Suite A-1, OH Phone: / Fax: Svcs: MR , North Holland Sylvania Road, OH Phone: / Fax: Svcs: OMR The Imaging Center , Talmadge Road, Suite H, OH Phone: / Fax: Svcs: MR, OMR, CNM The Hospital , North Cove Blvd., OH Phone: Svcs: MR, OMR, CNM, CT The University of Medical Center , Arlington Avenue, OH Phone: / Fax: WOOD COUNTY Bowling Green Wood County Hospital , West Wooster Street Bowling Green, OH Phone: Perrysburg PDI, LLC , Eckel Junction Road, Suite 2W Perrysburg, OH Phone: / Fax: Svcs: MR Note(s): These procedures may require preauthorization. Aetna's radiology management vendors may have more current information that will replace the information contained within this List. Effective January 1, 2012, Aetna requires all providers administering high-tech radiology services to be accredited by the American College of Radiology and/or the Intersocietal Accreditation Commission. Any provider who performs these services but is not accredited at the time of service may not be eligible for payment. Aetna s radiology management vendors will offer alternative accredited providers in accordance with these standards. MR - Closed MRI OMR - Open MRI CNM - Cardio Nuclear Medicine CT - CAT Scan PET - Positron Emission Tomography

2 Aetna "Select Provider" Listing - Low-Tech Radiology ALLEN COUNTY Lima Lima Memorial Health System , Bellefontaine Avenue Lima, OH Phone: Bay Park Community Memorial Hosptial , Bay Park Drive, OH Phone: Mercy St. Charles Hospital , Navarre Avenue, OH Phone: Sylvania Flower Hospital , Harroun Road Phone: Svcs: X, US, M Medical Imaging , Monroe Street, Suite 7 Phone: Svcs: X Mercy St. Anne Hospital , West Sylvania Avenue, OH Phone: Svcs: X, US, M Mercy St. Vincent Medical Center , Cherry Street, OH Phone: Sylvania Ultrasound Institute & Men's Health Ctr , Woodley Rd, Suite A, OH Phone: / Fax: Svcs: US , North Holland Sylvania Road, Suite B, OH Phone: / Fax: The Hospital , North Cove Blvd., OH Phone: The University of Medical Center , Arlington Avenue, OH Phone: / Fax: SANDUSKY COUNTY Bellevue The Bellevue Hospital , West Main Street Bellevue, OH Phone: / Fax: X - X-Ray FL - Fluoroscopy US - Ultrasound S - Sonogram BD - Bone Density M - Mammography

3 Aetna "Select Provider" Listing - Ambulatory Surgery ALLEN COUNTY Delphos Delphos Ambulatory Surgery Center , East 5th Street Delphos, OH Phone: Lima Eye Surgery Center of Western Ohio , West Market Street Lima, OH Phone: Svcs: OPT The Endoscopy Center of West Central Ohio , Shawnee Road Lima, OH Phone: Svcs: EN CRAWFORD COUNTY Bucyrus Bucyrus Community Hospital , North Sandusky Avenue , North Sandusky Street ERIE COUNTY Sandusky Firelands Regional Medical Center- South Campus , Hayes Avenue Sandusky, OH Phone: NovaMed Surgery Center of Sandusky, L.L.C , Hayes Avenue Sandusky, OH Phone: HANCOCK COUNTY Findlay Findlay Surgery Center , Medical Blvd. Findlay, OH Phone: HURON COUNTY Norwalk Podiatric Surgi-Center, INC , Executive Pkwy. Norwalk, OH Phone: Svcs: ORP Maumee Optivue , West Dussel Drive Phone: St. Luke's Hospital , Monclova Road Phone: Surgi+Care , Monclova Road Phone: The Eye Institute of Northwestern Ohio, Inc , Briarfield Blvd. Phone: / Fax: Svcs: OPT Mercy St. Charles Hospital , Navarre Avenue, OH Phone: Optivue , Navarre Avenue, OH Phone: / Fax: Sylvania Flower Hospital , Harroun Road Phone: Mercy St. Anne Hospital , West Sylvania Avenue, OH Phone: Mercy St. Vincent Medical Center , Cherry Street, OH Phone: Northwest Ohio Endoscopy Center , Monroe Street, Suite 111, OH Phone: Svcs: EN Optivue , South Reynolds Road, OH Phone: , Lewis Avenue, OH Phone: Parkway Surgical Center, Ltd , Executive Pkwy., OH Phone: / Fax: Reconstructive & Aesthetic Surgery Center, Inc , North Reynolds Road, Suite 250, OH Phone: / Fax: Surgery Center at Regency Park , Regency Court, Suite 101, OH Phone: The Hospital , North Cove Blvd., OH Phone: The University of Medical Center , Arlington Avenue, OH Phone: / Fax: Clinic Outpatient Surgery Center , Secor Road, OH Phone: West Central Surgical Center, LLC , West Central Avenue, OH Phone: / Fax: Wildwood Surgical Center , North Reynolds Road, Suite 190, OH Phone: / Fax: Note(s): Some ambulatory procedures require the physician to notify Aetna prior to performing services (e.g., colonoscopy and other scope procedures). These procedures were not used to determine this listing. GEN - General Surgery EN - Endoscopy INF - Infertility LT - Lithotripsy OPT - Opthalmology ORP - Orthopedics BA - Bariatric UR - Urology

4 Aetna "Select Provider" Listing - Sleep Studies ALLEN COUNTY Bluffton Blanchard Valley Regional Health Center-Bluffton Hospital , Garau Street Bluffton, OH Phone: Lima Sleep Center of Lima , West Market Street, Suite 200 Lima, OH Phone: / Fax: CRAWFORD COUNTY Bucyrus Bucyrus Community Hospital , North Sandusky Avenue , North Sandusky Street HANCOCK COUNTY Findlay Blanchard Valley Hospital , South Main Street Findlay, OH Phone: Maumee St. Luke's Hospital , Monclova Road Phone: Sleep Disorders Center, Ltd , Holland Road, Suite 300 Phone: / Fax: Sleep Disorders Center, Ltd , Navarre Avenue, OH Phone: Sleep Network of, Inc. Dba The Regional Center for Sleep Medicine , West Sylvania Avenue, Suite 202, OH Phone: / Fax: SANDUSKY COUNTY Bellevue The Bellevue Hospital , West Main Street Bellevue, OH Phone: / Fax: Fremont Memorial Hospital , South Taft Avenue Fremont, OH Phone: / Fax: WOOD COUNTY Bowling Green Wood County Hospital , West Wooster Street Bowling Green, OH Phone: Perrysburg Physician Diagnostic Sleep Technology Specialists LLC , West South Boundary Perrysburg, OH Phone: / Fax:

5 Aetna National Provider Directory Home Sleep Testing In home sleep tests, where appropriate, may cost less than lab based services. In addition to the Select List of local sleep study providers, we are including a list of national sleep study providers that can provide sleep studies in the home: National home sleep providers Name Phone number Fax number for orders Website Instant Diagnostic Systems, Inc. (888) (888) dba IDS Inc Nationwide Sleep Diagnostics LLC dba NiteWatch (800) (800) SleepQuest, Inc. (800) (650) Sleep Solutions Inc./NovaSom, Inc (877) (866) University Services (215) (267) SleepMed, Inc. dba Digitrace Care Services (877) Watermark Medical, Inc (877) (877) To learn more You can access more information on home sleep testing on our DocFind online provider directory. Simply go to and choose Find a Doctor. Once on DocFind: Search for Other (X- ray, Surg Ctrs, Med Equip, etc.) Select Type Home Sleep Testing Providers Once on a new page, you can select the Click here to find a provider link to review a broader provider list.

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