Aetna "Select Provider" Listing - Ambulatory Surgery Cleveland - January, CSA St. Vincent Charity Hospital

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OHIO ASHTABULA COUNTY Ashtabula Ashtabula County Medical 6460140, 34194 2420 Lake Avenue Ashtabula, OH 44004 Phone: 440-997-2262 CUYAHOGA COUNTY Beachwood Cleveland for Digestive Health & Endoscopy, LLC. 7316076, 5812636 3700 Park East Drive, Suite 100A Phone: 216-593-7700 Digestive Health, Inc. 4459146, 7300802 23250 Chagrin Blvd., Suite 110 Phone: 440-729-3399 / Fax: 216-591-9399 4459146, 482680 4110 Warrensville Road Phone: 216-591-1862 Bedford 19550 Rockside Road Bedford, OH 44146 Phone: 440-232-8381 / Fax: 440-232-9371 9568415, 4331451 Bedford Heights 9568415, 2514312 Bedford Height ASC 25350 Rockside Road, Suite 100 Bedford Heights, OH 44146 Phone: 440-232-8381 9568415, 2984282 Bedford Heights Health 25350 Rockside Road, Suite 200 Bedford Heights, OH 44146 Phone: 440-232-8381 Brecksville Brecksville Surgery LLC 7001 South Edgerton Road, Suite A Brecksville, OH 44141 Phone: 440-717-0591 / Fax: 440-717-0594 9818403, 5393441 Cleveland 7687449, 76433 9500 Euclid Avenue Cleveland, OH 44195 Phone: 330-287-4500 CSA St. Vincent Charity Hospital 2351 East 22nd Street Cleveland, OH 44115 Phone: 216-861-6200 / Fax: 216-363-3333 6460470, 2740213 MetroHealth Medical 2500 Metrohealth Drive Phone: 216-778-7800 6466150, 3400509 9568415, 5444337 Old Brooklyn Health 3311 Broadview Road Phone: 216-661-1545 9568415, 4914310 Cleveland Health 7997 Euclid Avenue Cleveland, OH 44103 Phone: 216-851-1880 East Cleveland CCF-Stephanie Tubbs Jones Health 9131877, 7094134 13944 Euclid Avenue East Cleveland, OH 44112 Phone: 216-767-4242 Mayfield Heights 7687449, 112193 6780 Mayfield Road Mayfield Heights, OH 44124 Phone: 216-643-3062 Consultants in Gastroenterology Endoscopy 8464635, 7213364 5900 Landerbrook Drive, Suite 195 Mayfield Heights, OH 44124 Phone: 440-461-2550 Middleburg Heights Southwest General Health 18697 East Bagley Road Phone: 440-816-8000 6460190, 34187 Surgery Pearl, LLC 6900 Pearl Road, Suite 101 Phone: 440-882-0103 9812121, 7683257 The Surgery Bagley 19250 Bagley Road Phone: 440-826-3240 / Fax: 440-826-3250 8462310, 2451426 Parma Parma Community General Hospital 7007 Powers Blvd. Parma, OH 44129 Phone: 440-743-3000 6460440, 39268 Parma Heights Vision Surgery, LLC 6355 Pearl Road Parma Heights, OH 44130 Phone: 440-886-2020 9325602, 6323898 Richmond Heights Cleveland Surgical Suites 5106 Wilson Mills Road Richmond Heights, OH 44143 Phone: 440-461-2570 4465141, 8480804 Rocky River Rocky River Health 20800 Ridge Road Rocky River, OH 44116 Phone: 440-333-1020 9568415, 5104347 South Euclid University Suburban Health 1611 South Green Road, Suite 124 South Euclid, OH 44121 Phone: 216-382-1868 / Fax: 216-382-0584 8462305, 34486 Westlake North Ohio Endoscopy, LLC 30701 Clemens Road Phone: 440-617-1212 / Fax: 440-617-1213 9529329, 4593550 Premier Ambulatory Outpatient Surgery 5061714, 4573537 25200 Ridge Road, Suite 3100 Phone: 440-331-4559 / Fax: 440-333-7044 GEAUGA COUNTY Chagrin Falls The Endoscopy at Bainbridge, LLC 9969077, 1043118 8185 East Washington Street, Suite 106 Chagrin Falls, OH 44023 Phone: 440-708-0582 / Fax: 440-708-0583 LAKE COUNTY Concord Twp Consultants in Gastroenterology Endoscopy 8464635, 5133345 7530 Fredle Drive Concord Twp, OH 44077 Phone: 440-386-2240 1 of 4

TriPoint Medical 7590 Auburn Road Concord TWP, OH 44077 Phone: 440-375-8100 6460930, 7593730 Madison TriPoint Medical 6270 North Ridge Road Madison, OH 44057 Phone: 440-428-0280 6460930, 7371016 Mentor Lake County Pain & Diagnostic 8401 Mentor Avenue, Suite A Phone: 440-205-0080 / Fax: 440-205-1820 7553666, 5962167 Mentor Surgery, Ltd. 9485 Mentor Avenue, Suite 1 Phone: 440-205-5725 5259642, 2541754 The Endoscopy Of Lake County 9614 Old Johnnycake Ridge Road Phone: 440-205-1225 / Fax: 404-205-1275 7617799, 2972746 TriPoint Medical 9485 Mentor Avenue Phone: 440-352-1200 6460930, 3560187 University Mednet Surgery 9000 Mentor Avenue Phone: 216-383-6730 7911019, 48974 Painesville G & G International, LLC d/b/a surgical Care 9733150, 4403256 2165 Mentor Avenue Painesville, OH 44077 Phone: 440-354-9775 / Fax: 440-354-9784 Willoughby CDH Endoscopy 34940 Ridge Road, Suite B Willoughby, OH 44094 Phone: 440-953-8568 5256499, 3961595 LORAIN COUNTY Elyria EMH Regional Medical 6460640, 3740 630 East River Street Phone: 440-329-7500 North Coast Surgery, LLC 1170 East Broad Street, Suite 104 Phone: 440-366-6029 / Fax: 440-366-6064 7174798, 8582247 Premium Surgery L.L.C. 5319 Hoag Drive Phone: 440-930-6050 / Fax: 440-934-8882 7077048, 9881211 Lorain Erie Shores Endoscopy 3600 Kolbe Road, Suite 19 Lorain, OH 44053 Phone: 440-960-7277, OPT, ORP 5787529, 577118 Mercy Regional Medical -East 205 West 20th Street Lorain, OH 44052 Phone: 440-233-1000 6460780, 3783 Lorain Health 200 West 9th Street Lorain, OH 44052 Phone: 440-242-2087 9568415, 5484313 MAHONING COUNTY Boardman St. Elizabeth Boardman Health 7660929, 9401341 8401 Market Street Phone: 330-729-2929 / Fax: 330-729-5591 The Orthopaedic Surgery Building B 6505 Market Street, Suite 101 Phone: 330-965-0580 Svcs: ORP 7166546, 4453215 Canfield Surgery of Canfield 7441592, 9722145 4147 Westford Drive Canfield, OH 44406 Phone: 330-702-1489 / Fax: 330-702-1545 Poland The for Advanced Eye Surgery 1031 West Western Reserve Road Poland, OH 44514 Phone: 330-965-0900 7182023, 7301129 Health 77 East Midlothian Blvd., OH 44507 Phone: 330-788-2487 9568415, 2664369 St. Elizabeth Health 1044 Belmont Avenue, OH 44504 Phone: 330-480-7211 6461190, 4333658 The Surgical Hospital at Southwoods 7630 Southern Blvd. Phone: 330-758-1954 9880424, 2073592 Tippecanoe Endoscopy, Inc 1210 Boardman Canfield Road Phone: 330-726-0132 5326133, 6200254 MEDINA COUNTY Medina Medina General Hospital 6460845, 142282 1000 East Washington Street Phone: 330-725-1000 Medina Health 4018 Medina Road, Suite C Phone: 330-723-1300 9568415, 4664318 The Medina Surgery 3780 Medina Road, Suite 120 Phone: 330-952-0014 / Fax: 330-952-0015 9164629, 1963924 PORTAGE COUNTY Kent 9568415, 9954332 Kent Health 138 East Main Street Kent, OH 44240 Phone: 330-678-8011 Western Reserve Surgery 1930 State Route 59 Kent, OH 44240 Phone: 330-677-3620 / Fax: 330-677-3624 Svcs: GEN, EN, ORP, Podiatry;Pain Mgmt. 4507294, 348857 Ravenna Robinson Memorial Hospital 6847 North Chestnut Street Ravenna, OH 44266 Phone: 330-297-0811 6460970, 39302 RICHLAND COUNTY Mansfield Advanced Eye Care Surgery, 7694902, 7880696 1991 Park Avenue West Phone: 419-529-0088 2 of 4

Ohio Eye Associates 466 South Trimble Road Phone: 419-756-8000 / Fax: 419-756-7100 5734290, 167861 Mansfield Health 384 Park Avenue West Phone: 419-525-3075 9568415, 8944417 STARK COUNTY Alliance Surgery Alliance, LTD 5749040, 9260139 975 Sawburg Avenue Alliance, OH 44601 Phone: 330-821-7997 / Fax: 330-821-7295 Canton CG Endoscopy, LTD 3722 Dressler Road Northwest Phone: 330-479-9000 / Fax: 330-477-5805 7881390, 1041631 Gastroenterology Associates, Inc. 4665 Belpar Street Phone: 330-493-1485 8467319, 147753 Gastroenterology Specialists, Inc. 2726 Fulton Drive Northwest Phone: 330-455-5011 / Fax: 330-588-7127 4592244, 5121851 GOC Endoscopy Inc. 4124 Munson Street Northwest, Suite A Phone: 330-492-6662 4505586, 8942057 Mercy Medical 1320 Mercy Drive Northwest Canton, OH 44708 Phone: 330-489-1000 6460240, 159197 Oasis Orthopaedic Ambulatory Surgical Intervention Svcs 5449716, 34005 4889 Munson Street Northwest Phone: 330-498-9898 / Fax: 330-498-9700 Svcs: GEN, EN, ORP, Pain Mgmt.,Spinal Surgery Canton Health 2663 Cleveland Avenue Northwest Canton, OH 44709 Phone: 330-456-7191 9568415, 3574263 Stark Ambulatory Surgery LLC. 4360 Fulton Drive Northwest Phone: 330-305-2020 / Fax: 330-305-0303 7058688, 1552242 The Eye Surgical, LLC 800 McKinley Avenue Northwest Canton, OH 44703 Phone: 330-639-0046 / Fax: 330-639-0042 7708870, 533779 Massillon Affinity Medical -Massillon Campus 6460835, 216570 875 8th Street Northeast Massillon, OH 44646 Phone: 330-832-8761 SUMMIT COUNTY Akron Crystal Clinic Orthopaedic - Surgery 9273333, 390721 3975 Embassy Pkwy. Akron, OH 44333 Phone: 330-668-4085 / Fax: 330-668-2624 Svcs: ORP Digestive Health, LTD 570 White Pond Drive, Suite 150 Akron, OH 44320 Phone: 330-869-0178 / Fax: 330-869-6065 4513023, 9791704 Park West Surgical One Park West Blvd., Suite 260 Akron, OH 44320 Phone: 330-864-6000 / Fax: 330-864-6020, Oculoplastics,Pain Mgmt. 7200868, 3802842 Akron Health 444 West Exchange Street Akron, OH 44302 Phone: 330-535-2671 9568415, 3494501 System Optics ASC Facility 3510 Manchester Road Akron, OH 44319 Phone: 330-630-9699 7751182, 3112262 Cuyahoga Falls The For Surgery 789 Graham Road Cuyahoga Falls, OH 44221 Phone: 330-923-7636 5931550, 6820531 Norton Digestive Wellness, LLC 3939 South Cleveland-Massillon Road Norton, OH 44203 Phone: 330-237-1058 / Fax: 330-237-1059 9839148, 7103119 Stow St. Clare Surgery 4441 Hudson Drive Stow, OH 44224 Phone: 330-920-4500 5833466, 3740584 Tallmadge System Optics ASC Facility 518 West Avenue Tallmadge, OH 44278 Phone: 330-630-9699 7751182, 144305 TRUMBULL COUNTY Cortland 9568415, 7894333 Cortland Health 2664 Elm Road, Bldg. C Cortland, OH 44410 Phone: 330-399-5104 Warren Lippy Surgery, LLC 3893 East Market Street Warren, OH 44484 Phone: 330-856-7585 9812160, 5881 Trumbull Memorial Hospital 1350 East Market Street Warren, OH 44483 Phone: 330-841-9011 / Fax: 330-841-9549 6461125, 9004395 Belmont Eye Surgery 3020 Belmont Avenue, OH 44505 Phone: 330-759-7672 5348084, 5920 Northside Medical 500 Gypsy Lane, OH 44504 Phone: 330-884-1000 6461200, 5434288 TUSCARAWAS COUNTY Dennison Trinity Hospital Twin City 6460625, 247046 819 North 1st Street Dennison, OH 44621 Phone: 740-922-2800 3 of 4

Dover Tuscarawas Ambulatory Surgery 7807017, 4801193 320 Oxford Street Dover, OH 44622 Phone: 330-365-2101 Svcs: GEN, EN, LT, OPT, ORP, UR WAYNE COUNTY Wooster 7687449, 1591757 721 East Milltown Road Phone: 330-287-4500 Eye Surgery of Wooster 3519 Friendsville Road Phone: 330-345-7200 / Fax: 330-345-8029 5777312, 274651 Wooster Health 334 East Milltown Road Phone: 330-345-7798 9568415, 6454439 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. 4 of 4

OHIO ASHTABULA COUNTY Ashtabula Ashtabula County Medical 6460140, 34194 2420 Lake Avenue Ashtabula, OH 44004 Phone: 440-997-2262 CUYAHOGA COUNTY Beachwood 7207189, 7743795 24700 Chagrin Blvd, STE 101 Phone: 330-759-5980 Brooklyn Preferred Diagnostic Sleep Laboraties of Ohio, Inc. 7622076, 2691415 7575 Northcliff Avenue, Suite 401 Brooklyn, OH 44144 Phone: 216-748-8283 Cleveland CSA St. Vincent Charity Hospital 2351 East 22nd Street Cleveland, OH 44115 Phone: 216-861-6200 / Fax: 216-363-3333 6460470, 39100 MetroHealth Medical 2500 Metrohealth Drive Phone: 216-778-7800 6466150, 142296 West Region Sleep 15805 Puritas Avenue Cleveland, OH 44135 Phone: 216-267-5933 7588185, 1080365 Middleburg Heights Remedy Sleep Disorders 7507 Pearl Road Phone: 440-933-7775 7959455, 1784013 Southwest General Health 18697 East Bagley Road Phone: 440-816-8000 6460190, 34187 North Olmsted Remedy Sleep Disorders 25761 Lorain Road, 2nd Floor North Olmsted, OH 44070 Phone: 440-734-4900 / Fax: 440-734-4902 7959455, 4361277 Aetna "Select Provider" Listing - Sleep Studies Parma West Region Sleep 6707 Powers Blvd., Suite 105 Parma, OH 44129 Phone: 440-842-8400 7588185, 409208 Westlake Westlake Sleep 25101 Detroit Road, Suite 450B Phone: 440-899-8136 / Fax: 440-899-7931 9155076, 5343086 GEAUGA COUNTY Chardon Geauga Sleep 8463705, 6264292 100 Seventh Avenue, Suite 225 Chardon, OH 44024 Phone: 440-285-9598 8463705, 1121719 13221 Ravenna Road, Suite 13 Chardon, OH 44024 Phone: 440-285-9598 HOLMES COUNTY Millersburg Joel Pomerene Memorial Hospital 6460855, 533355 981 Wooster Road Millersburg, OH 44654 Phone: 330-674-1015 LORAIN COUNTY Avon Lake Remedy Sleep Disorders 7959455, 3421009 32730 Walker Road, Suite D1 Avon Lake, OH 44012 Phone: 440-933-7775 / Fax: 440-933-9456 7959455, 5694312 32745 Walker Road, Suite C Avon Lake, OH 44012 Phone: 440-933-7775 / Fax: 440-933-9456 Elyria EMH Regional Medical 630 East River Street Phone: 440-329-7500 6460640, 3740 Oberlin Mercy Allen Hospital 200 West Lorain Street Oberlin, OH 44074 Phone: 440-775-1211 6460915, 159357 MAHONING COUNTY Boardman Crossroads Sleep Disorders, LLC 7831622, 2140367 721 Boardman-Poland Road, Suite 204 Phone: 330-965-0220 / Fax: 330-965-9622 250 DeBartolo Place, Suite 2755 Phone: 330-965-8335 / Fax: 330-965-8337 7207189, 9763229 The Surgical Hospital at Southwoods 7630 Southern Blvd. Phone: 330-758-1954 9880424, 2073592 PORTAGE COUNTY Ravenna Robinson Memorial Hospital 6460970, 39302 6847 North Chestnut Street Ravenna, OH 44266 Phone: 330-297-0811 STARK COUNTY Canton Mercy Medical 6460240, 159197 1320 Mercy Drive Northwest Canton, OH 44708 Phone: 330-489-1000 North Canton 6520 Whipple Avenue Northwest North Canton, OH 44720 Phone: 330-494-7297 / Fax: 330-494-7365 7207189, 3962079 SUMMIT COUNTY Cuyahoga Falls Crossroads Sleep Disorders, LLC 7831622, 2082574 267 West Portage Trail, Suite 100 Cuyahoga Falls, OH 44223 Phone: 330-923-0228 TRUMBULL COUNTY Girard 7207189, 3963848 1825 Tibbets Wick Girard, OH 44420 Phone: 330-759-9233 / Fax: 330-759-9677 Northside Medical 500 Gypsy Lane, OH 44504 Phone: 330-884-1000 6461200, 6080 1 of 1