DLP PERSON MEMORIAL HOSPITAL LLC· ROXBORO, NC

Hospital

615 RIDGE RD, ROXBORO, NC 27573

Procedures offered

663 total

ProcedureMinAvgMax
Urinalysis with microscopy
CPT 81001 • Laboratory
$3$6$7
Urinalysis nonautomated without microscopy
CPT 81002 • Laboratory
$2$7$11
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$2$4$5
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$13$31$35
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$25$69$127
Creatine kinase (CK) total
CPT 82550 • Laboratory
$5$15$28
Creatinine urine
CPT 82570 • Laboratory
$4$10$11
Ferritin
CPT 82728 • Laboratory
$11$26$30
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$8$22$40
Glucose quantitative blood
CPT 82947 • Laboratory
$3$7$9
Hemoglobin A1c
CPT 83036 • Laboratory
$8$18$21
Iron serum
CPT 83540 • Laboratory
$5$12$14
Iron binding capacity
CPT 83550 • Laboratory
$7$19$38
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$15$43$79
Free thyroxine (T4)
CPT 84439 • Laboratory
$8$21$39
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$14$39$70
Complete blood count with differential
CPT 85025 • Laboratory
$7$15$17
Complete blood count automated
CPT 85027 • Laboratory
$5$15$28
Prothrombin time (PT)
CPT 85610 • Laboratory
$3$10$17
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$6$12
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$5$12$13
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$11$25$28
Nuclear antigen antibody
CPT 86235 • Laboratory
$15$42$77
Heterophile antibodies screen
CPT 86308 • Laboratory
$4$12$22
TB skin test intradermal
CPT 86580 • Laboratory
$4$18$22
Blood typing ABO
CPT 86900 • Laboratory
$3$6$7
Blood typing Rh
CPT 86901 • Laboratory
$4$7$13
Urine culture bacterial colony count
CPT 87086 • Laboratory
$7$15$18
Chlamydia nucleic acid amplification
CPT 87491 • Laboratory
$29$67$77
Gonorrhea nucleic acid amplification
CPT 87591 • Laboratory
$29$73$105
SARS-CoV-2 COVID-19 amplified probe
CPT 87635 • Laboratory
$31$119$141
Influenza virus assay with direct optical
CPT 87804 • Laboratory
$10$34$49
Strep A assay with optic observation
CPT 87880 • Laboratory
$10$30$36
Amniocentesis diagnostic
CPT 59000 • Maternity
$1,755$5,654$6,953
Cordocentesis fetal blood sampling
CPT 59012 • Maternity
$1,085$5,780$6,954
Chorionic villus sampling
CPT 59015 • Maternity
$1,755$5,654$6,953
Fetal non-stress test
CPT 59025 • Maternity
$1,085$1,085$1,085
Insertion cervical dilator
CPT 59200 • Maternity
$1,085$5,780$6,954
Vaginal delivery including prenatal and postpartum care
CPT 59400 • Maternity
$3,287$3,287$3,287
Vaginal delivery only
CPT 59409 • Maternity
$6,575$6,878$6,954
Vaginal delivery including postpartum care
CPT 59410 • Maternity
$3,287$5,563$6,954
External cephalic version
CPT 59412 • Maternity
$6,575$6,575$6,575
Antepartum care 7 or more visits
CPT 59426 • Maternity
$3,287$3,287$3,287
Postpartum care only
CPT 59430 • Maternity
$3,287$6,037$6,953
Cesarean delivery including prenatal and postpartum care
CPT 59510 • Maternity
$3,287$3,287$3,287
Cesarean delivery only
CPT 59514 • Maternity
$3,287$3,287$3,287
Cesarean delivery including postpartum care
CPT 59515 • Maternity
$3,287$7,013$7,945
Vaginal delivery after prior cesarean (VBAC) including prenatal
CPT 59610 • Maternity
$3,287$3,287$3,287
Obstetric ultrasound first trimester
CPT 76801 • Maternity
$169$169$169
Obstetric ultrasound complete
CPT 76805 • Maternity
$210$210$210