SAMPSON REGIONAL MEDICAL CENTER· CLINTON, NC

HospitalCMS 3/5

607 BEAMAN ST, CLINTON, NC 28328

Procedures offered

934 total

ProcedureMinAvgMax
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$261$344$456
X-ray knee 1-2 views
CPT 73560 • Imaging
$9$31$44
X-ray ankle complete
CPT 73610 • Imaging
$27$38$47
MRI lower extremity without contrast
CPT 73718 • Imaging
$283$395$549
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$260$344$456
CT abdomen without contrast
CPT 74150 • Imaging
$174$213$257
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$212$250$310
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$87$300$397
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$325$383$445
Ultrasound abdominal complete
CPT 76700 • Imaging
$109$146$179
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$40$105$140
Ultrasound transvaginal
CPT 76830 • Imaging
$42$113$153
Ultrasound pelvic complete
CPT 76856 • Imaging
$42$107$136
Diagnostic mammography unilateral
CPT 77065 • Imaging
$33$122$163
Diagnostic mammography bilateral
CPT 77066 • Imaging
$39$153$206
Screening mammography bilateral
CPT 77067 • Imaging
$32$124$166
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$360$461$544
Venipuncture (routine blood draw)
CPT 36415 • Lab
$13$13$13
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$2$4$6
Basic metabolic panel
CPT 80048 • Laboratory
$5$11$15
Comprehensive metabolic panel
CPT 80053 • Laboratory
$6$13$19
Lipid panel
CPT 80061 • Laboratory
$8$17$24
Hepatic function panel
CPT 80076 • Laboratory
$4$10$15
Urinalysis with microscopy
CPT 81001 • Laboratory
$2$4$6
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$2$3$4
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$8$20$32
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$17$37$53
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$8$12
Creatinine urine
CPT 82570 • Laboratory
$3$6$9
Ferritin
CPT 82728 • Laboratory
$7$17$24
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$5$11$17
Glucose quantitative blood
CPT 82947 • Laboratory
$3$5$7
Hemoglobin A1c
CPT 83036 • Laboratory
$7$11$13
Iron serum
CPT 83540 • Laboratory
$3$7$9
Iron binding capacity
CPT 83550 • Laboratory
$4$9$12
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$10$23$33
Free thyroxine (T4)
CPT 84439 • Laboratory
$5$11$16
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$11$21$30
Complete blood count with differential
CPT 85025 • Laboratory
$5$9$10
Complete blood count automated
CPT 85027 • Laboratory
$3$6$9
Prothrombin time (PT)
CPT 85610 • Laboratory
$3$5$6
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$3$3
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$3$7$11
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$6$16$23
Nuclear antigen antibody
CPT 86235 • Laboratory
$9$22$32
Heterophile antibodies screen
CPT 86308 • Laboratory
$4$6$7
TB skin test intradermal
CPT 86580 • Laboratory
$5$10$14
Blood typing ABO
CPT 86900 • Laboratory
$1$4$5
Blood typing Rh
CPT 86901 • Laboratory
$1$4$5
Urine culture bacterial colony count
CPT 87086 • Laboratory
$4$9$14