ONSLOW MEMORIAL HOSPITAL INC· JACKSONVILLE, NC
HospitalCMS 1/5
317 WESTERN BLVD, JACKSONVILLE, NC 28546
Procedures offered
937 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| MRI thoracic spine without contrast CPT 72146 • Imaging | $134 | $310 | $523 |
| MRI lumbar spine without contrast CPT 72148 • Imaging | $131 | $328 | $523 |
| X-ray shoulder complete CPT 73030 • Imaging | $21 | $34 | $45 |
| MRI joint upper extremity without contrast CPT 73221 • Imaging | $73 | $301 | $523 |
| X-ray knee 1-2 views CPT 73560 • Imaging | $9 | $31 | $45 |
| X-ray ankle complete CPT 73610 • Imaging | $25 | $36 | $45 |
| MRI lower extremity without contrast CPT 73718 • Imaging | $72 | $307 | $523 |
| MRI joint lower extremity without contrast CPT 73721 • Imaging | $73 | $344 | $523 |
| CT abdomen without contrast CPT 74150 • Imaging | $64 | $202 | $275 |
| CT abdomen and pelvis without contrast CPT 74176 • Imaging | $94 | $183 | $235 |
| CT abdomen and pelvis with contrast CPT 74177 • Imaging | $98 | $268 | $376 |
| CT abdomen and pelvis without then with contrast CPT 74178 • Imaging | $108 | $322 | $477 |
| Ultrasound abdominal complete CPT 76700 • Imaging | $38 | $95 | $150 |
| Ultrasound retroperitoneal complete CPT 76770 • Imaging | $105 | $129 | $148 |
| Ultrasound transvaginal CPT 76830 • Imaging | $37 | $95 | $160 |
| Ultrasound pelvic complete CPT 76856 • Imaging | $42 | $93 | $138 |
| Diagnostic mammography unilateral CPT 77065 • Imaging | $94 | $118 | $143 |
| Diagnostic mammography bilateral CPT 77066 • Imaging | $50 | $131 | $182 |
| Screening mammography bilateral CPT 77067 • Imaging | $38 | $113 | $147 |
| Nuclear myocardial perfusion study CPT 78452 • Imaging | $336 | $402 | $534 |
| Venipuncture (routine blood draw) CPT 36415 • Lab | $3 | $3 | $3 |
| Urinalysis non-automated without microscopy CPT 81002 • Lab | $1 | $2 | $3 |
| Strep test rapid (Streptococcus group A direct) CPT 87880 • Lab | $12 | $12 | $12 |
| Basic metabolic panel CPT 80048 • Laboratory | $3 | $10 | $23 |
| Comprehensive metabolic panel CPT 80053 • Laboratory | $6 | $9 | $14 |
| Lipid panel CPT 80061 • Laboratory | $7 | $18 | $36 |
| Hepatic function panel CPT 80076 • Laboratory | $3 | $10 | $22 |
| Urinalysis with microscopy CPT 81001 • Laboratory | $1 | $3 | $4 |
| Urinalysis automated without microscopy CPT 81003 • Laboratory | $1 | $2 | $3 |
| Fecal hemoglobin immunoassay CPT 82274 • Laboratory | $8 | $18 | $32 |
| Vitamin D 25-hydroxy CPT 82306 • Laboratory | $16 | $38 | $81 |
| Creatine kinase (CK) total CPT 82550 • Laboratory | $2 | $8 | $18 |
| Creatinine urine CPT 82570 • Laboratory | $3 | $7 | $14 |
| Ferritin CPT 82728 • Laboratory | $4 | $17 | $37 |
| IgA IgD IgG IgM each CPT 82784 • Laboratory | $5 | $11 | $25 |
| Glucose quantitative blood CPT 82947 • Laboratory | $2 | $3 | $5 |
| Hemoglobin A1c CPT 83036 • Laboratory | $3 | $8 | $13 |
| Iron serum CPT 83540 • Laboratory | $2 | $5 | $9 |
| Iron binding capacity CPT 83550 • Laboratory | $3 | $7 | $10 |
| Prostate specific antigen (PSA) CPT 84153 • Laboratory | $6 | $23 | $50 |
| Free thyroxine (T4) CPT 84439 • Laboratory | $5 | $12 | $25 |
| Thyroid stimulating hormone (TSH) CPT 84443 • Laboratory | $9 | $22 | $46 |
| Complete blood count with differential CPT 85025 • Laboratory | $4 | $7 | $10 |
| Complete blood count automated CPT 85027 • Laboratory | $2 | $5 | $9 |
| Prothrombin time (PT) CPT 85610 • Laboratory | $1 | $4 | $5 |
| Sedimentation rate (ESR) automated CPT 85652 • Laboratory | $1 | $2 | $4 |
| Partial thromboplastin time (PTT) CPT 85730 • Laboratory | $3 | $8 | $16 |
| Cyclic citrullinated peptide antibody CPT 86200 • Laboratory | $6 | $15 | $35 |
| Nuclear antigen antibody CPT 86235 • Laboratory | $6 | $21 | $49 |
| Heterophile antibodies screen CPT 86308 • Laboratory | $3 | $5 | $7 |