ONSLOW MEMORIAL HOSPITAL INC· JACKSONVILLE, NC
HospitalCMS 1/5
317 WESTERN BLVD, JACKSONVILLE, NC 28546
Procedures offered
954 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $23 | $34 | $40 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $7 | $17 | $30 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $11 | $14 |
| Immunization admin injection single CPT 90471 • Preventive Care | $7 | $13 | $17 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $5 | $11 | $13 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $274 | $332 | $378 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $232 | $253 | $260 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $101 | $109 | $118 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $21 | $22 | $23 |
| MMR vaccine CPT 90707 • Preventive Care | $97 | $103 | $110 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $47 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $187 | $204 | $221 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $127 | $147 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $230 | $248 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $75 | $98 | $117 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $79 | $105 | $122 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $93 | $115 | $174 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $80 | $118 | $144 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $100 | $117 | $139 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $123 | $139 | $162 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $134 | $151 | $175 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $54 | $75 | $105 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $62 | $84 | $106 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $78 | $88 | $100 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $85 | $104 | $123 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $85 | $102 | $126 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $100 | $114 | $134 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $109 | $125 | $144 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $22 | $32 | $41 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $149 | $236 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $295 | $372 | $469 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $197 | $274 | $396 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $89 | $142 | $175 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $149 | $177 | $252 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $106 | $115 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $114 | $256 | $329 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $143 | $314 | $565 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $131 | $258 | $492 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $133 | $229 | $353 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $245 | $435 | $765 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $274 | $1,122 | $2,548 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $87 | $98 | $118 |
| Spirometry CPT 94010 • Pulmonology | $9 | $25 | $45 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $14 | $42 | $69 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $31 | $51 | $66 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $16 | $29 | $45 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $71 | $134 | $181 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $18 | $29 | $45 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $17 | $28 | $45 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $13 | $50 | $60 |