SOUTHEASTERN REGIONAL MEDICAL CENTER· LUMBERTON, NC
HospitalCMS 2/5
300 W 27 ST PO BOX 1408, LUMBERTON, NC 28359
Procedures offered
923 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| CT abdomen and pelvis without contrast CPT 74176 • Imaging | $6 | $182 | $358 |
| CT abdomen and pelvis with contrast CPT 74177 • Imaging | $10 | $250 | $490 |
| CT abdomen and pelvis without then with contrast CPT 74178 • Imaging | $9 | $183 | $358 |
| Ultrasound abdominal complete CPT 76700 • Imaging | $54 | $119 | $185 |
| Ultrasound retroperitoneal complete CPT 76770 • Imaging | $49 | $53 | $58 |
| Ultrasound transvaginal CPT 76830 • Imaging | $47 | $69 | $91 |
| Ultrasound pelvic complete CPT 76856 • Imaging | $46 | $52 | $58 |
| Diagnostic mammography unilateral CPT 77065 • Imaging | $54 | $128 | $201 |
| Diagnostic mammography bilateral CPT 77066 • Imaging | $66 | $160 | $254 |
| Screening mammography bilateral CPT 77067 • Imaging | $51 | $128 | $205 |
| Nuclear myocardial perfusion study CPT 78452 • Imaging | $639 | $970 | $1,301 |
| Urinalysis non-automated without microscopy CPT 81002 • Lab | $4 | $4 | $5 |
| Basic metabolic panel CPT 80048 • Laboratory | $9 | $10 | $12 |
| Comprehensive metabolic panel CPT 80053 • Laboratory | $15 | $18 | $21 |
| Lipid panel CPT 80061 • Laboratory | $18 | $23 | $27 |
| Hepatic function panel CPT 80076 • Laboratory | $8 | $10 | $11 |
| Urinalysis with microscopy CPT 81001 • Laboratory | $4 | $6 | $7 |
| Urinalysis automated without microscopy CPT 81003 • Laboratory | $2 | $3 | $3 |
| Fecal hemoglobin immunoassay CPT 82274 • Laboratory | $16 | $19 | $22 |
| Vitamin D 25-hydroxy CPT 82306 • Laboratory | $30 | $35 | $41 |
| Creatine kinase (CK) total CPT 82550 • Laboratory | $8 | $8 | $9 |
| Creatinine urine CPT 82570 • Laboratory | $6 | $7 | $7 |
| Ferritin CPT 82728 • Laboratory | $16 | $18 | $19 |
| IgA IgD IgG IgM each CPT 82784 • Laboratory | $9 | $11 | $13 |
| Glucose quantitative blood CPT 82947 • Laboratory | $4 | $5 | $5 |
| Hemoglobin A1c CPT 83036 • Laboratory | $13 | $16 | $19 |
| Iron serum CPT 83540 • Laboratory | $8 | $8 | $9 |
| Iron binding capacity CPT 83550 • Laboratory | $9 | $10 | $12 |
| Prostate specific antigen (PSA) CPT 84153 • Laboratory | $19 | $22 | $25 |
| Free thyroxine (T4) CPT 84439 • Laboratory | $9 | $11 | $12 |
| Thyroid stimulating hormone (TSH) CPT 84443 • Laboratory | $23 | $30 | $37 |
| Complete blood count with differential CPT 85025 • Laboratory | $11 | $21 | $31 |
| Complete blood count automated CPT 85027 • Laboratory | $8 | $8 | $9 |
| Prothrombin time (PT) CPT 85610 • Laboratory | $4 | $5 | $6 |
| Sedimentation rate (ESR) automated CPT 85652 • Laboratory | $3 | $3 | $4 |
| Partial thromboplastin time (PTT) CPT 85730 • Laboratory | $7 | $8 | $8 |
| Cyclic citrullinated peptide antibody CPT 86200 • Laboratory | $16 | $17 | $18 |
| Nuclear antigen antibody CPT 86235 • Laboratory | $18 | $21 | $25 |
| Heterophile antibodies screen CPT 86308 • Laboratory | $6 | $7 | $7 |
| TB skin test intradermal CPT 86580 • Laboratory | $13 | $14 | $15 |
| Blood typing ABO CPT 86900 • Laboratory | $3 | $4 | $4 |
| Blood typing Rh CPT 86901 • Laboratory | $3 | $4 | $4 |
| Urine culture bacterial colony count CPT 87086 • Laboratory | $10 | $10 | $11 |
| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $42 | $45 | $48 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $42 | $45 | $48 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $59 | $65 | $71 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $17 | $20 | $23 |
| Amniocentesis diagnostic CPT 59000 • Maternity | $4 | $93 | $183 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $6 | $6 | $6 |
| Chorionic villus sampling CPT 59015 • Maternity | $5 | $5 | $5 |