WILKES REGIONAL MEDICAL CENTER· NORTH WILKESBORO, NC

HospitalCMS 3/5

1370 WEST D ST, NORTH WILKESBORO, NC 28659

Procedures offered

932 total

ProcedureMinAvgMax
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$370$430$489
X-ray knee 1-2 views
CPT 73560 • Imaging
$36$50$81
X-ray ankle complete
CPT 73610 • Imaging
$11$50$88
MRI lower extremity without contrast
CPT 73718 • Imaging
$99$312$439
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$100$333$439
CT abdomen without contrast
CPT 74150 • Imaging
$87$188$270
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$174$258$440
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$156$387$730
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$130$499$819
Ultrasound abdominal complete
CPT 76700 • Imaging
$56$98$123
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$51$77$116
Ultrasound transvaginal
CPT 76830 • Imaging
$106$196$280
Ultrasound pelvic complete
CPT 76856 • Imaging
$107$167$230
Diagnostic mammography unilateral
CPT 77065 • Imaging
$104$142$196
Diagnostic mammography bilateral
CPT 77066 • Imaging
$73$154$249
Screening mammography bilateral
CPT 77067 • Imaging
$53$154$228
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$103$476$1,014
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$4$6$9
Basic metabolic panel
CPT 80048 • Laboratory
$4$13$21
Comprehensive metabolic panel
CPT 80053 • Laboratory
$7$15$21
Lipid panel
CPT 80061 • Laboratory
$11$21$33
Hepatic function panel
CPT 80076 • Laboratory
$4$11$16
Urinalysis with microscopy
CPT 81001 • Laboratory
$2$5$10
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$3$4$7
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$18$27$32
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$21$45$68
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$10$16
Creatinine urine
CPT 82570 • Laboratory
$3$8$13
Ferritin
CPT 82728 • Laboratory
$12$20$27
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$6$13$19
Glucose quantitative blood
CPT 82947 • Laboratory
$4$7$8
Hemoglobin A1c
CPT 83036 • Laboratory
$11$17$24
Iron serum
CPT 83540 • Laboratory
$4$9$13
Iron binding capacity
CPT 83550 • Laboratory
$6$13$18
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$13$27$37
Free thyroxine (T4)
CPT 84439 • Laboratory
$6$13$18
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$12$26$41
Complete blood count with differential
CPT 85025 • Laboratory
$9$14$19
Complete blood count automated
CPT 85027 • Laboratory
$4$9$16
Prothrombin time (PT)
CPT 85610 • Laboratory
$5$8$10
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$4$7
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$4$9$12
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$9$19$26
Nuclear antigen antibody
CPT 86235 • Laboratory
$13$26$36
Heterophile antibodies screen
CPT 86308 • Laboratory
$6$9$13
TB skin test intradermal
CPT 86580 • Laboratory
$9$14$20
Blood typing ABO
CPT 86900 • Laboratory
$2$4$6
Blood typing Rh
CPT 86901 • Laboratory
$2$4$6
Urine culture bacterial colony count
CPT 87086 • Laboratory
$8$12$16
Chlamydia nucleic acid amplification
CPT 87491 • Laboratory
$26$50$71