NOVANT HEALTH THOMASVILLE MEDICAL CENTER· THOMASVILLE, NC

HospitalCMS 3/5

207 OLD LEXINGTON RD BOX 789, THOMASVILLE, NC 27360

Procedures offered

937 total

ProcedureMinAvgMax
MRI thoracic spine without contrast
CPT 72146 • Imaging
$82$390$621
MRI lumbar spine without contrast
CPT 72148 • Imaging
$225$353$510
X-ray shoulder complete
CPT 73030 • Imaging
$19$40$68
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$137$254$456
X-ray knee 1-2 views
CPT 73560 • Imaging
$17$35$48
X-ray ankle complete
CPT 73610 • Imaging
$18$31$44
MRI lower extremity without contrast
CPT 73718 • Imaging
$72$298$456
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$238$431$581
CT abdomen without contrast
CPT 74150 • Imaging
$151$221$297
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$120$195$225
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$183$325$417
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$96$244$355
Ultrasound abdominal complete
CPT 76700 • Imaging
$109$167$245
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$72$226$653
Ultrasound transvaginal
CPT 76830 • Imaging
$33$72$142
Ultrasound pelvic complete
CPT 76856 • Imaging
$33$68$126
Diagnostic mammography unilateral
CPT 77065 • Imaging
$33$119$258
Diagnostic mammography bilateral
CPT 77066 • Imaging
$63$137$227
Screening mammography bilateral
CPT 77067 • Imaging
$51$113$187
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$96$391$792
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$2$6$16
Basic metabolic panel
CPT 80048 • Laboratory
$5$12$20
Comprehensive metabolic panel
CPT 80053 • Laboratory
$6$14$19
Lipid panel
CPT 80061 • Laboratory
$8$22$44
Hepatic function panel
CPT 80076 • Laboratory
$4$8$12
Urinalysis with microscopy
CPT 81001 • Laboratory
$2$3$5
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$1$3$5
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$8$24$32
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$17$33$51
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$9$11
Creatinine urine
CPT 82570 • Laboratory
$3$8$15
Ferritin
CPT 82728 • Laboratory
$7$20$34
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$5$13$30
Glucose quantitative blood
CPT 82947 • Laboratory
$3$5$7
Hemoglobin A1c
CPT 83036 • Laboratory
$7$13$20
Iron serum
CPT 83540 • Laboratory
$4$8$11
Iron binding capacity
CPT 83550 • Laboratory
$6$10$15
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$10$21$30
Free thyroxine (T4)
CPT 84439 • Laboratory
$5$11$20
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$11$22$30
Complete blood count with differential
CPT 85025 • Laboratory
$5$11$18
Complete blood count automated
CPT 85027 • Laboratory
$4$8$11
Prothrombin time (PT)
CPT 85610 • Laboratory
$3$6$8
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$3$5
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$6$8$10
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$6$13$19
Nuclear antigen antibody
CPT 86235 • Laboratory
$12$21$30
Heterophile antibodies screen
CPT 86308 • Laboratory
$4$8$12
TB skin test intradermal
CPT 86580 • Laboratory
$5$10$15
Blood typing ABO
CPT 86900 • Laboratory
$1$3$6