SENTARA ALBEMARLE REGIONAL MEDICAL CENTER· ELIZABETH CITY, NC

HospitalCMS 3/5

3050 HALSTEAD BLVD, ELIZABETH CITY, NC 27909

Procedures offered

949 total

ProcedureMinAvgMax
Chest X-ray 2 views
CPT 71046 • Imaging
$11$21$32
CT chest without contrast
CPT 71250 • Imaging
$31$146$318
CT chest with contrast
CPT 71260 • Imaging
$174$344$700
CT chest without then with contrast
CPT 71270 • Imaging
$206$206$206
CT angiography chest
CPT 71275 • Imaging
$244$501$696
CT cervical spine without contrast
CPT 72125 • Imaging
$136$136$136
CT thoracic spine without contrast
CPT 72128 • Imaging
$135$135$135
CT lumbar spine without contrast
CPT 72131 • Imaging
$135$135$135
MRI cervical spine without contrast
CPT 72141 • Imaging
$31$368$738
MRI thoracic spine without contrast
CPT 72146 • Imaging
$104$288$538
MRI lumbar spine without contrast
CPT 72148 • Imaging
$196$445$1,092
CT pelvis with contrast
CPT 72193 • Imaging
$31$31$31
X-ray shoulder complete
CPT 73030 • Imaging
$15$31$37
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$194$393$597
X-ray knee 1-2 views
CPT 73560 • Imaging
$9$25$36
X-ray ankle complete
CPT 73610 • Imaging
$8$34$50
MRI lower extremity without contrast
CPT 73718 • Imaging
$79$425$681
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$31$230$522
CT abdomen without contrast
CPT 74150 • Imaging
$125$290$694
CT abdomen without then with contrast
CPT 74170 • Imaging
$243$243$243
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$89$178$330
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$94$302$387
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$200$382$572
Ultrasound abdominal complete
CPT 76700 • Imaging
$94$158$202
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$39$135$192
Ultrasound transvaginal
CPT 76830 • Imaging
$99$122$149
Ultrasound pelvic complete
CPT 76856 • Imaging
$75$128$240
Diagnostic mammography unilateral
CPT 77065 • Imaging
$36$108$222
Diagnostic mammography bilateral
CPT 77066 • Imaging
$67$140$281
Screening mammography bilateral
CPT 77067 • Imaging
$77$130$226
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$381$503$730
Collection of venous blood by venipuncture
CPT 36415 • Laboratory
$2$4$4
Basic metabolic panel
CPT 80048 • Laboratory
$6$9$17
Comprehensive metabolic panel
CPT 80053 • Laboratory
$9$11$16
Lipid panel
CPT 80061 • Laboratory
$11$14$24
Hepatic function panel
CPT 80076 • Laboratory
$7$8$13
Urinalysis with microscopy
CPT 81001 • Laboratory
$3$3$7
Urinalysis nonautomated without microscopy
CPT 81002 • Laboratory
$2$4$5
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$1$2$5
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$5$15$22
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$24$30$42
Creatine kinase (CK) total
CPT 82550 • Laboratory
$5$7$10
Creatinine urine
CPT 82570 • Laboratory
$4$6$8
Ferritin
CPT 82728 • Laboratory
$10$14$21
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$7$10$14
Glucose quantitative blood
CPT 82947 • Laboratory
$3$4$8
Hemoglobin A1c
CPT 83036 • Laboratory
$7$12$20
Iron serum
CPT 83540 • Laboratory
$5$7$10
Iron binding capacity
CPT 83550 • Laboratory
$7$9$14
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$13$21$29