SENTARA ALBEMARLE REGIONAL MEDICAL CENTER· ELIZABETH CITY, NC

HospitalCMS 3/5

3050 HALSTEAD BLVD, ELIZABETH CITY, NC 27909

Procedures offered

938 total

ProcedureMinAvgMax
MRI thoracic spine without contrast
CPT 72146 • Imaging
$140$342$538
MRI lumbar spine without contrast
CPT 72148 • Imaging
$196$477$1,092
X-ray shoulder complete
CPT 73030 • Imaging
$15$29$37
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$194$385$597
X-ray knee 1-2 views
CPT 73560 • Imaging
$9$22$36
X-ray ankle complete
CPT 73610 • Imaging
$8$34$50
MRI lower extremity without contrast
CPT 73718 • Imaging
$79$406$681
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$86$298$522
CT abdomen without contrast
CPT 74150 • Imaging
$125$315$694
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$89$176$330
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$94$293$387
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$200$391$572
Ultrasound abdominal complete
CPT 76700 • Imaging
$94$156$202
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$39$137$192
Ultrasound transvaginal
CPT 76830 • Imaging
$99$117$149
Ultrasound pelvic complete
CPT 76856 • Imaging
$75$133$240
Diagnostic mammography unilateral
CPT 77065 • Imaging
$43$121$222
Diagnostic mammography bilateral
CPT 77066 • Imaging
$67$139$281
Screening mammography bilateral
CPT 77067 • Imaging
$77$136$226
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$381$532$730
Venipuncture (routine blood draw)
CPT 36415 • Lab
$4$4$4
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$2$4$5
Strep test rapid (Streptococcus group A direct)
CPT 87880 • Lab
$14$14$14
Basic metabolic panel
CPT 80048 • Laboratory
$6$10$17
Comprehensive metabolic panel
CPT 80053 • Laboratory
$9$12$16
Lipid panel
CPT 80061 • Laboratory
$11$15$24
Hepatic function panel
CPT 80076 • Laboratory
$7$9$13
Urinalysis with microscopy
CPT 81001 • Laboratory
$3$4$7
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$32$42
Creatine kinase (CK) total
CPT 82550 • Laboratory
$5$8$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$11$14
Glucose quantitative blood
CPT 82947 • Laboratory
$3$5$8
Hemoglobin A1c
CPT 83036 • Laboratory
$7$13$20
Iron serum
CPT 83540 • Laboratory
$5$7$10
Iron binding capacity
CPT 83550 • Laboratory
$7$10$14
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$13$22$29
Free thyroxine (T4)
CPT 84439 • Laboratory
$7$11$14
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$12$18$26
Complete blood count with differential
CPT 85025 • Laboratory
$5$9$16
Complete blood count automated
CPT 85027 • Laboratory
$5$9$13
Prothrombin time (PT)
CPT 85610 • Laboratory
$3$5$8
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$3$4
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$5$7$9
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$11$16$20
Nuclear antigen antibody
CPT 86235 • Laboratory
$15$21$28
Heterophile antibodies screen
CPT 86308 • Laboratory
$4$7$11