SENTARA ALBEMARLE REGIONAL MEDICAL CENTER· ELIZABETH CITY, NC
HospitalCMS 3/5
3050 HALSTEAD BLVD, ELIZABETH CITY, NC 27909
Procedures offered
949 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Free thyroxine (T4) CPT 84439 • Laboratory | $7 | $10 | $14 |
| Thyroid stimulating hormone (TSH) CPT 84443 • Laboratory | $12 | $17 | $26 |
| Complete blood count with differential CPT 85025 • Laboratory | $5 | $8 | $16 |
| Complete blood count automated CPT 85027 • Laboratory | $5 | $8 | $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 | $6 | $9 |
| Cyclic citrullinated peptide antibody CPT 86200 • Laboratory | $11 | $16 | $20 |
| Nuclear antigen antibody CPT 86235 • Laboratory | $15 | $19 | $28 |
| Heterophile antibodies screen CPT 86308 • Laboratory | $4 | $6 | $11 |
| TB skin test intradermal CPT 86580 • Laboratory | $9 | $12 | $17 |
| Blood typing ABO CPT 86900 • Laboratory | $2 | $3 | $5 |
| Blood typing Rh CPT 86901 • Laboratory | $2 | $4 | $10 |
| Urine culture bacterial colony count CPT 87086 • Laboratory | $7 | $9 | $17 |
| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $25 | $36 | $54 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $29 | $36 | $54 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $21 | $50 | $70 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $11 | $16 | $23 |
| Strep A assay with optic observation CPT 87880 • Laboratory | $14 | $14 | $14 |
| Amniocentesis diagnostic CPT 59000 • Maternity | $83 | $153 | $177 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $228 | $319 | $553 |
| Chorionic villus sampling CPT 59015 • Maternity | $134 | $217 | $330 |
| Fetal non-stress test CPT 59025 • Maternity | $22 | $45 | $70 |
| Insertion cervical dilator CPT 59200 • Maternity | $48 | $89 | $141 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $1,698 | $2,503 | $3,316 |
| Vaginal delivery only CPT 59409 • Maternity | $908 | $1,135 | $1,485 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $975 | $1,368 | $1,575 |
| External cephalic version CPT 59412 • Maternity | $100 | $142 | $205 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $154 | $914 | $1,417 |
| Postpartum care only CPT 59430 • Maternity | $173 | $248 | $360 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $2,417 | $2,951 | $3,658 |
| Cesarean delivery only CPT 59514 • Maternity | $1,259 | $1,381 | $1,737 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,012 | $1,576 | $1,843 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $2,695 | $2,958 | $3,462 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $103 | $181 | $320 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $45 | $124 | $180 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $118 | $209 | $303 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $41 | $69 | $111 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $40 | $92 | $152 |
| Interactive complexity add-on CPT 90785 • Mental Health | $4 | $15 | $21 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $101 | $186 | $247 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $104 | $193 | $276 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $41 | $72 | $107 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $10 | $69 | $97 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $75 | $109 | $141 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $35 | $93 | $123 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $109 | $190 | $304 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $61 | $127 | $163 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $113 | $167 | $199 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $81 | $94 |