MOORESVILLE HOSPITAL MANAGEMENT ASSOCIATES LLC· MOORESVILLE, NC
ProviderCMS 2/5
171 FAIRVIEW RD, MOORESVILLE, NC 28117
Procedures offered
948 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| CT chest without contrast CPT 71250 • Imaging | $30 | $343 | $650 |
| CT chest with contrast CPT 71260 • Imaging | $30 | $342 | $650 |
| CT chest without then with contrast CPT 71270 • Imaging | $650 | $650 | $650 |
| CT angiography chest CPT 71275 • Imaging | $209 | $503 | $650 |
| CT cervical spine without contrast CPT 72125 • Imaging | $650 | $650 | $650 |
| CT thoracic spine without contrast CPT 72128 • Imaging | $650 | $650 | $650 |
| CT lumbar spine without contrast CPT 72131 • Imaging | $650 | $650 | $650 |
| MRI cervical spine without contrast CPT 72141 • Imaging | $30 | $628 | $1,200 |
| MRI thoracic spine without contrast CPT 72146 • Imaging | $73 | $755 | $1,200 |
| MRI lumbar spine without contrast CPT 72148 • Imaging | $30 | $642 | $1,200 |
| CT pelvis with contrast CPT 72193 • Imaging | $650 | $650 | $650 |
| X-ray shoulder complete CPT 73030 • Imaging | $10 | $22 | $30 |
| MRI joint upper extremity without contrast CPT 73221 • Imaging | $30 | $623 | $1,200 |
| X-ray knee 1-2 views CPT 73560 • Imaging | $22 | $37 | $70 |
| X-ray ankle complete CPT 73610 • Imaging | $27 | $36 | $58 |
| MRI lower extremity without contrast CPT 73718 • Imaging | $30 | $610 | $1,200 |
| MRI joint lower extremity without contrast CPT 73721 • Imaging | $30 | $690 | $1,200 |
| CT abdomen without contrast CPT 74150 • Imaging | $30 | $351 | $650 |
| CT abdomen without then with contrast CPT 74170 • Imaging | $650 | $650 | $650 |
| CT abdomen and pelvis without contrast CPT 74176 • Imaging | $85 | $333 | $650 |
| CT abdomen and pelvis with contrast CPT 74177 • Imaging | $89 | $445 | $650 |
| CT abdomen and pelvis without then with contrast CPT 74178 • Imaging | $126 | $546 | $1,074 |
| Ultrasound abdominal complete CPT 76700 • Imaging | $30 | $124 | $238 |
| Ultrasound retroperitoneal complete CPT 76770 • Imaging | $30 | $108 | $222 |
| Ultrasound transvaginal CPT 76830 • Imaging | $30 | $102 | $245 |
| Ultrasound pelvic complete CPT 76856 • Imaging | $35 | $59 | $93 |
| Diagnostic mammography unilateral CPT 77065 • Imaging | $29 | $164 | $385 |
| Diagnostic mammography bilateral CPT 77066 • Imaging | $50 | $113 | $169 |
| Screening mammography bilateral CPT 77067 • Imaging | $112 | $139 | $189 |
| Nuclear myocardial perfusion study CPT 78452 • Imaging | $95 | $395 | $735 |
| Collection of venous blood by venipuncture CPT 36415 • Laboratory | $8 | $8 | $8 |
| Basic metabolic panel CPT 80048 • Laboratory | $4 | $12 | $23 |
| Comprehensive metabolic panel CPT 80053 • Laboratory | $5 | $13 | $24 |
| Lipid panel CPT 80061 • Laboratory | $7 | $12 | $15 |
| Hepatic function panel CPT 80076 • Laboratory | $7 | $9 | $11 |
| Urinalysis with microscopy CPT 81001 • Laboratory | $2 | $3 | $4 |
| Urinalysis nonautomated without microscopy CPT 81002 • Laboratory | $2 | $3 | $4 |
| Urinalysis automated without microscopy CPT 81003 • Laboratory | $2 | $3 | $6 |
| Fecal hemoglobin immunoassay CPT 82274 • Laboratory | $8 | $18 | $32 |
| Vitamin D 25-hydroxy CPT 82306 • Laboratory | $15 | $27 | $34 |
| Creatine kinase (CK) total CPT 82550 • Laboratory | $3 | $9 | $19 |
| Creatinine urine CPT 82570 • Laboratory | $3 | $7 | $15 |
| Ferritin CPT 82728 • Laboratory | $7 | $12 | $16 |
| IgA IgD IgG IgM each CPT 82784 • Laboratory | $5 | $8 | $11 |
| Glucose quantitative blood CPT 82947 • Laboratory | $2 | $3 | $4 |
| Hemoglobin A1c CPT 83036 • Laboratory | $5 | $14 | $28 |
| Iron serum CPT 83540 • Laboratory | $3 | $9 | $19 |
| Iron binding capacity CPT 83550 • Laboratory | $4 | $12 | $25 |
| Prostate specific antigen (PSA) CPT 84153 • Laboratory | $9 | $16 | $21 |
| Free thyroxine (T4) CPT 84439 • Laboratory | $5 | $12 | $26 |