LAKE NORMAN REGIONAL MEDICAL CENTER· MOORESVILLE, NC

HospitalCMS 2/5

171 FAIRVIEW ROAD, MOORESVILLE, NC 28117

Procedures offered

935 total

ProcedureMinAvgMax
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$30$334$641
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$315$706
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$30$298$640
CT abdomen without contrast
CPT 74150 • Imaging
$30$127$257
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$86$175$218
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$174$328$569
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$126$469$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
Venipuncture (routine blood draw)
CPT 36415 • Lab
$8$8$8
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$2$3$4
Strep test rapid (Streptococcus group A direct)
CPT 87880 • Lab
$7$7$7
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 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
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$8$22$47
Complete blood count with differential
CPT 85025 • Laboratory
$4$11$22
Complete blood count automated
CPT 85027 • Laboratory
$3$8$19
Prothrombin time (PT)
CPT 85610 • Laboratory
$2$6$11
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$1$4$8
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$3$8$17
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$6$11$15
Nuclear antigen antibody
CPT 86235 • Laboratory
$9$16$21
Heterophile antibodies screen
CPT 86308 • Laboratory
$3$5$6
TB skin test intradermal
CPT 86580 • Laboratory
$6$7$9
Blood typing ABO
CPT 86900 • Laboratory
$2$4$9
Blood typing Rh
CPT 86901 • Laboratory
$2$3$3