DLP FRYE REGIONAL MEDICAL CENTER LLC· HICKORY, NC
ProviderCMS 2/5
420 N CENTER ST, HICKORY, NC 28601
Procedures offered
953 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $27 | $30 | $34 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $13 | $17 | $21 |
| Immunization admin injection single CPT 90471 • Preventive Care | $27 | $39 | $70 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $17 | $18 | $21 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $369 | $374 | $378 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $241 | $251 | $260 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $92 | $105 | $118 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $21 | $41 | $62 |
| MMR vaccine CPT 90707 • Preventive Care | $109 | $110 | $110 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $56 | $89 | $133 |
| Varicella vaccine CPT 90716 • Preventive Care | $163 | $192 | $221 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $126 | $130 | $135 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $187 | $217 | $248 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $161 | $170 | $179 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $117 | $125 | $133 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $176 | $185 | $195 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $198 | $209 | $220 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $192 | $202 | $213 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $222 | $234 | $247 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $241 | $254 | $267 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $145 | $153 | $161 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $154 | $163 | $172 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $154 | $163 | $171 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $188 | $230 | $271 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $174 | $183 | $192 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $185 | $195 | $205 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $220 | $269 | $318 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $40 | $51 | $63 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $278 | $1,674 | $2,712 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $261 | $1,304 | $2,712 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $261 | $1,467 | $2,712 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $246 | $257 | $268 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $245 | $261 | $276 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $187 | $190 | $193 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $295 | $2,282 | $5,358 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $406 | $2,411 | $5,358 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $233 | $2,091 | $5,358 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $497 | $2,279 | $5,358 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $533 | $2,289 | $5,358 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $1,282 | $2,841 | $6,142 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $91 | $137 | $153 |
| Spirometry CPT 94010 • Pulmonology | $14 | $41 | $51 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $56 | $80 | $90 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $41 | $73 | $101 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $24 | $31 | $37 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $37 | $92 | $147 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $11 | $35 | $50 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $25 | $26 | $27 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $66 | $82 | $88 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $50 | $57 | $65 |