DLP MARIA PARHAM MEDICAL CENTER LLC· HENDERSON, NC

HospitalCMS 2/5

566 RUIN CREEK RD, HENDERSON, NC 27536

Procedures offered

540 total

ProcedureMinAvgMax
CT chest with contrast
CPT 71260 • Imaging
$230$230$230
CT angiography chest
CPT 71275 • Imaging
$302$302$302
MRI cervical spine without contrast
CPT 72141 • Imaging
$226$226$226
MRI thoracic spine without contrast
CPT 72146 • Imaging
$226$226$226
MRI lumbar spine without contrast
CPT 72148 • Imaging
$225$225$225
X-ray shoulder complete
CPT 73030 • Imaging
$29$29$29
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$238$238$238
X-ray knee 1-2 views
CPT 73560 • Imaging
$31$31$31
X-ray ankle complete
CPT 73610 • Imaging
$32$32$32
MRI lower extremity without contrast
CPT 73718 • Imaging
$292$292$292
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$238$238$238
CT abdomen without contrast
CPT 74150 • Imaging
$151$151$151
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$203$203$203
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$313$313$313
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$355$355$355
Ultrasound abdominal complete
CPT 76700 • Imaging
$124$124$124
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$115$115$115
Ultrasound transvaginal
CPT 76830 • Imaging
$124$124$124
Ultrasound pelvic complete
CPT 76856 • Imaging
$112$112$112
Diagnostic mammography unilateral
CPT 77065 • Imaging
$134$134$134
Diagnostic mammography bilateral
CPT 77066 • Imaging
$170$170$170
Screening mammography bilateral
CPT 77067 • Imaging
$137$137$137
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$613$613$613
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$11$11$11
Comprehensive metabolic panel
CPT 80053 • Laboratory
$35$36$36
Lipid panel
CPT 80061 • Laboratory
$56$57$58
Hepatic function panel
CPT 80076 • Laboratory
$33$34$34
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$123$125$127
Creatine kinase (CK) total
CPT 82550 • Laboratory
$27$28$28
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$39$39$40
Iron binding capacity
CPT 83550 • Laboratory
$36$37$38
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$77$78$79
Free thyroxine (T4)
CPT 84439 • Laboratory
$38$38$39
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$68$69$70
Complete blood count automated
CPT 85027 • Laboratory
$27$27$28
Prothrombin time (PT)
CPT 85610 • Laboratory
$16$17$17
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$11$11$12
Nuclear antigen antibody
CPT 86235 • Laboratory
$75$76$77
Heterophile antibodies screen
CPT 86308 • Laboratory
$22$22$22
Blood typing Rh
CPT 86901 • Laboratory
$12$13$13
Gonorrhea nucleic acid amplification
CPT 87591 • Laboratory
$102$104$105
Influenza virus assay with direct optical
CPT 87804 • Laboratory
$48$48$49
Amniocentesis diagnostic
CPT 59000 • Maternity
$188$3,130$6,072
Cordocentesis fetal blood sampling
CPT 59012 • Maternity
$308$405$502
Chorionic villus sampling
CPT 59015 • Maternity
$234$3,153$6,072
Fetal non-stress test
CPT 59025 • Maternity
$72$287$502
Insertion cervical dilator
CPT 59200 • Maternity
$107$305$502
Vaginal delivery including prenatal and postpartum care
CPT 59400 • Maternity
$3,156$5,069$6,982
Vaginal delivery only
CPT 59409 • Maternity
$1,237$8,295$15,352
Vaginal delivery including postpartum care
CPT 59410 • Maternity
$1,578$4,280$6,982