CAPE FEAR VALLEY HOKE HOSPITAL· RAEFORD, NC

HospitalCMS 4/5

210 MEDICAL PAVILION DRIVE, RAEFORD, NC 28376

Procedures offered

936 total

ProcedureMinAvgMax
MRI thoracic spine without contrast
CPT 72146 • Imaging
$45$177$291
MRI lumbar spine without contrast
CPT 72148 • Imaging
$173$258$490
X-ray shoulder complete
CPT 73030 • Imaging
$11$27$39
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$82$230$490
X-ray knee 1-2 views
CPT 73560 • Imaging
$28$43$63
X-ray ankle complete
CPT 73610 • Imaging
$12$43$67
MRI lower extremity without contrast
CPT 73718 • Imaging
$226$368$684
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$84$231$555
CT abdomen without contrast
CPT 74150 • Imaging
$73$149$350
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$120$212$317
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$334$398$514
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$123$366$829
Ultrasound abdominal complete
CPT 76700 • Imaging
$94$148$289
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$78$151$267
Ultrasound transvaginal
CPT 76830 • Imaging
$123$170$243
Ultrasound pelvic complete
CPT 76856 • Imaging
$78$130$218
Diagnostic mammography unilateral
CPT 77065 • Imaging
$37$165$312
Diagnostic mammography bilateral
CPT 77066 • Imaging
$46$176$396
Screening mammography bilateral
CPT 77067 • Imaging
$47$122$320
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$372$560$701
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$2$4$6
Basic metabolic panel
CPT 80048 • Laboratory
$5$9$16
Comprehensive metabolic panel
CPT 80053 • Laboratory
$6$11$20
Lipid panel
CPT 80061 • Laboratory
$8$21$53
Hepatic function panel
CPT 80076 • Laboratory
$4$8$15
Urinalysis with microscopy
CPT 81001 • Laboratory
$2$4$7
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$2$3$5
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$8$21$33
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$17$31$55
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$7$12
Creatinine urine
CPT 82570 • Laboratory
$3$4$5
Ferritin
CPT 82728 • Laboratory
$7$21$54
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$5$10$19
Glucose quantitative blood
CPT 82947 • Laboratory
$3$5$8
Hemoglobin A1c
CPT 83036 • Laboratory
$7$11$18
Iron serum
CPT 83540 • Laboratory
$3$7$12
Iron binding capacity
CPT 83550 • Laboratory
$4$9$16
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$10$19$34
Free thyroxine (T4)
CPT 84439 • Laboratory
$5$9$17
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$11$18$31
Complete blood count with differential
CPT 85025 • Laboratory
$5$9$14
Complete blood count automated
CPT 85027 • Laboratory
$3$6$12
Prothrombin time (PT)
CPT 85610 • Laboratory
$3$5$9
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$3$5
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$3$6$12
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$6$13$24
Nuclear antigen antibody
CPT 86235 • Laboratory
$9$19$37
Heterophile antibodies screen
CPT 86308 • Laboratory
$4$5$6
TB skin test intradermal
CPT 86580 • Laboratory
$5$11$17
Blood typing ABO
CPT 86900 • Laboratory
$1$3$6