VIDANT CHOWAN HOSPITAL· EDENTON, NC

HospitalCMS 2/5

211 VIRGINIA RD, EDENTON, NC 27932

Procedures offered

928 total

ProcedureMinAvgMax
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$456$509$602
CT abdomen without contrast
CPT 74150 • Imaging
$257$325$398
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$212$313$389
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$332$398$530
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$158$397$707
Ultrasound abdominal complete
CPT 76700 • Imaging
$109$172$238
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$105$144$219
Ultrasound transvaginal
CPT 76830 • Imaging
$42$70$85
Ultrasound pelvic complete
CPT 76856 • Imaging
$42$70$85
Diagnostic mammography unilateral
CPT 77065 • Imaging
$133$148$171
Diagnostic mammography bilateral
CPT 77066 • Imaging
$76$153$215
Screening mammography bilateral
CPT 77067 • Imaging
$136$172$204
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$360$535$644
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$3$4$5
Basic metabolic panel
CPT 80048 • Laboratory
$9$14$17
Comprehensive metabolic panel
CPT 80053 • Laboratory
$7$12$17
Lipid panel
CPT 80061 • Laboratory
$22$28$36
Hepatic function panel
CPT 80076 • Laboratory
$6$12$22
Urinalysis with microscopy
CPT 81001 • Laboratory
$3$5$6
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$3$3$4
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$17$27$32
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$20$53$81
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$12$18
Creatinine urine
CPT 82570 • Laboratory
$5$8$14
Ferritin
CPT 82728 • Laboratory
$9$24$37
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$6$16$25
Glucose quantitative blood
CPT 82947 • Laboratory
$4$5$6
Hemoglobin A1c
CPT 83036 • Laboratory
$6$12$19
Iron serum
CPT 83540 • Laboratory
$4$8$13
Iron binding capacity
CPT 83550 • Laboratory
$6$11$17
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$12$27$36
Free thyroxine (T4)
CPT 84439 • Laboratory
$6$16$25
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$18$32$46
Complete blood count with differential
CPT 85025 • Laboratory
$8$11$15
Complete blood count automated
CPT 85027 • Laboratory
$7$10$13
Prothrombin time (PT)
CPT 85610 • Laboratory
$4$6$8
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$3$5
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$4$11$16
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$9$18$35
Nuclear antigen antibody
CPT 86235 • Laboratory
$12$26$49
Heterophile antibodies screen
CPT 86308 • Laboratory
$5$6$6
TB skin test intradermal
CPT 86580 • Laboratory
$7$7$7
Blood typing ABO
CPT 86900 • Laboratory
$2$4$8
Blood typing Rh
CPT 86901 • Laboratory
$2$5$10
Urine culture bacterial colony count
CPT 87086 • Laboratory
$5$7$8
Chlamydia nucleic acid amplification
CPT 87491 • Laboratory
$24$61$90
Gonorrhea nucleic acid amplification
CPT 87591 • Laboratory
$24$61$90
SARS-CoV-2 COVID-19 amplified probe
CPT 87635 • Laboratory
$44$65$101
Influenza virus assay with direct optical
CPT 87804 • Laboratory
$13$16$22
Amniocentesis diagnostic
CPT 59000 • Maternity
$30$88$136