ASHE MEMORIAL HOSPITAL· JEFFERSON, NC
HospitalCMS 3/5
200 HOSPITAL AVE, JEFFERSON, NC 28640
Procedures offered
935 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| MRI thoracic spine without contrast CPT 72146 • Imaging | $65 | $387 | $596 |
| MRI lumbar spine without contrast CPT 72148 • Imaging | $74 | $396 | $615 |
| X-ray shoulder complete CPT 73030 • Imaging | $10 | $34 | $76 |
| MRI joint upper extremity without contrast CPT 73221 • Imaging | $136 | $432 | $615 |
| X-ray knee 1-2 views CPT 73560 • Imaging | $11 | $27 | $41 |
| X-ray ankle complete CPT 73610 • Imaging | $8 | $30 | $80 |
| MRI lower extremity without contrast CPT 73718 • Imaging | $67 | $361 | $615 |
| MRI joint lower extremity without contrast CPT 73721 • Imaging | $68 | $337 | $615 |
| CT abdomen without contrast CPT 74150 • Imaging | $170 | $238 | $299 |
| CT abdomen and pelvis without contrast CPT 74176 • Imaging | $108 | $204 | $402 |
| CT abdomen and pelvis with contrast CPT 74177 • Imaging | $80 | $271 | $352 |
| CT abdomen and pelvis without then with contrast CPT 74178 • Imaging | $125 | $370 | $748 |
| Ultrasound abdominal complete CPT 76700 • Imaging | $40 | $115 | $251 |
| Ultrasound retroperitoneal complete CPT 76770 • Imaging | $37 | $117 | $235 |
| Ultrasound transvaginal CPT 76830 • Imaging | $73 | $160 | $257 |
| Ultrasound pelvic complete CPT 76856 • Imaging | $73 | $117 | $228 |
| Diagnostic mammography unilateral CPT 77065 • Imaging | $38 | $119 | $274 |
| Diagnostic mammography bilateral CPT 77066 • Imaging | $44 | $148 | $345 |
| Screening mammography bilateral CPT 77067 • Imaging | $86 | $159 | $280 |
| Nuclear myocardial perfusion study CPT 78452 • Imaging | $368 | $528 | $924 |
| Urinalysis non-automated without microscopy CPT 81002 • Lab | $2 | $4 | $8 |
| Basic metabolic panel CPT 80048 • Laboratory | $5 | $11 | $19 |
| Comprehensive metabolic panel CPT 80053 • Laboratory | $5 | $11 | $15 |
| Lipid panel CPT 80061 • Laboratory | $8 | $12 | $19 |
| Hepatic function panel CPT 80076 • Laboratory | $4 | $7 | $12 |
| Urinalysis with microscopy CPT 81001 • Laboratory | $2 | $4 | $6 |
| Urinalysis automated without microscopy CPT 81003 • Laboratory | $2 | $2 | $3 |
| Fecal hemoglobin immunoassay CPT 82274 • Laboratory | $8 | $13 | $23 |
| Vitamin D 25-hydroxy CPT 82306 • Laboratory | $17 | $26 | $42 |
| Creatine kinase (CK) total CPT 82550 • Laboratory | $4 | $8 | $14 |
| Creatinine urine CPT 82570 • Laboratory | $3 | $7 | $11 |
| Ferritin CPT 82728 • Laboratory | $7 | $12 | $19 |
| IgA IgD IgG IgM each CPT 82784 • Laboratory | $5 | $12 | $20 |
| Glucose quantitative blood CPT 82947 • Laboratory | $2 | $3 | $6 |
| Hemoglobin A1c CPT 83036 • Laboratory | $6 | $12 | $18 |
| Iron serum CPT 83540 • Laboratory | $3 | $8 | $14 |
| Iron binding capacity CPT 83550 • Laboratory | $4 | $8 | $12 |
| Prostate specific antigen (PSA) CPT 84153 • Laboratory | $9 | $19 | $26 |
| Free thyroxine (T4) CPT 84439 • Laboratory | $4 | $11 | $20 |
| Thyroid stimulating hormone (TSH) CPT 84443 • Laboratory | $10 | $18 | $24 |
| Complete blood count with differential CPT 85025 • Laboratory | $5 | $9 | $15 |
| Complete blood count automated CPT 85027 • Laboratory | $3 | $7 | $14 |
| Prothrombin time (PT) CPT 85610 • Laboratory | $3 | $5 | $8 |
| Sedimentation rate (ESR) automated CPT 85652 • Laboratory | $2 | $3 | $6 |
| Partial thromboplastin time (PTT) CPT 85730 • Laboratory | $3 | $7 | $13 |
| Cyclic citrullinated peptide antibody CPT 86200 • Laboratory | $6 | $11 | $18 |
| Nuclear antigen antibody CPT 86235 • Laboratory | $9 | $16 | $25 |
| Heterophile antibodies screen CPT 86308 • Laboratory | $3 | $6 | $11 |
| TB skin test intradermal CPT 86580 • Laboratory | $3 | $10 | $23 |
| Blood typing ABO CPT 86900 • Laboratory | $1 | $3 | $4 |