IREDELL DAVIS BEHAVIORAL HEALTH HOSPITAL· STATESVILLE, NC

Hospital

557 Brookdale Drive, STATESVILLE, NC 28677

Procedures offered

939 total

ProcedureMinAvgMax
MRI thoracic spine without contrast
CPT 72146 • Imaging
$65$229$433
MRI lumbar spine without contrast
CPT 72148 • Imaging
$56$342$880
X-ray shoulder complete
CPT 73030 • Imaging
$29$41$65
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$51$376$880
X-ray knee 1-2 views
CPT 73560 • Imaging
$7$28$50
X-ray ankle complete
CPT 73610 • Imaging
$8$29$54
MRI lower extremity without contrast
CPT 73718 • Imaging
$50$368$880
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$60$350$880
CT abdomen without contrast
CPT 74150 • Imaging
$44$191$481
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$6$183$481
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$10$243$461
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$9$282$523
Ultrasound abdominal complete
CPT 76700 • Imaging
$30$105$297
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$30$101$287
Ultrasound transvaginal
CPT 76830 • Imaging
$42$73$115
Ultrasound pelvic complete
CPT 76856 • Imaging
$42$94$175
Diagnostic mammography unilateral
CPT 77065 • Imaging
$31$81$152
Diagnostic mammography bilateral
CPT 77066 • Imaging
$38$104$169
Screening mammography bilateral
CPT 77067 • Imaging
$33$91$136
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$71$435$713
Venipuncture (routine blood draw)
CPT 36415 • Lab
$5$5$5
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$2$4$6
Strep test rapid (Streptococcus group A direct)
CPT 87880 • Lab
$10$10$10
Basic metabolic panel
CPT 80048 • Laboratory
$4$9$15
Comprehensive metabolic panel
CPT 80053 • Laboratory
$4$11$19
Lipid panel
CPT 80061 • Laboratory
$8$17$25
Hepatic function panel
CPT 80076 • Laboratory
$4$8$15
Urinalysis with microscopy
CPT 81001 • Laboratory
$2$3$6
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$1$2$4
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$8$19$32
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$15$30$53
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$9$14
Creatinine urine
CPT 82570 • Laboratory
$3$7$12
Ferritin
CPT 82728 • Laboratory
$7$18$30
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$7$14$21
Glucose quantitative blood
CPT 82947 • Laboratory
$2$5$7
Hemoglobin A1c
CPT 83036 • Laboratory
$6$9$13
Iron serum
CPT 83540 • Laboratory
$3$6$9
Iron binding capacity
CPT 83550 • Laboratory
$4$8$12
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$8$18$33
Free thyroxine (T4)
CPT 84439 • Laboratory
$6$11$16
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$11$21$30
Complete blood count with differential
CPT 85025 • Laboratory
$5$10$16
Complete blood count automated
CPT 85027 • Laboratory
$3$5$9
Prothrombin time (PT)
CPT 85610 • Laboratory
$2$5$7
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$3$6
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$4$7$11
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$12$18$23
Nuclear antigen antibody
CPT 86235 • Laboratory
$12$21$32
Heterophile antibodies screen
CPT 86308 • Laboratory
$3$6$11