GASTON FAMILY HEALTH SERVICES, INC.· BELMONT, NC
ProviderClinic/Center, Federally Qualified Health Center (FQHC)
210 SCHOOL ST, BELMONT, NC 28012
Procedures offered
947 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| CT chest without contrast CPT 71250 • Imaging | $30 | $85 | $139 |
| CT chest with contrast CPT 71260 • Imaging | $49 | $49 | $49 |
| CT chest without then with contrast CPT 71270 • Imaging | $30 | $110 | $191 |
| CT angiography chest CPT 71275 • Imaging | $292 | $292 | $292 |
| CT cervical spine without contrast CPT 72125 • Imaging | $30 | $35 | $39 |
| CT thoracic spine without contrast CPT 72128 • Imaging | $30 | $60 | $90 |
| CT lumbar spine without contrast CPT 72131 • Imaging | $30 | $76 | $121 |
| MRI cervical spine without contrast CPT 72141 • Imaging | $30 | $114 | $199 |
| MRI thoracic spine without contrast CPT 72146 • Imaging | $30 | $72 | $114 |
| MRI lumbar spine without contrast CPT 72148 • Imaging | $30 | $115 | $199 |
| CT pelvis without contrast CPT 72192 • Imaging | $53 | $53 | $53 |
| CT pelvis with contrast CPT 72193 • Imaging | $30 | $134 | $237 |
| X-ray shoulder complete CPT 73030 • Imaging | $30 | $33 | $35 |
| MRI joint upper extremity without contrast CPT 73221 • Imaging | $180 | $180 | $180 |
| X-ray knee 1-2 views CPT 73560 • Imaging | $19 | $25 | $30 |
| X-ray ankle complete CPT 73610 • Imaging | $30 | $30 | $30 |
| MRI lower extremity without contrast CPT 73718 • Imaging | $225 | $225 | $225 |
| MRI joint lower extremity without contrast CPT 73721 • Imaging | $144 | $144 | $144 |
| CT abdomen without contrast CPT 74150 • Imaging | $30 | $73 | $117 |
| CT abdomen with contrast CPT 74160 • Imaging | $193 | $193 | $193 |
| CT abdomen without then with contrast CPT 74170 • Imaging | $30 | $117 | $203 |
| CT abdomen and pelvis without contrast CPT 74176 • Imaging | $90 | $90 | $90 |
| CT abdomen and pelvis with contrast CPT 74177 • Imaging | $313 | $314 | $315 |
| CT abdomen and pelvis without then with contrast CPT 74178 • Imaging | $93 | $222 | $351 |
| Ultrasound abdominal complete CPT 76700 • Imaging | $36 | $36 | $36 |
| Ultrasound retroperitoneal complete CPT 76770 • Imaging | $30 | $52 | $73 |
| Ultrasound transvaginal CPT 76830 • Imaging | $27 | $27 | $27 |
| Ultrasound pelvic complete CPT 76856 • Imaging | $30 | $30 | $30 |
| Diagnostic mammography unilateral CPT 77065 • Imaging | $40 | $75 | $110 |
| Diagnostic mammography bilateral CPT 77066 • Imaging | $132 | $132 | $132 |
| Screening mammography bilateral CPT 77067 • Imaging | $112 | $116 | $120 |
| DEXA bone density study axial skeleton CPT 77080 • Imaging | $30 | $30 | $30 |
| Nuclear myocardial perfusion study CPT 78452 • Imaging | $311 | $351 | $391 |
| Collection of venous blood by venipuncture CPT 36415 • Laboratory | $2 | $2 | $2 |
| Basic metabolic panel CPT 80048 • Laboratory | $5 | $6 | $7 |
| Comprehensive metabolic panel CPT 80053 • Laboratory | $6 | $6 | $6 |
| Lipid panel CPT 80061 • Laboratory | $6 | $8 | $11 |
| Hepatic function panel CPT 80076 • Laboratory | $3 | $5 | $7 |
| Urinalysis with microscopy CPT 81001 • Laboratory | $3 | $3 | $3 |
| Urinalysis nonautomated without microscopy CPT 81002 • Laboratory | $3 | $3 | $3 |
| Urinalysis automated without microscopy CPT 81003 • Laboratory | $1 | $2 | $2 |
| Fecal hemoglobin immunoassay CPT 82274 • Laboratory | $10 | $10 | $10 |
| Vitamin D 25-hydroxy CPT 82306 • Laboratory | $18 | $21 | $24 |
| Creatine kinase (CK) total CPT 82550 • Laboratory | $2 | $4 | $5 |
| Creatinine urine CPT 82570 • Laboratory | $2 | $2 | $2 |
| Ferritin CPT 82728 • Laboratory | $8 | $8 | $8 |
| IgA IgD IgG IgM each CPT 82784 • Laboratory | $3 | $3 | $3 |
| Glucose quantitative blood CPT 82947 • Laboratory | $2 | $2 | $2 |
| Hemoglobin A1c CPT 83036 • Laboratory | $6 | $6 | $6 |
| Iron serum CPT 83540 • Laboratory | $1 | $2 | $3 |