GOSHEN MEDICAL CENTER INCORPORATED· WHITEVILLE, NC

ProviderClinic/Center, Federally Qualified Health Center (FQHC)Clinic/Center, Multi-Specialty

5 WHITEVILLE TOWNE CTR, WHITEVILLE, NC 28472

Procedures offered

952 total

ProcedureMinAvgMax
Chest X-ray single view
CPT 71045 • Imaging
$9$18$33
Chest X-ray 2 views
CPT 71046 • Imaging
$11$24$43
CT chest without contrast
CPT 71250 • Imaging
$52$113$221
CT chest with contrast
CPT 71260 • Imaging
$63$95$160
CT chest without then with contrast
CPT 71270 • Imaging
$131$131$131
CT angiography chest
CPT 71275 • Imaging
$77$103$144
CT cervical spine without contrast
CPT 72125 • Imaging
$49$66$84
CT thoracic spine without contrast
CPT 72128 • Imaging
$49$88$127
CT lumbar spine without contrast
CPT 72131 • Imaging
$49$87$126
MRI cervical spine without contrast
CPT 72141 • Imaging
$71$126$195
MRI thoracic spine without contrast
CPT 72146 • Imaging
$63$68$71
MRI lumbar spine without contrast
CPT 72148 • Imaging
$177$187$191
CT pelvis without contrast
CPT 72192 • Imaging
$52$85$119
CT pelvis with contrast
CPT 72193 • Imaging
$55$126$196
X-ray shoulder complete
CPT 73030 • Imaging
$19$33$44
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$58$63$66
X-ray knee 1-2 views
CPT 73560 • Imaging
$20$34$44
X-ray ankle complete
CPT 73610 • Imaging
$7$34$47
MRI lower extremity without contrast
CPT 73718 • Imaging
$57$62$65
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$57$63$66
CT abdomen without contrast
CPT 74150 • Imaging
$122$134$139
CT abdomen with contrast
CPT 74160 • Imaging
$54$54$54
CT abdomen without then with contrast
CPT 74170 • Imaging
$59$63$67
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$84$119$184
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$88$253$510
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$97$245$572
Ultrasound abdominal complete
CPT 76700 • Imaging
$39$75$100
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$61$74$80
Ultrasound transvaginal
CPT 76830 • Imaging
$33$56$100
Ultrasound pelvic complete
CPT 76856 • Imaging
$29$46$76
Diagnostic mammography unilateral
CPT 77065 • Imaging
$39$80$126
Diagnostic mammography bilateral
CPT 77066 • Imaging
$95$136$156
Screening mammography bilateral
CPT 77067 • Imaging
$37$119$202
DEXA bone density study axial skeleton
CPT 77080 • Imaging
$8$24$40
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$305$314$319
Collection of venous blood by venipuncture
CPT 36415 • Laboratory
$2$3$5
Basic metabolic panel
CPT 80048 • Laboratory
$4$8$10
Comprehensive metabolic panel
CPT 80053 • Laboratory
$3$8$12
Lipid panel
CPT 80061 • Laboratory
$3$10$16
Hepatic function panel
CPT 80076 • Laboratory
$4$4$5
Urinalysis with microscopy
CPT 81001 • Laboratory
$1$2$3
Urinalysis nonautomated without microscopy
CPT 81002 • Laboratory
$1$3$6
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$1$2$3
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$7$16$25
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$7$23$35
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$7$10
Creatinine urine
CPT 82570 • Laboratory
$1$2$3
Ferritin
CPT 82728 • Laboratory
$3$11$16
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$5$5$6
Glucose quantitative blood
CPT 82947 • Laboratory
$2$2$4