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
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Immunization admin each additional component CPT 90461 • Preventive Care | $7 | $9 | $12 |
| Immunization admin injection single CPT 90471 • Preventive Care | $14 | $15 | $18 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $11 | $13 | $15 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $251 | $301 | $336 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $197 | $249 | $379 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $84 | $105 | $136 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $19 | $20 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $80 | $101 | $137 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $29 | $38 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $157 | $194 | $240 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $113 | $137 | $196 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $207 | $224 | $275 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $90 | $125 | $156 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $70 | $126 | $163 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $74 | $130 | $170 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $87 | $149 | $193 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $109 | $145 | $187 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $118 | $161 | $217 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $139 | $190 | $235 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $83 | $101 | $141 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $65 | $109 | $165 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $65 | $111 | $150 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $81 | $120 | $164 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $76 | $118 | $168 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $83 | $144 | $180 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $87 | $121 | $194 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $32 | $32 | $33 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $47 | $47 | $47 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $169 | $253 | $316 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $274 | $295 | $316 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $138 | $214 | $240 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $141 | $215 | $240 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $95 | $150 | $187 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $112 | $112 | $112 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $110 | $112 | $113 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $56 | $132 | $209 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $134 | $134 | $134 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $146 | $224 | $303 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $899 | $899 | $899 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $79 | $79 | $79 |
| Spirometry CPT 94010 • Pulmonology | $22 | $34 | $44 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $27 | $44 | $55 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $24 | $24 | $24 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $19 | $28 | $36 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $59 | $151 | $243 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $6 | $17 | $44 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $13 | $15 | $16 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $10 | $43 | $54 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $19 | $30 | $37 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $46 | $46 | $46 |