PLATTE VALLEY ORAL & MAXILLOFACIAL SURGERY LLC· SCOTTSBLUFF, NC

Provider

416 VALLEY VIEW DRIVE, SCOTTSBLUFF, NC 69361

Procedures offered

946 total

Procedure	Min	Avg	Max
HPV vaccine 9-valent CPT 90651 • Preventive Care	$230	$230	$230
Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care	$181	$181	$181
Rotavirus vaccine pentavalent CPT 90680 • Preventive Care	$71	$71	$71
Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care	$16	$16	$16
MMR vaccine CPT 90707 • Preventive Care	$52	$60	$68
Tdap vaccine age 7 years or older CPT 90715 • Preventive Care	$35	$35	$35
Varicella vaccine CPT 90716 • Preventive Care	$134	$134	$134
Pneumococcal vaccine adult CPT 90732 • Preventive Care	$82	$82	$82
Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care	$151	$151	$151
Preventive visit new patient infant CPT 99381 • Preventive Care	$55	$79	$103
Preventive visit new patient age 1-4 CPT 99382 • Preventive Care	$59	$59	$59
Preventive visit new patient age 5-11 CPT 99383 • Preventive Care	$63	$63	$63
Preventive visit new patient age 12-17 CPT 99384 • Preventive Care	$98	$112	$125
Preventive visit new patient age 18-39 CPT 99385 • Preventive Care	$95	$95	$95
Preventive visit new patient age 40-64 CPT 99386 • Preventive Care	$110	$110	$110
Preventive visit new patient age 65+ CPT 99387 • Preventive Care	$93	$93	$93
Preventive visit established patient infant CPT 99391 • Preventive Care	$71	$71	$71
Preventive visit established patient age 1-4 CPT 99392 • Preventive Care	$70	$73	$76
Preventive visit established patient age 5-11 CPT 99393 • Preventive Care	$76	$76	$76
Preventive visit established patient age 12-17 CPT 99394 • Preventive Care	$83	$83	$83
Preventive visit established patient age 18-39 CPT 99395 • Preventive Care	$85	$85	$85
Preventive visit established patient age 40-64 CPT 99396 • Preventive Care	$70	$70	$70
Preventive visit established patient age 65+ CPT 99397 • Preventive Care	$14	$56	$98
Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care	$29	$29	$29
Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care	$126	$126	$126
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$25	$80	$135
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$238	$238	$238
Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care	$118	$137	$156
Annual wellness visit initial HCPCS G0438 • Preventive Care	$121	$136	$151
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$82	$100	$118
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$174	$205	$235
Bronchoscopy with brushing CPT 31623 • Pulmonology	$97	$97	$97
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$181	$181	$181
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$248	$248	$248
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$263	$263	$263
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$790	$790	$790
Ventilation assist and management initiation CPT 94002 • Pulmonology	$66	$66	$66
Spirometry CPT 94010 • Pulmonology	$19	$22	$25
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$33	$33	$33
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$22	$22	$22
Respiratory flow volume loop CPT 94375 • Pulmonology	$28	$28	$28
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$114	$114	$114
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$13	$13	$13
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$12	$12	$12
Plethysmography lung volumes CPT 94726 • Pulmonology	$9	$30	$52
Gas dilution lung volumes CPT 94727 • Pulmonology	$9	$10	$11
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$34	$34	$34
Pulse oximetry single measurement CPT 94760 • Pulmonology	$2	$2	$2
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$19	$21	$22
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$52	$52	$52