COUNTY OF MONTGOMERY· TROY, NC

Provider

217 S MAIN ST, TROY, NC 27371

Procedures offered

952 total

Procedure	Min	Avg	Max
Immunization admin each additional component CPT 90461 • Preventive Care	$12	$12	$12
Immunization admin injection single CPT 90471 • Preventive Care	$12	$15	$23
Immunization admin injection each additional CPT 90472 • Preventive Care	$9	$11	$12
HPV vaccine 9-valent CPT 90651 • Preventive Care	$329	$342	$369
Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care	$231	$243	$258
Rotavirus vaccine pentavalent CPT 90680 • Preventive Care	$102	$107	$115
Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care	$5	$17	$22
MMR vaccine CPT 90707 • Preventive Care	$97	$101	$107
Tdap vaccine age 7 years or older CPT 90715 • Preventive Care	$40	$46	$55
Varicella vaccine CPT 90716 • Preventive Care	$192	$200	$215
Pneumococcal vaccine adult CPT 90732 • Preventive Care	$117	$129	$133
Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care	$216	$224	$241
Preventive visit new patient infant CPT 99381 • Preventive Care	$5	$54	$103
Preventive visit new patient age 1-4 CPT 99382 • Preventive Care	$97	$102	$108
Preventive visit new patient age 5-11 CPT 99383 • Preventive Care	$95	$103	$112
Preventive visit new patient age 12-17 CPT 99384 • Preventive Care	$72	$84	$95
Preventive visit new patient age 18-39 CPT 99385 • Preventive Care	$104	$133	$153
Preventive visit new patient age 40-64 CPT 99386 • Preventive Care	$121	$132	$142
Preventive visit new patient age 65+ CPT 99387 • Preventive Care	$5	$63	$120
Preventive visit established patient infant CPT 99391 • Preventive Care	$70	$81	$92
Preventive visit established patient age 1-4 CPT 99392 • Preventive Care	$5	$38	$72
Preventive visit established patient age 5-11 CPT 99393 • Preventive Care	$56	$81	$98
Preventive visit established patient age 12-17 CPT 99394 • Preventive Care	$64	$86	$107
Preventive visit established patient age 18-39 CPT 99395 • Preventive Care	$5	$97	$137
Preventive visit established patient age 40-64 CPT 99396 • Preventive Care	$5	$113	$147
Preventive visit established patient age 65+ CPT 99397 • Preventive Care	$5	$66	$126
Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care	$36	$36	$36
Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care	$61	$61	$61
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$209	$209	$209
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$378	$378	$378
Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care	$120	$120	$120
Annual wellness visit initial HCPCS G0438 • Preventive Care	$159	$159	$159
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$106	$106	$106
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$141	$155	$168
Bronchoscopy with brushing CPT 31623 • Pulmonology	$142	$272	$403
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$142	$157	$171
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$323	$361	$399
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$183	$203	$222
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$306	$563	$820
Ventilation assist and management initiation CPT 94002 • Pulmonology	$86	$87	$89
Spirometry CPT 94010 • Pulmonology	$8	$17	$26
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$12	$33	$54
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$56	$57	$58
Respiratory flow volume loop CPT 94375 • Pulmonology	$20	$29	$37
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$145	$150	$155
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$12	$14	$16
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$13	$14	$16
Plethysmography lung volumes CPT 94726 • Pulmonology	$12	$13	$14
Gas dilution lung volumes CPT 94727 • Pulmonology	$28	$37	$46
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$8	$33	$58