GRANVILLE HEALTH SYSTEM· OXFORD, NC
Hospital
1010 COLLEGE ST, OXFORD, NC 27565
Procedures offered
450 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Iron binding capacity CPT 83550 • Laboratory | $9 | $11 | $12 |
| Prostate specific antigen (PSA) CPT 84153 • Laboratory | $18 | $18 | $18 |
| Free thyroxine (T4) CPT 84439 • Laboratory | $9 | $11 | $12 |
| Thyroid stimulating hormone (TSH) CPT 84443 • Laboratory | $17 | $20 | $23 |
| Complete blood count with differential CPT 85025 • Laboratory | $8 | $10 | $11 |
| Complete blood count automated CPT 85027 • Laboratory | $6 | $8 | $9 |
| Prothrombin time (PT) CPT 85610 • Laboratory | $4 | $5 | $5 |
| Sedimentation rate (ESR) automated CPT 85652 • Laboratory | $3 | $3 | $4 |
| Partial thromboplastin time (PTT) CPT 85730 • Laboratory | $6 | $7 | $8 |
| Cyclic citrullinated peptide antibody CPT 86200 • Laboratory | $12 | $13 | $13 |
| Nuclear antigen antibody CPT 86235 • Laboratory | $18 | $22 | $25 |
| Heterophile antibodies screen CPT 86308 • Laboratory | $5 | $6 | $7 |
| TB skin test intradermal CPT 86580 • Laboratory | $23 | $23 | $23 |
| Blood typing ABO CPT 86900 • Laboratory | $3 | $4 | $4 |
| Blood typing Rh CPT 86901 • Laboratory | $3 | $3 | $3 |
| Urine culture bacterial colony count CPT 87086 • Laboratory | $8 | $10 | $11 |
| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $34 | $34 | $35 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $34 | $34 | $35 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $51 | $55 | $62 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $17 | $17 | $17 |
| Strep A assay with optic observation CPT 87880 • Laboratory | $16 | $16 | $17 |
| Fetal non-stress test CPT 59025 • Maternity | $22 | $39 | $56 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $125 | $188 | $252 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $143 | $198 | $252 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $524 | $524 | $524 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $53 | $130 | $252 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $60 | $137 | $252 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $195 | $212 | $229 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $123 | $123 | $123 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $139 | $139 | $139 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $174 | $174 | $174 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $131 | $131 | $131 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $194 | $226 | $259 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $69 | $69 | $69 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $36 | $71 | $106 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $36 | $93 | $150 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $211 | $211 | $211 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,257 | $1,257 | $1,257 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $36 | $331 | $626 |
| Excision chalazion single CPT 67800 • Ophthalmology | $36 | $92 | $149 |
| Arthrocentesis aspiration major joint CPT 20610 • Orthopedics | $76 | $76 | $76 |
| Tendon sheath incision trigger finger CPT 26055 • Orthopedics | $341 | $520 | $698 |
| Total hip replacement CPT 27130 • Orthopedics | $1,506 | $1,506 | $1,506 |
| Total knee replacement CPT 27447 • Orthopedics | $1,504 | $1,504 | $1,504 |
| Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics | $1,255 | $1,255 | $1,255 |
| Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics | $636 | $636 | $636 |
| Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics | $809 | $809 | $809 |
| Arthroscopy knee ACL repair CPT 29888 • Orthopedics | $1,147 | $1,147 | $1,147 |
| Peripheral nerve block injection CPT 64450 • Pain Management | $50 | $69 | $89 |
| Cytopathology concentration technique CPT 88108 • Pathology | $33 | $33 | $33 |