INDRANI ACOSTA· WINSTON SALEM, NC

Physician group

3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103

Procedures offered

953 total

Procedure	Min	Avg	Max
Immunization admin first vaccine component CPT 90460 • Preventive Care	$20	$25	$34
Immunization admin each additional component CPT 90461 • Preventive Care	$13	$22	$31
Immunization admin injection single CPT 90471 • Preventive Care	$20	$22	$25
Immunization admin injection each additional CPT 90472 • Preventive Care	$22	$27	$31
HPV vaccine 9-valent CPT 90651 • Preventive Care	$335	$366	$398
Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care	$310	$479	$648
Rotavirus vaccine pentavalent CPT 90680 • Preventive Care	$122	$122	$122
Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care	$25	$40	$54
MMR vaccine CPT 90707 • Preventive Care	$108	$108	$108
Tdap vaccine age 7 years or older CPT 90715 • Preventive Care	$60	$78	$96
Varicella vaccine CPT 90716 • Preventive Care	$232	$232	$232
Pneumococcal vaccine adult CPT 90732 • Preventive Care	$133	$137	$141
Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care	$259	$259	$259
Preventive visit new patient infant CPT 99381 • Preventive Care	$87	$154	$249
Preventive visit new patient age 1-4 CPT 99382 • Preventive Care	$185	$223	$260
Preventive visit new patient age 5-11 CPT 99383 • Preventive Care	$204	$237	$270
Preventive visit new patient age 12-17 CPT 99384 • Preventive Care	$81	$160	$291
Preventive visit new patient age 18-39 CPT 99385 • Preventive Care	$212	$255	$298
Preventive visit new patient age 40-64 CPT 99386 • Preventive Care	$246	$296	$345
Preventive visit new patient age 65+ CPT 99387 • Preventive Care	$355	$364	$373
Preventive visit established patient infant CPT 99391 • Preventive Care	$115	$115	$115
Preventive visit established patient age 1-4 CPT 99392 • Preventive Care	$125	$182	$239
Preventive visit established patient age 5-11 CPT 99393 • Preventive Care	$167	$167	$167
Preventive visit established patient age 12-17 CPT 99394 • Preventive Care	$248	$248	$248
Preventive visit established patient age 18-39 CPT 99395 • Preventive Care	$71	$163	$255
Preventive visit established patient age 40-64 CPT 99396 • Preventive Care	$271	$279	$287
Preventive visit established patient age 65+ CPT 99397 • Preventive Care	$106	$168	$291
Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care	$48	$54	$59
Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care	$84	$197	$310
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$112	$272	$585
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$241	$414	$586
Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care	$126	$195	$253
Annual wellness visit initial HCPCS G0438 • Preventive Care	$253	$307	$361
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$183	$190	$197
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$45	$410	$606
Bronchoscopy with brushing CPT 31623 • Pulmonology	$219	$450	$680
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$446	$446	$446
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$548	$708	$868
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$157	$402	$648
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$1,726	$2,454	$3,182
Ventilation assist and management initiation CPT 94002 • Pulmonology	$73	$148	$223
Spirometry CPT 94010 • Pulmonology	$45	$49	$56
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$45	$72	$100
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$45	$48	$51
Respiratory flow volume loop CPT 94375 • Pulmonology	$18	$28	$38
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$45	$150	$255
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$40	$43	$45
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$38	$41	$45
Plethysmography lung volumes CPT 94726 • Pulmonology	$42	$63	$85
Gas dilution lung volumes CPT 94727 • Pulmonology	$34	$51	$69