Patient Price Information List
Disclaimer: North Carolina Specialty Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.
Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.
Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.
North Carolina Specialty Hospital Patient Information Price List
LOCAL MARKET HOSPITALS
In order to present a meaningful comparison, North Carolina Specialty Hospital has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 6/30/2021. North Carolina Specialty Hospital charges are displayed and compared with the local market charge, consisting of the following hospitals:
Alamance Regional Medical Center
Burlington
NC
Duke Health Raleigh Hospital
Raleigh
NC
Duke Regional Hospital
Durham
NC
Duke University Hospital
Durham
NC
Granville Health Systems
Oxford
NC
Person Memorial Hospital
Roxboro
NC
Rex Hospital
Raleigh
NC
University North Carolina Hospital
Chapel Hill
NC
WakeMed Raleigh Campus
Raleigh
NC
North Carolina Specialty Hospital Patient Information Price List
INPATIENT ROOM AND BOARD DAILY CHARGES
INPATIENT ROOM AND BOARD DAILY CHARGES
Description
Variance
Private Room
Private Room
46% lower than market
North Carolina Specialty Hospital Patient Information Price List
CMS SHOPPABLE SERVICE
CMS SHOPPABLE SERVICE
Description
Variance
Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]
Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]
Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the abdomen and pelvis. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans. The CT scan is then performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the abdomen and pelvis. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data which is then displayed on the monitor as two-dimensional cross-sectional images of the abdomen or pelvis. The physician reviews the data and images as they are obtained and may request additional sections to provide more detail on areas of interest.
69% lower than market
Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]
Cataract removal involving removal of the front part of the capsule and the central part of the lens with lens prosthesis insertion [HCPCS 66984]
58% lower than market
Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]
Colon (large bowel) examination with endoscope for diagnosis (high risk) [HCPCS 45378]
A flexible colonoscopy is performed with or without collection of specimens by brushing or washing. The colonoscope is inserted into the rectum and advanced through the colon to the cecum or a point within the terminal ileum, using air insufflation to separate the mucosal folds for better visualization. Mucosal surfaces of the colon are inspected and any abnormalities are noted. The endoscope is then withdrawn as mucosal surfaces are again inspected for ulcerations, varices, bleeding sites, lesions, strictures, or other abnormalities. Cytology (cell) samples may be obtained using a brush introduced through the endoscope. Alternatively, sterile water may be introduced to wash the mucosal lining and the fluid aspirated to obtain cell samples. Cytology samples are sent for separately reportable laboratory analysis.
16% higher than market
Gallbladder removal with an endoscope [HCPCS 47562]
Gallbladder removal with an endoscope [HCPCS 47562]
The gallbladder is removed by laparoscopic technique. A small portal incision is made at the navel and a trocar is inserted. The scope and video camera are then inserted at this site. The abdomen is inflated with carbon dioxide. Two to three additional abdominal portal incisions are made and trocars are inserted for placing surgical instruments. The gallbladder is identified. If the gallbladder is distended, a needle may be used to drain bile from the gallbladder. Grasper clamps are applied. The Hartmann's pouch is identified and retracted, exposing the triangle of Calot. The cystic artery and cystic duct are identified. The cystic duct is dissected free and transected. The cystic artery is dissected free, ligated, and doubly divided. Electrocautery is used to dissect the gallbladder off the liver bed. The gallbladder is placed in an extraction sac and removed from the abdomen through one of the small incisions.
64% lower than market
Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]
Groin hernia repair for patient 5 years of age or older (herniated tissue that is not trapped) [HCPCS 49505]
An initial inguinal hernia repair is performed on a patient who is five years or older. An inguinal hernia is a condition where structures protrude through a weakness in the abdominal wall in the groin area. Incarcerated hernia tissue cannot be pushed back into its normal position. Strangulated hernias are those in which circulation is compromised. An incision is made over the internal ring. The skin, fat, and subcutaneous fascia are incised down to the aponeurosis of the external oblique muscle. The external ring is identified and the external oblique aponeurosis is slit. The internal ring is opened and the inguinal canal is exposed. In males, the spermatic cord and its covering are mobilized and the covering is removed. The hernia sac is dissected free into the retroperitoneum, opened, and inspected for the presence of bowel or bladder wall. Any bowel or bladder content is reduced (pushed back into the abdominal cavity) and the hernia sac is transected and inverted into the abdominal cavity. A mesh plug may be placed to reinforce the repair. In women, the sac is inspected for the ovary. If the ovary is present, it is returned to the abdomen. The sac is then resected together with the round ligament. The internal ring is closed and the posterior wall of the inguinal canal is repaired.
71% lower than market
Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]
Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]
Computerized tomography, also referred to as a CT scan, uses special x-ray equipment and computer technology to produce multiple cross-sectional images of the region being studied. In this study, CT scan of the head or brain is performed. The patient is positioned on the CT examination table. An initial pass is made through the CT scanner to determine the starting position of the scans after which the CT scan is performed. As the table moves slowly through the scanner, numerous x-ray beams and electronic x-ray detectors rotate around the body region being examined. The amount of radiation being absorbed is measured. As the beams and detectors rotate around the body, the table is moved through the scanner. A computer program processes the data and renders the data in two-dimensional cross-sectional images of the body region being examined. This data is displayed on a monitor. The physician reviews the data as it is being obtained and may request additional sections to provide more detail of areas of interest.
75% lower than market
Knee cartilage removal with endoscope (one knee) [HCPCS 29881]
Knee cartilage removal with endoscope (one knee) [HCPCS 29881]
59% lower than market
Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]
Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]
A urinalysis is performed by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and/or urobilinogen. Urinalysis can quickly screen for conditions that do not immediately produce symptoms such as diabetes mellitus, kidney disease, or urinary tract infection. A dip stick allows qualitative and semi-quantitative analysis using a paper or plastic stick with color strips for each agent being tested. The stick is dipped in the urine specimen and the color strips are then compared to a color chart to determine the presence or absence and/or a rough estimate of the concentration of each agent tested. Reagent tablets use an absorbent mat with a few drops of urine placed on the mat followed by a reagent tablet. A drop of distilled, deionized water is then placed on the tablet and the color change is observed. Bilirubin is a byproduct of the breakdown of red blood cells by the liver. Normally bilirubin is excreted through the bowel, but in patients with liver disease, bilirubin is filtered by the kidneys and excreted in the urine. Glucose is a sugar that is normally filtered by the glomerulus and excreted only in small quantities in the urine. Excess sugar in the urine (glycosuria) is indicative of diabetes mellitus. The peroxidase activity of erythrocytes is used to detect hemoglobin in the urine which may be indicative of hematuria, myoglobinuria, or hemoglobinuria. Ketones in the urine are the result of diabetic ketoacidosis or calorie deprivation (starvation). A leukocyte esterase test identifies the presence of white blood cells in the urine. The presence of nitrites in the urine is indicative of bacteria. The pH identifies the acid-base levels in the urine. The presence of excessive amounts of protein (proteinuria) may be indicative of nephrotic syndrome. Specific gravity measures urine density and is indicative of the kidneys' ability to concentrate and dilute urine. Following dip stick or reagent testing, the urine sample may be examined under a microscope. The urine sample is placed in a test tube and centrifuged. The sediment is resuspended. A drop of the resuspended sediment is then placed on a glass slide, cover-slipped, and examined under a microscope for crystals, casts, squamous cells, blood (white, red) cells, and bacteria.
77% lower than market
Lab analysis of urine specimen by dipstick without microscope (non-automated) [HCPCS 81002]
Lab analysis of urine specimen by dipstick without microscope (non-automated) [HCPCS 81002]
A urinalysis is performed by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, and/or urobilinogen. Urinalysis can quickly screen for conditions that do not immediately produce symptoms such as diabetes mellitus, kidney disease, or urinary tract infection. A dip stick allows qualitative and semi-quantitative analysis using a paper or plastic stick with color strips for each agent being tested. The stick is dipped in the urine specimen and the color strips are then compared to a color chart to determine the presence or absence and/or a rough estimate of the concentration of each agent tested. Reagent tablets use an absorbent mat with a few drops of urine placed on the mat followed by a reagent tablet. A drop of distilled, deionized water is then placed on the tablet and the color change is observed. Bilirubin is a byproduct of the breakdown of red blood cells by the liver. Normally bilirubin is excreted through the bowel, but in patients with liver disease, bilirubin is filtered by the kidneys and excreted in the urine. Glucose is a sugar that is normally filtered by the glomerulus and excreted only in small quantities in the urine. Excess sugar in the urine (glycosuria) is indicative of diabetes mellitus. The peroxidase activity of erythrocytes is used to detect hemoglobin in the urine which may be indicative of hematuria, myoglobinuria, or hemoglobinuria. Ketones in the urine are the result of diabetic ketoacidosis or calorie deprivation (starvation). A leukocyte esterase test identifies the presence of white blood cells in the urine. The presence of nitrites in the urine is indicative of bacteria. The pH identifies the acid-base levels in the urine. The presence of excessive amounts of protein (proteinuria) may be indicative of nephrotic syndrome. Specific gravity measures urine density and is indicative of the kidneys' ability to concentrate and dilute urine. Following dip stick or reagent testing, the urine sample may be examined under a microscope. The urine sample is placed in a test tube and centrifuged. The sediment is resuspended. A drop of the resuspended sediment is then placed on a glass slide, cover-slipped, and examined under a microscope for crystals, casts, squamous cells, blood (white, red) cells, and bacteria.
74% lower than market
Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]
Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]
Prothrombin time (PT) measures how long it takes for blood to clot. Prothrombin, also called factor II, is one of the clotting factors made by the liver and adequate levels of vitamin K are needed for the liver to produce sufficient prothrombin. Prothrombin time is used to help identify the cause of abnormal bleeding or bruising; to check whether blood thinning medication, such as warfarin (Coumadin), is working; to check for low levels of blood clotting factors I, II, V, VII, and X; to check for low levels of vitamin K; to check liver function, to see how quickly the body is using up its clotting factors. The test is performed using electromagnetic mechanical clot detection. If prothrombin time is elevated and the patient is not on a blood thinning medication, a second prothrombin time using substitution plasma fractions, also referred to as a prothrombin time mixing study, may be performed. This is performed by mixing patient plasma with normal plasma using a 1:1 mix. The mixture is incubated and the clotting time is again measured. If the result does not correct, it may be indicative that the patient has an inhibitor, such as lupus anticoagulant. If the result does correct, the patient may have a coagulation factor deficiency.
79% lower than market
Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]
Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]
A blood test is performed to determine levels of thyroid stimulating hormone (TSH). TSH is produced in the pituitary and helps to regulate two other thyroid hormones, triiodothyronine (T3) and thyroxin (T4), which in turn help regulate the body's metabolic processes. TSH levels are tested to determine whether the thyroid is functioning properly. Patients with symptoms of weight gain, tiredness, dry skin, constipation, or menstrual irregularities may have an underactive thyroid (hypothyroidism). Patients with symptoms of weight loss, rapid heart rate, nervousness, diarrhea, feeling of being too hot, or menstrual irregularities may have an overactive thyroid (hypothyroidism). TSH levels are also periodically tested in individuals on thyroid medications. The test is performed by electrochemiluminescent immunoassay.
44% lower than market
Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]
Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]
This test may also be referred to as an activated PTT or aPTT. PTT may be performed to diagnose the cause of bleeding or as a screening test prior to surgery to rule-out coagulation defects. A silica and synthetic phospholipid PTT reagent is mixed with the patient plasma. The silica provides a negatively-charged particulate surface that activates the contact pathway for coagulation. Clot formation is initiated by adding calcium chloride to the mixture. Clotting time is measured photo-optically.
60% lower than market
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]
Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]
An automated complete blood count (CBC) is performed with or without automated differential white blood cell (WBC) count. A CBC is used as a screening test to evaluate overall health and symptoms such as fatigue, bruising, bleeding, and inflammation, or to help diagnose infection. A CBC includes measurement of hemoglobin (Hgb) and hematocrit (Hct), red blood cell (RBC) count, white blood cell (WBC) count with or without differential, and platelet count. Hgb measures the amount of oxygen-carrying protein in the blood. Hct refers to the volume of red blood cells (erythrocytes) in a given volume of blood and is usually expressed as a percentage of total blood volume. RBC count is the number of red blood cells (erythrocytes) in a specific volume of blood. WBC count is the number of white blood cells (leukocytes) in a specific volume of blood. There are five types of WBCs: neutrophils, eosinophils, basophils, monocytes, and lymphocytes. If a differential is performed, each of the five types is counted separately. Platelet count is the number of platelets (thrombocytes) in the blood. Platelets are responsible for blood clotting. The CBC is performed with an automated blood cell counting instrument that can also be programmed to provide an automated WBC differential count.
68% lower than market
Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]
Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]
"A lipid panel is obtained to assess the risk for cardiovascular disease and to monitor appropriate treatment. Lipids are comprised of cholesterol, protein, and triglycerides. They are stored in cells and circulate in the blood. Lipids are important for cell health and as an energy source. A lipid panel should include a measurement of triglycerides and total serum cholesterol and then calculate to find the measurement of high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) and very low density lipoprotein (VLDL-C). HDL contains the highest ratio of cholesterol and is often referred to as ""good cholesterol"" because it is capable of transporting excess cholesterol in the blood to the liver for removal. LDL contains the highest ratio of protein and is considered ""bad cholesterol"" because it transports and deposits cholesterol in the walls of blood vessels. VLDL contains the highest ratio of triglycerides and high levels are also considered ""bad"" because it converts to LDL after depositing triglyceride molecules in the walls of blood vessels. A blood sample is obtained by separately reportable venipuncture or finger stick. Serum/plasma is tested using quantitative enzymatic method."
58% lower than market
Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]
Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]
A basic metabolic blood panel is obtained that includes ionized calcium levels along with carbon dioxide (bicarbonate) (CO2), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN). A basic metabolic panel with measurement of ionized calcium may be used to screen for or monitor overall metabolic function or identify imbalances. Ionized or free calcium flows freely in the blood, is not attached to any proteins, and represents the amount of calcium available to support metabolic processes such as heart function, muscle contraction, nerve function, and blood clotting. Total carbon dioxide (bicarbonate) (CO2) level is composed of CO2, bicarbonate (HCO3-), and carbonic acid (H2CO3) with the primary constituent being bicarbonate, a negatively charged electrolyte that works in conjunction with other electrolytes, such as potassium, sodium, and chloride, to maintain proper acid-base balance and electrical neutrality at the cellular level. Chloride is also a negatively charged electrolyte that helps regulate body fluid and maintain proper acid-base balance. Creatinine is a waste product excreted by the kidneys that is produced in the muscles while breaking down creatine, a compound used by the muscles to create energy. Blood levels of creatinine provide a good measurement of renal function. Glucose is a simple sugar and the main source of energy for the body, regulated by insulin. When more glucose is available than is required, it is stored in the liver as glycogen or stored in adipose tissue as fat. Glucose measurement determines whether the glucose/insulin metabolic process is functioning properly. Both potassium and sodium are positively charged electrolytes that work in conjunction with other electrolytes to regulate body fluid, stimulate muscle contraction, and maintain proper acid-base balance and both are essential for maintaining normal metabolic processes. Urea is a waste product produced in the liver by the breakdown of protein from a sequence of chemical reactions referred to as the urea or Krebs-Henseleit cycle. Urea is taken up by the kidneys and excreted in the urine. Blood urea nitrogen, BUN, is a measure of renal function, and helps monitor renal disease and the effectiveness of dialysis.
79% lower than market
Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]
Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]
A comprehensive metabolic panel is obtained that includes albumin, bilirubin, total calcium, carbon dioxide, chloride, creatinine, glucose, alkaline phosphatase, potassium, total protein, sodium, alanine amino transferase (ALT) (SGPT), aspartate amino transferase (AST) (SGOT), and urea nitrogen (BUN). This test is used to evaluate electrolytes and fluid balance as well as liver and kidney function. It is also used to help rule out conditions such as diabetes. Tests related to electrolytes and fluid balance include: carbon dioxide, chloride, potassium, and sodium. Tests specific to liver function include: albumin, bilirubin, alkaline phosphatase, ALT, AST, and total protein. Tests specific to kidney function include: BUN and creatinine. Calcium is needed to support metabolic processes such as heart function, muscle contraction, nerve function, and blood clotting. Glucose is the main source of energy for the body and is regulated by insulin. Glucose measurement determines whether the glucose/insulin metabolic process is functioning properly.
80% lower than market
Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]
Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]
Therapeutic exercise is the application of careful, graduated force to the body to increase strength, endurance, range of motion, and flexibility. Increased muscle strength is achieved by the deliberate overloading of a targeted muscle or muscle group and improved endurance is achieved by raising the intensity of the strengthening exercise to the targeted area(s) over a prolonged period of time. To maintain range of motion (ROM) and flexibility requires the careful movement and stretching of contractile and non-contractile tissue that may tighten with injury or neurological disease, causing weakness and/or spasticity. Therapeutic exercise can increase blood flow to the targeted area, reduce pain and inflammation, reduce the risk of blood clots from venous stasis, decrease muscle atrophy and improve coordination and motor control. Therapeutic exercise may be prescribed following acute illness or injury and for chronic conditions that affect physical activity or function.
74% lower than market
Shoulder examination and shoulder bone shaving with endoscope [HCPCS 29826]
Shoulder examination and shoulder bone shaving with endoscope [HCPCS 29826]
49% lower than market
Spinal fusion other than the neck without major complications
Spinal fusion other than the neck without major complications
34% lower than market
Total Knee or Hip Replacement
Total Knee or Hip Replacement
39% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT LABORATORY AND PATHOLOGY
OUTPATIENT LABORATORY AND PATHOLOGY
Description
Variance
Lab analysis by immunoassay (ELISA) to identify the severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen [HCPCS 87426]
Lab analysis by immunoassay (ELISA) to identify the severe acute respiratory syndrome coronavirus 2 (Covid-19) antigen [HCPCS 87426]
45% lower than market
Lab analysis of any culture (except blood) to identify anaerobic bacteria [HCPCS 87075]
Lab analysis of any culture (except blood) to identify anaerobic bacteria [HCPCS 87075]
A tissue sample is collected and placed in a medium conducive to the growth of bacteria. The culture is examined for the growth of bacteria that can survive without oxygen.
58% lower than market
Lab analysis of any culture (except blood) to identify fungus (mold or yeast) [HCPCS 87102]
Lab analysis of any culture (except blood) to identify fungus (mold or yeast) [HCPCS 87102]
68% lower than market
Lab analysis of any culture (except urine, blood, or stool) to identify bacteria [HCPCS 87070]
Lab analysis of any culture (except urine, blood, or stool) to identify bacteria [HCPCS 87070]
A tissue sample besides blood, urine, or stool is collected and placed in a medium conducive to the growth of bacteria. The culture is examined for the growth of bacteria.
58% lower than market
Lab analysis of urine specimen by dipstick to detect the hormone found in women in early pregnancy [HCPCS 81025]
Lab analysis of urine specimen by dipstick to detect the hormone found in women in early pregnancy [HCPCS 81025]
Pregnancy tests detect the presence of human chorionic gonadotropin (hCG) in the urine. HCG is produced by the placenta and can be detected in urine shortly after the embryo attaches to the uterine lining. The test may be performed by collecting a urine specimen and dipping a stick treated to detect the presence of hCG in the urine. The presence of hCG is indicated by a color change in the treated section of the dipstick indicating a positive pregnancy test. If no color change occurs, the test is negative.
74% lower than market
Lab analysis to evaluate an antimicrobial drug (antibiotic, antifungal, antiviral) by disk method (per plate) [HCPCS 87184]
Lab analysis to evaluate an antimicrobial drug (antibiotic, antifungal, antiviral) by disk method (per plate) [HCPCS 87184]
62% lower than market
Lab analysis to measure red blood cell sedimentation rate to detect inflammation (non-automated) [HCPCS 85651]
Lab analysis to measure red blood cell sedimentation rate to detect inflammation (non-automated) [HCPCS 85651]
Lab test for Sedimentation rate
72% lower than market
Lab analysis to measure the amount of C-reactive protein in serum to identify infection or inflammation [HCPCS 86140]
Lab analysis to measure the amount of C-reactive protein in serum to identify infection or inflammation [HCPCS 86140]
A blood test is performed to measure C-reactive protein (CRP) levels. This standard test has a wide value range. CRP is an acute phase protein, synthesized by the liver and released in response to inflammation and infection. The test is not diagnostic for any specific disease or condition but can be used as a marker to monitor the body's response to treatment(s) or to evaluate the need for further testing. Elevation of CRP levels may be found during pregnancy, with the use of oral contraceptives, or hormone replacement therapy. Diseases/conditions that cause an elevation of CRP include: lymphoma, arteritis/vasculitis, osteomyelitis, inflammatory bowel disease, rheumatoid arthritis, pelvic inflammatory disease (PID), systemic lupus erythematosus (SLE), acute infections, burns, surgical procedures, and organ transplants. A blood sample is obtained by separately reportable venipuncture. Serum in neonates is tested using immunoassay. Serum/plasma in all other patients is tested using quantitative immunoturbidimetric method.
72% lower than market
Lab analysis to measure the blood potassium level in blood specimen [HCPCS 84132]
Lab analysis to measure the blood potassium level in blood specimen [HCPCS 84132]
A blood sample is obtained to measure potassium level. Potassium is a positively charged electrolyte that works in conjunction with other electrolytes, such as sodium, chloride, and carbon dioxide (CO2), to regulate body fluid, stimulate muscle contraction, and maintain proper acid-base balance. Potassium is found in all body fluids but mostly stored within cells, not in extracellular fluids, blood serum, or plasma. Small fluctuations in blood potassium, either too high (hyperkalemia) or too low (hypokalemia), can have serious, even life-threatening, consequences. Potassium level is used to screen for and monitor renal disease; monitor patients on certain medications, such as diuretics, as well as patients with acute and chronic conditions, such as dehydration or endocrine disorders. Because blood potassium affects heart rhythm and respiratory rate, it is routinely checked prior to major surgical procedures. Potassium is measured by ion-selective electrode (ISE) methodology.
59% lower than market
Lab analysis to measure the glucose (sugar) level in blood [HCPCS 82947]
Lab analysis to measure the glucose (sugar) level in blood [HCPCS 82947]
A blood sample is obtained to measure total (quantitative) blood glucose level. Glucose is a simple sugar that is the main source of energy for the body. Carbohydrates are broken down into simple sugars, primarily glucose, absorbed by the intestine, and circulated in the blood. Insulin, a hormone produced by the pancreas, regulates glucose level in the blood and transports glucose to cells in other tissues and organs. When more glucose is available in the blood than is required, it is converted to glycogen and stored in the liver or converted to fat and stored in adipose (fat) tissue. If the glucose/insulin metabolic process is working properly, blood glucose will remain at a fairly constant, healthy level. Glucose is measured to determine whether the glucose/insulin metabolic process is functioning properly. It is used to monitor glucose levels and determine whether they are too low (hypoglycemia) or too high (hyperglycemia) as well as test for diabetes and monitor blood sugar control in diabetics.
37% lower than market
Lab analysis to measure the hemoglobin A1C level in blood specimen [HCPCS 83036]
Lab analysis to measure the hemoglobin A1C level in blood specimen [HCPCS 83036]
A blood test is performed to measure glycosylated hemoglobin (HbA1C) levels. Plasma glucose binds to hemoglobin and the HbA1C test measures the average plasma glucose concentration over the life of red blood cells (approximately 90-120 days). HbA1C levels may be used as a diagnostic reference for patients with suspected diabetes mellitus (DM) and to monitor blood glucose control in patients with known DM. HbA1C levels should be monitored at least every 6 months in patients with DM and more frequently when the level is >7.0%. A blood sample is obtained by separately reportable venipuncture. Whole blood is tested using quantitative high performance liquid chromatography/boronate affinity.
51% lower than market
Lab analysis to measure the lactate dehydrogenase (enzyme) level [HCPCS 83615]
Lab analysis to measure the lactate dehydrogenase (enzyme) level [HCPCS 83615]
A blood or body fluid test is performed to measure lactate dehydrogenase (LD) (LDH) levels. LDH is an enzyme present in red blood cells (RBCs) and in the tissue of heart, liver, pancreas, kidney, skeletal muscle, brain and lungs. LDH levels are used as a marker for tissue and RBC damage. Elevated blood levels can be caused by stroke, myocardial infarction, liver disease, pancreatitis, muscular dystrophy, infectious mononucleosis, hemolytic anemia and tumors/cancers such as lymphoma. Elevated cerebral spinal fluid (CSF) levels are usually indicative of bacterial meningitis. LDH levels in pleural and/or pericardial fluid can indicate if the effusion is an exudate, caused by an infection or a transudate caused by fluid pressure problem. A blood sample is obtained by separately reportable venipuncture. Cerebral spinal fluid is obtained by separately reportable lumbar puncture (spinal tap). Pericardial fluid is obtained by separately reportable pericardiocentesis. Fluid from a pleural effusion is obtained by separately reportable thoracentesis. Serum or plasma and all body fluids are tested using quantitative enzymatic methodology.
50% lower than market
Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]
Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]
A blood, urine, or fecal test is performed to measure magnesium levels. Magnesium is an essential dietary mineral responsible for enzyme function, energy production, and contraction and relaxation of muscle fibers. Decreased levels may result from severe burns, metabolic disorders, certain medications, and low blood calcium levels. A blood sample is obtained by separately reportable venipuncture. Red blood cells (RBCs) are tested using quantitative inductively coupled plasma-mass spectrometry. Serum/plasma is tested using quantitative spectrophotometry. A 24-hour voided urine specimen is tested using quantitative spectrophotometry. A random or 24-hour fecal sample is tested using quantitative spectrophotometry.
50% lower than market
Lab blood analysis to identify antigens of red blood cell antibodies (other than ABO or Rh(D)) [HCPCS 86905]
Lab blood analysis to identify antigens of red blood cell antibodies (other than ABO or Rh(D)) [HCPCS 86905]
38% lower than market
Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]
Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]
A blood specimen is tested to determine blood type (ABO) or Rh(D). Blood is grouped using an ABO blood typing system which identifies four blood types: type A, B, AB, or O. The blood sample is mixed with antibodies against Type A and B blood and then checked to determine if the blood cells agglutinate, or stick together. Type A blood has anti-B antibodies; type B blood has anti-A antibodies; type O blood has antibodies to both A and B; and type AB blood does not have anti-A or anti-B antibodies. Type A blood agglutinates when type B antibodies are introduced. Type B blood agglutinates when type A antibodies are introduced. Type O blood agglutinates when type A or B antibodies are introduced. Type AB blood does not agglutinate when type A or B antibodies are introduced. The blood is then back typed. Blood serum is mixed with blood that is known to be type A or B.
65% lower than market
Lab blood analysis to identify antigens on red blood cell surface and determine the patient's Rh (D) type (Rh positive or Rh negative) [HCPCS 86901]
Lab blood analysis to identify antigens on red blood cell surface and determine the patient's Rh (D) type (Rh positive or Rh negative) [HCPCS 86901]
A blood specimen is tested to determine blood type (ABO) or Rh(D). In Rh(D), blood is tested for Rh factor, which is an antigen on red blood cells. Blood is Rh+ if the antigen is present or Rh- if the antigen is absent. Blood is tested by mixing the blood sample with antibodies against Rh factor and then checking for agglutination. If agglutination occurs, the blood is Rh+. If the blood does not agglutinate, it is Rh-.
65% lower than market
Pathology lab analysis of special stained specimen slides to examine tissue (each additional procedure) [HCPCS 88341]
Pathology lab analysis of special stained specimen slides to examine tissue (each additional procedure) [HCPCS 88341]
70% lower than market
Pathology lab analysis of tissue with microscope (intermediate complexity) [HCPCS 88305]
Pathology lab analysis of tissue with microscope (intermediate complexity) [HCPCS 88305]
Tissue removed during a surgical procedure, such as a biopsy, excision, or resection, is examined macroscopically (gross or visual examination) and then under a microscope. The cells, tissues, or organ are transported from the surgical suite to the pathologist. The pathologist first visually examines the specimen and notes any defining characteristics. The specimen is then prepared for microscopic evaluation. The physician carefully analyzes the specimens to help establish a diagnosis, identify the presence or absence of malignant neoplasm, identify the exact type malignancy if present, examine the margins of the specimen to determine whether or not the entire diseased area was removed. A written report of findings is then prepared and a copy sent to the treating physician. Pathology services are reported based on the type of tissue examined, whether or not the tissue is expected to be normal or diseased, the difficulty of the pathology exam, and the time required to complete the exam.
57% lower than market
Pathology lab analysis of tissue with microscope (moderately low complexity) [HCPCS 88304]
Pathology lab analysis of tissue with microscope (moderately low complexity) [HCPCS 88304]
Tissue removed during a surgical procedure, such as a biopsy, excision, or resection, is examined macroscopically (gross or visual examination) and then under a microscope. The cells, tissues, or organ are transported from the surgical suite to the pathologist. The pathologist first visually examines the specimen and notes any defining characteristics. The specimen is then prepared for microscopic evaluation. The physician carefully analyzes the specimens to help establish a diagnosis, identify the presence or absence of malignant neoplasm, identify the exact type malignancy if present, examine the margins of the specimen to determine whether or not the entire diseased area was removed. A written report of findings is then prepared and a copy sent to the treating physician. Pathology services are reported based on the type of tissue examined, whether or not the tissue is expected to be normal or diseased, the difficulty of the pathology exam, and the time required to complete the exam.
51% lower than market
Pathology lab analysis with tissue preparation for examination by removing any calcium present [HCPCS 88311]
Pathology lab analysis with tissue preparation for examination by removing any calcium present [HCPCS 88311]
59% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT MEDICINE
OUTPATIENT MEDICINE
Description
Variance
Tissue removal from wounds per session (first 20 sq cm or less) [HCPCS 97597]
Tissue removal from wounds per session (first 20 sq cm or less) [HCPCS 97597]
80% lower than market
Wound vac therapy (negative pressure wound therapy) per session (surface area less than or equal to 50 square cm) [HCPCS 97607]
Wound vac therapy (negative pressure wound therapy) per session (surface area less than or equal to 50 square cm) [HCPCS 97607]
12% higher than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT OBSERVATION
OUTPATIENT OBSERVATION
Description
Variance
Hospital observation per hr [HCPCS G0378]
Hospital observation per hr [HCPCS G0378]
Hospital observation service, per hour
96% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT OTHER
OUTPATIENT OTHER
Description
Variance
Eye fluid drainage device insertion internally into the tissue of the eye near the base of the cornea where eye fluid flows out of the eye (each additional device insertion) [HCPCS 0376T]
Eye fluid drainage device insertion internally into the tissue of the eye near the base of the cornea where eye fluid flows out of the eye (each additional device insertion) [HCPCS 0376T]
65% lower than market
Puraply am, per square centimeter
Puraply am, per square centimeter
79% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY
OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY
Description
Variance
Function improvement activities with one-on-one contact between patient and provider (each 15 minutes) [HCPCS 97530]
Function improvement activities with one-on-one contact between patient and provider (each 15 minutes) [HCPCS 97530]
In a one-on-one physical therapy session, the provider instructs and assists the patient in therapeutic activities designed to address specific functional limitations. The therapeutic activities are specifically developed and modified for the patient. Dynamic/movement activities, also called kinetic activities, that are designed to improve functional performance such as lifting, bending, pushing, pulling, jumping and reaching are included in this service. For example, the patient may be given therapeutic activities to perform to improve the ability to sit, stand, and get out of bed after an injury without straining or risking reinjury. This code is reported for each 15 minutes of one-on-one therapeutic activity provided.
75% lower than market
Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]
Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]
Gait training is a therapeutic procedure that observes and educates an individual in the manner of walking including the rhythm, cadence, step, stride, and speed. The objective of gait training is to strengthen muscles and joints, improve balance and posture, and develop muscle memory. As the lower extremities are retrained for repetitive motion, the body also benefits from the exercise with increased endurance, improved heart/lung function, and reduced or improved osteoporosis. Gait training is an appropriate therapeutic procedure following brain and/or spinal cord injury, stroke, fracture of the pelvis and/or lower extremity, joint injury or replacement of the knee, hip, or ankle, amputation, and for certain musculoskeletal and/or neurological diseases. A treadmill fitted with a safety harness is initially used to ensure safe walking. As the patient gains strength and balance, step training and stair climbing is added to the treatment modality.
73% lower than market
Physical therapy evaluation (typically 20 minutes) [HCPCS 97161]
Physical therapy evaluation (typically 20 minutes) [HCPCS 97161]
A physical therapy evaluation or re-evaluation is performed. The physical therapist takes a history of the current complaint including onset of symptoms, comorbidities, changes since the onset, treatment received for the symptoms or condition, medications prescribed for it, and any other medications the patient is taking. A physical examination of body systems is done to assess physical structure and function, any activities or movements that exacerbate the symptoms, limit activity, or restrict participation in movement, as well as anything that helps to relieve the symptoms. The evaluation may involve provocative maneuvers or positions that increase symptoms; tests for joint flexibility and muscle strength; assessments of general mobility, posture, and core strength; evaluation of muscle tone; and tests for restrictions of movement caused by myofascial disorders. Following the history and physical, the therapist determines the patient's clinical presentation characteristics, provides a detailed explanation of the condition, identifies physical therapy treatment options, and explains how often and how long physical therapy modalities should be applied. The physical therapist will then develop a plan of care with clinical decision making based on patient assessment and/or measurable functional outcome. The plan of care may include both physical therapy in the clinic and exercises or changes in the home environment. Upon re-evaluation, the established care plan is reviewed and an interim history is taken requiring the use of standardized tests and measures. The patient's response to treatment is evaluated and the plan of care is revised based on the patient's measurable response.
10% lower than market
Training activities for home and self-care management (each 15 minutes) [HCPCS 97535]
Training activities for home and self-care management (each 15 minutes) [HCPCS 97535]
Self-care/home managemeThe patient receives one-on-one training to improve the ability to care for himself/herself and maintain independence. This may include training in activities of daily living (ADL), such as bed mobility, transfers, dressing, grooming, eating, bathing and toileting. The patient is given instruction on compensatory measures that can be taken to overcome any physical, mental or emotional disabilities. The patient receives training in how to adapt meal preparation to his/her specific needs and how to perform activities safely. The patient may also receive instruction in the use of assistive technology devices and adaptive equipment which includes any item used to improve the functional capability of the patient in the home and with ADL. This code is reported for each 15 minutes of one-on-one self-care/home management training designed to meet the specific needs of the patient.nt training, which includes instructions in the use of any assisting equipment.
73% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT PULMONARY THERAPY
OUTPATIENT PULMONARY THERAPY
Description
Variance
Routine EKG (electrocardiogram) tracing using at least 12 wires [HCPCS 93005]
Routine EKG (electrocardiogram) tracing using at least 12 wires [HCPCS 93005]
An ECG is used to evaluate the electrical activity of the heart. The test is performed with the patient lying prone on the exam table. Small plastic patches are attached at specific locations on the chest, abdomen, arms, and/or legs. Leads (wires) from the ECG tracing device are then attached to the patches. A tracing is obtained of the electrical signals from the heart. Electrical activity begins in the sinoatrial node which generates an electrical stimulus at regular intervals, usually 60 to 100 times per minute. This stimulus travels through the conduction pathways to the sinoatrial node causing the atria to contract. The stimulus then travels along the bundle of His which divides into right and left pathways providing electrical stimulation of the ventricles causing them to contract. Each contraction of the ventricles represents one heart beat. The ECG tracing includes the following elements: P wave, QRS complex, ST segment, and T wave. The P wave, a small upward notch in the tracing, indicates electrical stimulation of the atria. This is followed by the QRS complex which indicates the ventricles are electrically stimulated to contract. The short flat ST segment follows and indicates the time between the end of the ventricular contraction and the T wave. The T wave represents the recovery period of the ventricles. The physician reviews, interprets, and provides a written report of the ECG recording taking care to note any abnormalities.
80% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT SUPPLIES
OUTPATIENT SUPPLIES
Description
Variance
Anchor/screw bn/bn,tis/bn [HCPCS C1713]
Anchor/screw bn/bn,tis/bn [HCPCS C1713]
95% lower than market
Mesh (implantable) [HCPCS C1781]
Mesh (implantable) [HCPCS C1781]
87% lower than market
Ocular imp, aqueous drain de [HCPCS C1783]
Ocular imp, aqueous drain de [HCPCS C1783]
6% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT SURGICAL SERVICES
OUTPATIENT SURGICAL SERVICES
Description
Variance
Anesthetic agent and/or steroid injection into brachial nerve bundle of arm [HCPCS 64415]
Anesthetic agent and/or steroid injection into brachial nerve bundle of arm [HCPCS 64415]
31% lower than market
Bone joints removal of bones between wrist and fingers [HCPCS 25447]
Bone joints removal of bones between wrist and fingers [HCPCS 25447]
72% lower than market
Broken lower forearm bone or growth plate separation treatment with hardware insertion (3 or more fragments, open treatment) [HCPCS 25609]
Broken lower forearm bone or growth plate separation treatment with hardware insertion (3 or more fragments, open treatment) [HCPCS 25609]
62% lower than market
Cage or mesh device insertion into spine bone and disc during spine fusion [HCPCS 22853]
Cage or mesh device insertion into spine bone and disc during spine fusion [HCPCS 22853]
20% lower than market
Chemical agent application to wound tissue [HCPCS 17250]
Chemical agent application to wound tissue [HCPCS 17250]
84% lower than market
Complex cataract removal with lens insertion [HCPCS 66982]
Complex cataract removal with lens insertion [HCPCS 66982]
49% lower than market
Glaucoma treatment with creation of eye fluid drainage (primary) [HCPCS 66170]
Glaucoma treatment with creation of eye fluid drainage (primary) [HCPCS 66170]
59% lower than market
Hand tendon transplant without graft [HCPCS 26480]
Hand tendon transplant without graft [HCPCS 26480]
38% lower than market
Knee cartilage removal with endoscope (both knees) [HCPCS 29880]
Knee cartilage removal with endoscope (both knees) [HCPCS 29880]
56% lower than market
Knee joint repair at lower or upper part of joint (inside and outside compartments [HCPCS 27447]
Knee joint repair at lower or upper part of joint (inside and outside compartments [HCPCS 27447]
23% lower than market
Knee joint repair at lower or upper part of joint (inside or outside compartments) [HCPCS 27446]
Knee joint repair at lower or upper part of joint (inside or outside compartments) [HCPCS 27446]
22% lower than market
Leg cast application (rigid, total contact) [HCPCS 29445]
Leg cast application (rigid, total contact) [HCPCS 29445]
60% lower than market
Median nerve of hand release and/or relocation [HCPCS 64721]
Median nerve of hand release and/or relocation [HCPCS 64721]
57% lower than market
Partial lower spinal bone removal with release of spinal cord and/or nerves (single vertebral segment) [HCPCS 63047]
Partial lower spinal bone removal with release of spinal cord and/or nerves (single vertebral segment) [HCPCS 63047]
47% lower than market
Partial removal of spine bone with release of spinal cord and/or nerves (each additional vertebral segment) [HCPCS 63048]
Partial removal of spine bone with release of spinal cord and/or nerves (each additional vertebral segment) [HCPCS 63048]
66% lower than market
Partial spinal bone removal with release of spinal cord or spinal nerves in lower spine (single interspace) [HCPCS 63030]
Partial spinal bone removal with release of spinal cord or spinal nerves in lower spine (single interspace) [HCPCS 63030]
52% lower than market
Shoulder examination and release of shoulder biceps tendon with endoscope [HCPCS 29828]
Shoulder examination and release of shoulder biceps tendon with endoscope [HCPCS 29828]
43% lower than market
Shoulder examination and removal of abnormal shoulder joint tissue with endoscope (extensive) [HCPCS 29823]
Shoulder examination and removal of abnormal shoulder joint tissue with endoscope (extensive) [HCPCS 29823]
52% lower than market
Shoulder examination and removal of collar bone at shoulder with endoscope (partial) [HCPCS 29824]
Shoulder examination and removal of collar bone at shoulder with endoscope (partial) [HCPCS 29824]
44% lower than market
Shoulder examination and shoulder rotator cuff repair with endoscope [HCPCS 29827]
Shoulder examination and shoulder rotator cuff repair with endoscope [HCPCS 29827]
43% lower than market
Shoulder examination and shoulder scar tissue release or removal with endoscope [HCPCS 29825]
Shoulder examination and shoulder scar tissue release or removal with endoscope [HCPCS 29825]
8% lower than market
Skin substitute graft application to trunk, arms, and legs for wound up to 100 sq cm (first 25 sq cm) [HCPCS 15271]
Skin substitute graft application to trunk, arms, and legs for wound up to 100 sq cm (first 25 sq cm) [HCPCS 15271]
49% lower than market
Spinal bones fusion on frontside of spine with vertebral disc removal at upper spinal column (complex) [HCPCS 22551]
Spinal bones fusion on frontside of spine with vertebral disc removal at upper spinal column (complex) [HCPCS 22551]
8% higher than market
Tendon covering incision [HCPCS 26055]
Tendon covering incision [HCPCS 26055]
63% lower than market
Thigh bone replacement and hip joint prosthesis [HCPCS 27130]
Thigh bone replacement and hip joint prosthesis [HCPCS 27130]
36% lower than market
Ulnar nerve at elbow release and/or relocation [HCPCS 64718]
Ulnar nerve at elbow release and/or relocation [HCPCS 64718]
67% lower than market
Unlisted front (anterior) eye procedure [HCPCS 66999]
Unlisted front (anterior) eye procedure [HCPCS 66999]
72% lower than market
Unlisted procedure of joint with endoscope [HCPCS 29999]
Unlisted procedure of joint with endoscope [HCPCS 29999]
67% lower than market
Vein wound compression system application to lower leg below knee including ankle and foot [HCPCS 29581]
Vein wound compression system application to lower leg below knee including ankle and foot [HCPCS 29581]
71% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT VISION SERVICES
OUTPATIENT VISION SERVICES
Description
Variance
Astigmatism-correct function [HCPCS V2787]
Astigmatism-correct function [HCPCS V2787]
12% higher than market
Post chmbr intraocular lens [HCPCS V2632]
Post chmbr intraocular lens [HCPCS V2632]
43% lower than market
Presbyopia-correct function [HCPCS V2788]
Presbyopia-correct function [HCPCS V2788]
12% lower than market
North Carolina Specialty Hospital Patient Information Price List
OUTPATIENT X-RAY AND RADIOLOGICAL
OUTPATIENT X-RAY AND RADIOLOGICAL
Description
Variance
Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]
Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]
A vascular ultrasound study is performed to evaluate veins in the extremities. A duplex scan uses both B-mode and Doppler studies. A clear gel is placed on the skin of the extremity over the region to be studied. A B-mode transducer is placed on the skin and real-time images of the veins are obtained. A Doppler probe within the B-mode transducer provides information on the pattern and direction of blood flow in the veins. The B-mode transducer produces ultrasonic sound waves that move through the skin and bounce off the veins when the probe is moved over the region being studied. The Doppler probe produces sound waves that bounce off blood cells moving within the veins. The reflected sound waves are sent to an amplifier that makes the sound waves audible. The pitch of the sound waves changes if there is reduced blood flow, or ceases altogether if a vessel is completely obstructed. A computer converts the sound waves to images that are overlaid with colors to produce video images showing the speed and direction of blood flow as well as any obstruction. Spectral Doppler analysis is performed to provide information on anatomy and hemodynamic function. The duplex scan may include a baseline evaluation followed by additional scans obtained with compression or using other maneuvers that alter blood flow. The physician reviews the duplex scan and provides a written interpretation of findings.
58% lower than market
Chest x-ray (2 views) [HCPCS 71046]
Chest x-ray (2 views) [HCPCS 71046]
A radiologic examination of the chest is performed. Chest radiographs (X-rays) provide images of the heart, lungs, bronchi, major blood vessels (aorta, vena cava, pulmonary vessels), and bones, (sternum, ribs, clavicle, scapula, spine). The most common views are frontal (also referred to as anteroposterior or AP), posteroanterior (PA), and lateral. To obtain a frontal view, the patient is positioned facing the x-ray machine. A PA view is obtained with the patient's back toward the x-ray machine. For a lateral view, the patient is positioned with side of the chest toward the machine. Other views that may be obtained include apical lordotic, oblique, and lateral decubitus. An apical lordotic image provides better visualization of the apical (top) regions of the lungs. The patient is positioned with the back arched so that the tops of the lungs can be x-rayed. Oblique views may be obtained to evaluate a pulmonary or mediastinal mass or opacity or to provide additional images of the heart and great vessels. There are four positions used for oblique views including right and left anterior oblique, and right and left posterior oblique. Anterior oblique views are obtained with the patient standing and the chest rotated 45 degrees. The arm closest to the x-ray cassette is flexed with the hand resting on the hip. The opposite arm is raised as high as possible. The part of the chest farthest away from the x-ray cassette is the area being studied. Posterior oblique views are typically obtained only when the patient is too ill to stand or lay prone for anterior oblique views. A lateral decubitus view is obtained with the patient lying on the side; the patient's head rests on one arm, and the other arm is raised over the head with the elbow bent. Images are recorded on hard copy film or stored electronically as digital images. The physician reviews the images, notes any abnormalities, and provides a written interpretation of the findings.
42% lower than market
Knee x-ray (1 or 2 views) [HCPCS 73560]
Knee x-ray (1 or 2 views) [HCPCS 73560]
A radiologic examination of the knee images the femur, tibia, fibula, patella, and soft tissue. X-ray imaging uses indirect ionizing radiation to take pictures inside the body. X-rays work on non-uniform material, such as human tissue, because of the different density and composition of the object, which allows some of the x-rays to be absorbed and some to pass through and be captured behind the object on a detector. This produces a 2D image of the structures. The radiographs may be taken to look for the cause of pain, limping, or swelling, or conditions such as fractures, dislocations, deformities, degenerative disease, osteomyelitis, arthritis, foreign body, and cysts or tumors. Knee x-rays may also be used to determine whether there is satisfactory alignment of lower extremity bones following fracture treatment. Standard views of the knee include front to back anteroposterior (AP), lateral (side), and back to front posteroanterior (PA) with variations in the flexion of the joint, and weight bearing and non-weight bearing postures.
37% lower than market
North Carolina Specialty Hospital Patient Information Price List
INPATIENT ORTHOPEDIC SURGERY
INPATIENT ORTHOPEDIC SURGERY
Description
Variance
Combined anterior/posterior spinal fusion without complications
Combined anterior/posterior spinal fusion without complications
35% lower than market
Total Knee or Hip Revision
Total Knee or Hip Revision
30% lower than market
Total Shoulder Replacement
Total Shoulder Replacement
41% lower than market
North Carolina Specialty Hospital Patient Information Price List
BILLING PROCESS AND INFORMATION
BILLING PROCESS AND INFORMATION
How You Can Help
Thank you for choosing North Carolina Specialty Hospital for your healthcare needs. At North Carolina Specialty Hospital, we are committed to making the billing process as patient-friendly as possible. Here are some ways you can help the billing process go smoothly.
• Please give us complete health insurance information.
In addition to your health insurance card, we may ask for a photo ID. If you have been seen at North Carolina Specialty Hospital, let us know if your personal information or insurance information has changed since your last visit.
• Please understand and follow the requirements of your health plan.
Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and North Carolina Specialty Hospital is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.
• Please respond promptly to any requests from your insurance provider.
You may receive multiple bills for your hospital visit, including your family doctor, specialists, physicians to read x-rays, give anesthesia, or do blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from North Carolina Specialty Hospital indicating the bill is now your responsibility. All bills sent to you are due upon receipt.
Questions about Price and Billing Information
Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.
To ask questions or get more information about a bill for services you've received, please contact our Customer Call Center at (919) 595-8454.
If you need more information about the price of a future service, please contact our Price Hotline at (919) 595-8454. A CPT code is strongly encouraged when you call. You can obtain the CPT code from the ordering physician.
Online Payment, Registration, & Scheduling
For the convenience of our patients, a number of online services are available at https://www.ncspecialty.com/. North Carolina Specialty Hospital offers secure online payment.
North Carolina Specialty Hospital also offers pre-registration and appointment requests through a secure online form at https://www.ncspecialty.com/. Patients may pre-register for surgeries, admissions, outpatient procedures and tests at least three business days in advance. Patients may also pre-register for maternity services up to three months prior to their expected delivery date.
Financial Assistance
We are pleased to offer financial assistance to patients with limited resources and inadequate medical insurance coverage. Eligibility is determined by total family income/assets. The patient must agree to apply for other assistance available to pay hospital charges (Medicaid, Medicare, private insurance) before being discharged.
North Carolina Specialty Hospital's Charity Care Policy
North Carolina Specialty Hospital provides high quality care to everyone, regardless of their ability to pay.
North Carolina Specialty Hospital's charity care policy includes:
• Substantial charity care guidelines that provide free care for individuals and families who earn less than 200 percent of the federal poverty level.
• Sliding scale fees to provide substantially discounted care for individuals and families who are between 200 and 400 percent of the federal poverty level.
• Hardship policy for those patients who would not otherwise qualify for charity care but have unique circumstances.
In many cases, North Carolina Specialty Hospital offers interest free loans for up to one year to assist patients.
For more information, please contact our Customer Call Center at (919) 595-8454.
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