▸ Hospital · VA · CCN 490089
Carilion Franklin Memorial Hospital
180 FLOYD AVE, ROCKY MOUNT, VA, 490089
Compliance grade
A
100/100
Procedures tracked
128
of 209 target codes
Payers
16
with negotiated rates
Rates published
32,435
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 15 | $17,389 | $6,085.98 | $8,711.64 | $12,859 | $53,851 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 16 | $500 | $175 | $8.21 | $280.43 | $475 |
| ED visit level 2 | CPT | 99282 | 16 | $800 | $280 | $30.07 | $448.68 | $760 |
| ED visit level 3 | CPT | 99283 | 16 | $1,320 | $462 | $50.96 | $740.32 | $1,337.59 |
| ED visit level 4 | CPT | 99284 | 16 | $2,178 | $762.3 | $86.82 | $1,221.53 | $2,069.1 |
| ED visit level 5 | CPT | 99285 | 16 | $3,315 | $1,160.25 | $125.82 | $1,859.22 | $3,149.25 |
| Critical care, first hour | CPT | 99291 | 16 | $4,156 | $1,454.6 | $209.58 | $2,330.9 | $4,047.59 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 16 | $2,282 | $798.7 | $91.78 | $1,171.81 | $2,167.9 |
| CT head with contrast | CPT | 70460 | 16 | $2,940 | $1,029 | $136.06 | $1,509.69 | $2,793 |
| CT head with and without contrast | CPT | 70470 | 16 | $3,604 | $1,261.4 | $153.99 | $1,850.66 | $3,423.8 |
| CT neck with contrast | CPT | 70491 | 16 | $2,904 | $1,016.4 | $153.99 | $1,491.21 | $2,758.8 |
| MRI brain without contrast | CPT | 70551 | 16 | $3,407 | $1,192.45 | $180.53 | $1,749.5 | $3,236.65 |
| MRI brain with contrast | CPT | 70552 | 16 | $3,920 | $1,372 | $248.85 | $2,012.92 | $3,724 |
| MRI brain with and without contrast | CPT | 70553 | 16 | $6,565 | $2,297.75 | $293.01 | $3,371.13 | $6,236.75 |
| Chest X-ray single view | CPT | 71045 | 16 | $364 | $127.4 | $22.97 | $175.55 | $426.43 |
| Chest X-ray 2 views | CPT | 71046 | 16 | $415 | $145.25 | $30.14 | $152.8 | $426.43 |
| Chest X-ray 3 views | CPT | 71047 | 16 | $415 | $145.25 | $37.89 | $232.76 | $426.43 |
| CT chest without contrast | CPT | 71250 | 16 | $2,482 | $868.7 | $91.78 | $1,274.51 | $2,357.9 |
| CT chest with contrast | CPT | 71260 | 16 | $2,939 | $1,028.65 | $153.37 | $1,509.18 | $2,792.05 |
| CT chest with and without contrast | CPT | 71270 | 16 | $3,924 | $1,373.4 | $153.99 | $2,014.98 | $3,727.8 |
| MRI chest without contrast | CPT | 71550 | 16 | $4,159 | $1,455.65 | $209.48 | $2,135.65 | $3,951.05 |
| MRI chest with and without contrast | CPT | 71552 | 16 | $5,679 | $1,987.65 | $306.29 | $2,916.17 | $5,395.05 |
| Lumbosacral spine X-ray | CPT | 72100 | 16 | $631 | $220.85 | $35.81 | $353.9 | $599.45 |
| CT cervical spine without contrast | CPT | 72125 | 16 | $2,869 | $1,004.15 | $91.78 | $1,473.23 | $2,725.55 |
| CT thoracic spine without contrast | CPT | 72128 | 16 | $2,071 | $724.85 | $91.78 | $1,063.46 | $1,967.45 |
| CT lumbar spine without contrast | CPT | 72131 | 16 | $2,933 | $1,026.55 | $91.78 | $1,506.1 | $2,786.35 |
| MRI cervical spine without contrast | CPT | 72141 | 16 | $4,128 | $1,444.8 | $175.46 | $2,119.73 | $3,921.6 |
| MRI thoracic spine without contrast | CPT | 72146 | 16 | $3,510 | $1,228.5 | $175.15 | $1,802.39 | $3,334.5 |
| MRI lumbar spine without contrast | CPT | 72148 | 16 | $3,578 | $1,252.3 | $176.04 | $1,837.3 | $3,399.1 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 16 | $3,320 | $1,162 | $249.15 | $1,714.62 | $3,154 |
| MRI cervical spine with and without contrast | CPT | 72156 | 16 | $6,943 | $2,430.05 | $294.5 | $3,565.23 | $6,595.85 |
| MRI lumbar spine with contrast | CPT | 72158 | 16 | $6,010 | $2,103.5 | $293.91 | $3,086.14 | $5,709.5 |
| CT pelvis without contrast | CPT | 72192 | 16 | $2,001 | $700.35 | $91.78 | $1,027.52 | $1,900.95 |
| CT pelvis with contrast | CPT | 72193 | 16 | $4,247 | $1,486.45 | $153.99 | $2,180.84 | $4,034.65 |
| Shoulder X-ray | CPT | 73030 | 16 | $538 | $188.3 | $31.33 | $301.74 | $511.1 |
| Humerus X-ray | CPT | 73060 | 16 | $538 | $188.3 | $28.64 | $301.74 | $511.1 |
| Hand X-ray 3 views | CPT | 73130 | 16 | $526 | $184.1 | $33.42 | $295.01 | $499.7 |
| MRI upper extremity joint without contrast | CPT | 73221 | 16 | $3,747 | $1,311.45 | $186.78 | $1,924.09 | $3,559.65 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 16 | $6,615 | $2,315.25 | $306.29 | $3,396.81 | $6,284.25 |
| Knee X-ray 1-2 views | CPT | 73560 | 16 | $432 | $151.2 | $30.73 | $242.29 | $426.43 |
| Ankle X-ray 3 views | CPT | 73610 | 16 | $590 | $206.5 | $32.82 | $330.9 | $560.5 |
| MRI lower extremity joint without contrast | CPT | 73721 | 16 | $3,865 | $1,352.75 | $186.49 | $1,984.68 | $3,671.75 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 16 | $6,926 | $2,424.1 | $306.29 | $3,556.5 | $6,579.7 |
| CT abdomen without contrast | CPT | 74150 | 16 | $1,888 | $660.8 | $91.78 | $969.49 | $1,793.6 |
| CT abdomen with contrast | CPT | 74160 | 16 | $3,285 | $1,149.75 | $153.99 | $1,686.85 | $3,120.75 |
| CT abdomen with and without contrast | CPT | 74170 | 16 | $3,523 | $1,233.05 | $153.99 | $1,809.06 | $3,346.85 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 16 | $3,402 | $1,190.7 | $167.99 | $1,746.93 | $3,231.9 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 16 | $4,406 | $1,542.1 | $278.69 | $2,262.48 | $4,185.7 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 16 | $6,154 | $2,153.9 | $306.29 | $3,160.08 | $5,846.3 |
| MRI abdomen without contrast | CPT | 74181 | 16 | $3,251 | $1,137.85 | $180.22 | $1,669.39 | $3,088.45 |
| MRI abdomen with and without contrast | CPT | 74183 | 16 | $5,684 | $1,989.4 | $306.29 | $2,918.74 | $5,399.8 |
| Abdominal ultrasound complete | CPT | 76700 | 16 | $1,507 | $527.45 | $91.78 | $773.85 | $1,431.65 |
| Abdominal ultrasound limited | CPT | 76705 | 16 | $1,176 | $411.6 | $77.88 | $603.88 | $1,117.2 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 16 | $1,128 | $394.8 | $91.78 | $579.23 | $1,071.6 |
| Obstetric ultrasound first trimester | CPT | 76801 | 16 | $889 | $311.15 | $91.78 | $475 | $844.55 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 16 | $1,155 | $404.25 | $91.78 | $593.1 | $1,097.25 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 16 | $1,232 | $431.2 | $178.76 | $690.97 | $1,170.4 |
| Transvaginal ultrasound | CPT | 76830 | 16 | $1,106 | $387.1 | $91.78 | $567.93 | $1,050.7 |
| Pelvic ultrasound complete | CPT | 76856 | 16 | $1,220 | $427 | $91.78 | $626.47 | $1,159 |
| Scrotal ultrasound | CPT | 76870 | 16 | $1,535 | $537.25 | $89.51 | $788.23 | $1,458.25 |
| Diagnostic mammography unilateral | CPT | 77065 | 16 | $653 | $228.55 | $126.35 | $419.23 | $620.35 |
| Screening mammography bilateral | CPT | 77067 | 16 | $634 | $221.9 | $129.03 | $407.03 | $602.3 |
| EKG tracing only | CPT | 93005 | 16 | $298 | $104.3 | $5.67 | $167.14 | $289.06 |
| Transthoracic echocardiogram complete | CPT | 93306 | 16 | $2,806 | $982.1 | $174.62 | $1,573.75 | $2,677.47 |
| Transthoracic echocardiogram | CPT | 93307 | 16 | $2,483 | $869.05 | $121.49 | $1,275.02 | $2,358.85 |
| Stress echocardiogram | CPT | 93350 | 16 | $4,406 | $1,542.1 | $164.61 | $2,416.52 | $4,185.7 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 15 | $41,164 | $14,407 | $13,258 | $27,744 | $44,297 |
| COPD w MCC | MS-DRG | 190 | 15 | $28,433 | $9,951.46 | $9,397.67 | $19,164 | $33,005 |
| COPD w CC | MS-DRG | 191 | 15 | $23,585 | $8,254.74 | $7,151.97 | $15,896 | $26,057 |
| COPD w/o CC/MCC | MS-DRG | 192 | 15 | $23,634 | $8,271.98 | $5,446.7 | $15,693 | $22,453 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 15 | $23,944 | $8,380.28 | $6,837.22 | $16,138 | $26,925 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 15 | $20,105 | $7,036.84 | $5,332.16 | $13,551 | $19,977 |
| AMI discharged alive w MCC | MS-DRG | 280 | 15 | $36,650 | $12,827 | $13,609 | $24,702 | $43,375 |
| AMI discharged alive w CC | MS-DRG | 281 | 15 | $28,346 | $9,921 | $7,797.6 | $18,822 | $26,928 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 15 | $35,281 | $12,348 | $6,134.75 | $21,874 | $33,517 |
| Heart failure & shock w MCC | MS-DRG | 291 | 15 | $31,172 | $10,910 | $10,892 | $21,010 | $40,822 |
| Heart failure & shock w CC | MS-DRG | 292 | 15 | $36,472 | $12,765 | $7,202.87 | $22,957 | $34,648 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 15 | $11,785 | $4,124.58 | $4,801.92 | $7,942.75 | $16,503 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 15 | $37,905 | $13,267 | $10,215 | $25,548 | $36,010 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 15 | $25,530 | $8,935.61 | $6,241.64 | $17,207 | $24,254 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 15 | $23,473 | $8,215.62 | $4,802.76 | $14,766 | $22,300 |
| GI hemorrhage w CC | MS-DRG | 378 | 15 | $32,507 | $11,378 | $8,320.21 | $21,910 | $30,882 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 15 | $23,473 | $8,215.41 | $5,348.28 | $15,586 | $22,299 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 15 | $23,228 | $8,129.89 | $6,614.09 | $15,656 | $23,451 |
| Kidney/UTI w MCC | MS-DRG | 689 | 15 | $31,805 | $11,132 | $9,843.93 | $21,437 | $37,348 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 15 | $24,967 | $8,738.47 | $6,867.76 | $16,828 | $23,719 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 15 | $45,535 | $15,937 | $16,480 | $30,691 | $52,525 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 15 | $34,114 | $11,940 | $8,681.63 | $22,993 | $32,408 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 16 | $363 | $127.05 | $8.88 | $233.05 | $344.85 |
| General health panel | CPT | 80050 | 16 | $940 | $329 | $8.78 | $603.48 | $893 |
| Electrolyte panel | CPT | 80051 | 16 | $274 | $95.9 | $7.36 | $175.91 | $260.3 |
| Comprehensive metabolic panel | CPT | 80053 | 16 | $487 | $170.45 | $11.09 | $312.66 | $462.65 |
| Lipid panel | CPT | 80061 | 16 | $183 | $64.05 | $14.06 | $117.49 | $173.85 |
| Renal function panel | CPT | 80069 | 16 | $258 | $90.3 | $9.11 | $165.64 | $245.1 |
| Hepatic function panel | CPT | 80076 | 16 | $238 | $83.3 | $8.58 | $152.8 | $226.1 |
| Urinalysis non-automated | CPT | 81002 | 16 | $35 | $12.25 | $3.11 | $22.47 | $33.25 |
| Urinalysis automated | CPT | 81003 | 16 | $70 | $24.5 | $2.36 | $44.94 | $66.5 |
| Glucose quantitative | CPT | 82947 | 16 | $89 | $31.15 | $4.13 | $57.14 | $84.55 |
| Hemoglobin A1c | CPT | 83036 | 16 | $140 | $49 | $10.2 | $89.88 | $133 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 16 | $279 | $97.65 | $17.64 | $179.12 | $265.05 |
| Complete blood count with automated differential | CPT | 85025 | 16 | $146 | $51.1 | $8.16 | $93.73 | $138.7 |
| Complete blood count without differential | CPT | 85027 | 16 | $146 | $51.1 | $6.79 | $93.73 | $138.7 |
| Urine culture bacterial | CPT | 87086 | 16 | $161 | $56.35 | $8.47 | $103.36 | $152.95 |
| Urine culture identification | CPT | 87088 | 16 | $113 | $39.55 | $8.49 | $72.55 | $107.35 |
| Tissue exam by pathologist level IV | CPT | 88305 | 16 | $564 | $197.4 | $45.75 | $289.62 | $535.8 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 16 | $964 | $337.4 | $49.73 | $540.66 | $990.66 |
| Vaginal delivery only | CPT | 59409 | 16 | $11,268 | $3,943.8 | $806.8 | $6,319.66 | $15,862 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 16 | $260 | $91 | $55.37 | $166.92 | $247 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 16 | $350 | $122.5 | $85.93 | $224.7 | $332.5 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 16 | $450 | $157.5 | $128.77 | $288.9 | $427.5 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 16 | $585 | $204.75 | $169.94 | $375.57 | $555.75 |
| Office visit, established patient, 5 min | CPT | 99211 | 16 | $131 | $45.85 | $17.9 | $84.1 | $124.45 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 16 | $175 | $61.25 | $43.48 | $112.35 | $166.25 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 16 | $225 | $78.75 | $70.08 | $144.45 | $213.75 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 16 | $390 | $136.5 | $98.72 | $222.96 | $370.5 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 16 | $390 | $136.5 | $138.75 | $250.38 | $370.5 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 16 | $3,323 | $1,163.05 | $119.31 | $1,863.71 | $4,444.25 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 16 | $3,323 | $1,163.05 | $119.31 | $1,863.71 | $4,444.25 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 16 | $3,231 | $1,130.85 | $96.47 | $1,812.11 | $4,556.84 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 16 | $3,231 | $1,130.85 | $96.47 | $1,812.11 | $4,556.84 |
| Colonoscopy diagnostic | CPT | 45378 | 16 | $3,231 | $1,130.85 | $96.47 | $1,812.11 | $4,556.84 |
| Colonoscopy with biopsy | CPT | 45380 | 16 | $4,179 | $1,462.65 | $387.6 | $2,343.79 | $5,863.57 |
| Colonoscopy with polyp removal | CPT | 45385 | 16 | $4,179 | $1,462.65 | $405.8 | $2,343.79 | $5,863.57 |
| surgery | ||||||||
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 15 | $130,203 | $45,571 | $38,996 | $86,856 | $124,289 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 15 | $111,859 | $39,151 | $20,338 | $69,353 | $106,266 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 15 | $79,692 | $27,892 | $14,278 | $49,409 | $75,708 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 15 | $70,050 | $24,518 | $14,351 | $43,431 | $66,548 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 15 | $57,288 | $20,051 | $11,587 | $35,518 | $54,423 |
Payer mix (top 16)
| Payer | Codes covered | Median rate |
|---|---|---|
| vhn - ultra | 128 | $1,820.32 |
| Anthem BCBS | 128 | $512.27 |
| Cigna | 128 | $2,078.28 |
| connecticare | 128 | $2,055.2 |
| Aetna | 128 | $874.5 |
| gateway - tier 1 | 128 | $2,789.2 |
| gateway - tier 2 | 128 | $2,348.8 |
| gateway - tier 3 | 128 | $1,614.8 |
| Humana | 128 | $214.13 |
| sentara health plan | 128 | $298.59 |
| UnitedHealthcare | 128 | $796.98 |
| vhn | 128 | $2,348.8 |
| vhn - link | 128 | $2,642.4 |
| vhn - plus | 128 | $2,260.72 |
| vhn - secondary payors | 128 | $2,789.2 |
| First Health | 100 | $127.56 |