Novant Health Ballantyne Medical Center — price list

← Hospital overviewVerified from Novant Health Ballantyne Medical Center’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

122 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
""Y SET"" TUBING Outpatient	A4719 HCPCS	—	—	—	—
& CHLAMYDIA AG DFA Outpatient	87270 CPT	$241	$121	$11.98 – $234	—
<50% TOTAL PT OUTPT RA ENCTS Outpatient	M1008 HCPCS	—	—	—	—
<6YR NEW ONSET HD ACHE Outpatient	G2193 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED NOT ORD Outpatient	G9368 HCPCS	—	—	—	—
>= 2 SAME HI-RSK MED ORD Outpatient	G9367 HCPCS	—	—	—	—
>=2 SAME HI-RSK MED W/O DIAG Outpatient	M1209 HCPCS	—	—	—	—
>=2 SAME MEDS TBL4 NOT ORD Outpatient	M1210 HCPCS	—	—	—	—
>=50% TOTAL PT OUTPT RA ENCT Outpatient	M1007 HCPCS	—	—	—	—
>=86Y NO HX COLO CA/RSN SCOP Outpatient	G9659 HCPCS	—	—	—	—
>55 YRS TEMP HD ACHE Outpatient	G2192 HCPCS	—	—	—	—
1 ADMN RSV MONOC ANTB IM NJX Outpatient	96381 CPT	—	—	—	—
1 BOD TEMP >=35.5 Outpatient	G9773 HCPCS	—	—	—	—
1 BODYTEMP >=35.5CW/IN 30MIN Outpatient	4559F CPT	—	—	—	—
1 CC STERILE SYRINGE&NEEDLE Outpatient	A4206 HCPCS	—	—	—	—
1 EM CORE SESSION Outpatient	G9873 HCPCS	—	—	—	—
1 MED VISIT IN 24MO Outpatient	G9247 HCPCS	—	—	—	—
1 OR NO CT SINUS W/IN 90D DX Outpatient	G9354 HCPCS	—	—	—	—
1,25-DIHYDROXYVITAMIN D LEVEL Outpatient	82652 CPT	$571	$286	$38.50 – $554	—
100 INSULIN SYRINGES Outpatient	S8490 HCPCS	—	—	—	—
11-DEHYDRO THROMBOXANE B2 Outpatient	83520 CPT	$931	$466	$17.27 – $903	—
11-DEOXYCORTISOL Outpatient	82634 CPT	$652	$326	$29.28 – $632	—
11-DESOXYCORTICOSTERONE Outpatient	82633 CPT	$692	$346	$30.98 – $671	—
12-LEAD ECG PERFORMED Outpatient	3120F CPT	—	—	—	—
17 HYDROXYPROGESTERONE URINE Outpatient	83498 CPT	$329	$165	$27.17 – $319	—
17-HYDROPREGNENOLONE Outpatient	84143 CPT	$363	$182	$22.81 – $352	—
17-HYDROXYPROGESTERONE Outpatient	83498 CPT	$251	$126	$27.17 – $243	—
17-KETOSTEROIDS TOTAL Outpatient	83586 CPT	$524	$262	$12.80 – $508	—
17-OH CORTICOSTEROID UR 24 HR Outpatient	83491 CPT	$1,089	$545	$17.90 – $1,056	—
1DOSE MENIG VAC BTWN 11 & 13 Outpatient	G9414 HCPCS	—	—	—	—