Ascension St. Vincent's Southside (St. Luke's-St. Vincent's HealthCare, Inc.)
4201 Belfort Rd, Jacksonville, FL · Ascension · · NPI 1396926747
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | not published | not published | $589.86 – $1,259.60 | 31 |
| Decalcification CPT 88311 | $14.34 | $38.75 | $7.66 – $19.43 | 4 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $1,606.17 | $4,341.00 | $3.50 – $3.50 | 3 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | not published | not published | $319.62 – $682.53 | 31 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $46.35 | $125.28 | $10.02 – $13.41 | 4 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $141.62 | $382.75 | $41.90 – $418.53 | 33 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $45.90 | $124.05 | $33.93 – $60.58 | 5 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | not published | not published | $124.21 – $265.25 | 31 |
| Dermabrasion segmental face 15781 CPT 15781 | not published | not published | $678.00 – $1,447.81 | 31 |
| Dermabrasion suprfl any site CPT 15783 | not published | not published | $385.00 – $822.13 | 31 |
| Dermagraft HCPCS Q4106 | $2,223.15 | $6,008.50 | $67.41 – $112.36 | 5 |
| Design mlc device for imrt CPT 77338 | not published | not published | $352.75 – $760.70 | 32 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $26.17 | $70.73 | $5.48 – $10.84 | 5 |
| Desoxycorticosterone CPT 82633 | not published | not published | $27.26 – $77.45 | 35 |
| Dest mal lesion feenlm <0.5cm 17280 CPT 17280 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion feenlm 0.6-1cm 17281 CPT 17281 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion feenlm 1.1 - 2.0 cm 17282 CPT 17282 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion snhfg <0.5cm 17270 CPT 17270 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion snhfg 0.6-1cm 17271 CPT 17271 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion snhfg 1.1-2cm 17272 CPT 17272 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion tal <0.5 17260 CPT 17260 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion tal 0.6-1.0cm 17261 CPT 17261 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion tal 1.1-2.0cm 17262 CPT 17262 | not published | not published | $191.47 – $408.87 | 31 |
| Dest mal lesion tal 2.1-3.0cm 17263 CPT 17263 | not published | not published | $191.47 – $408.87 | 31 |
| Destroy premlg lesns;1st lesn 17000 CPT 17000 | not published | not published | $191.47 – $408.87 | 31 |
| Destruct ben lesion 15/> 17111 CPT 17111 | not published | not published | $191.47 – $408.87 | 31 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | not published | not published | $589.86 – $1,259.60 | 31 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction benign lesions < 14 lesions CPT 17110 | not published | not published | $191.47 – $408.87 | 31 |
| Destruction by injection tx of nerve 64630 CPT 64630 | not published | not published | $857.91 – $1,832.00 | 31 |
| Destruction cryosurgery anal lesion(s) simpl 46916 CPT 46916 | not published | not published | $191.47 – $408.87 | 31 |
| Destruction mal lsn s/n/h/f/g 2.1-3cm CPT 17273 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction mal lsn s/n/h/f/g 3.1-4cm CPT 17274 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction mal lsn t/a/l 3.1-4cm CPT 17264 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction mal lsn t/a/l >4cm CPT 17266 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction premal lesions 15/> 17004 CPT 17004 | not published | not published | $385.00 – $822.13 | 31 |
| Destruction rectal tumor 45190 CPT 45190 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $26.43 – $75.08 | 35 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $38.43 – $109.18 | 35 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $27.03 – $27.03 | 2 |
| Devel tst phys/qhp 1st hr CPT 96112 | $277.87 | $751.00 | $150.77 – $321.95 | 33 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | $139.86 | $378.00 | $132.75 – $132.75 | 2 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $64.42 – $194.81 | 33 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $25.51 | $68.94 | $0.07 – $0.09 | 4 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $110.00 | $297.31 | $0.11 – $0.17 | 4 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $68.45 | $185.00 | $1.53 – $1.77 | 4 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $80.11 | $216.53 | $7.38 – $12.21 | 4 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $64.99 | $175.66 | $2.22 – $2.70 | 4 |
| Dextrose 5 % IV bolus HCPCS J7070 | $80.67 | $218.01 | $4.44 – $5.40 | 4 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $58.28 | $157.50 | $19.56 – $55.58 | 35 |
| Diabetes (HbA1c) Test CPT 83036 | $11.38 | $30.75 | $8.54 – $24.28 | 35 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $384.53 – $5,618.00 | 32 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $124.21 – $5,618.00 | 32 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $114.15 | $308.50 | $247.55 – $247.55 | 1 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $78.63 | $212.50 | $193.03 – $193.03 | 1 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $187.08 – $399.48 | 31 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $187.08 – $5,618.00 | 32 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $303.96 | $821.50 | $98.11 – $344.86 | 33 |
| Diagnostic Mammogram (one breast) CPT 77065 | $301.55 | $815.00 | $77.10 – $270.63 | 33 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $84.84 – $194.81 | 32 |
| Dialysis one evaluation CPT 90945 | $1,622.82 | $4,386.00 | $207.18 – $876.23 | 33 |
| Diathermy eg microwave CPT 97024 | not published | not published | $6.70 – $17.45 | 33 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $19.89 | $53.75 | $12.83 – $12.83 | 3 |
| Dicyclomine injection HCPCS J0500 | $121.10 | $327.29 | $15.69 – $22.35 | 4 |
| Diffusing capacity CPT 94729 | $462.13 | $1,249.00 | $108.38 – $108.38 | 2 |
| Digital analysis of eeg CPT 95957 | not published | not published | $437.25 – $437.25 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $124.14 | $335.50 | $13.23 – $13.23 | 3 |
| Digoxin total therapeutic drug level CPT 80162 | $67.25 | $181.75 | $11.69 – $33.20 | 35 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $235.32 | $636.00 | $61.56 – $61.56 | 3 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $903.46 – $1,929.25 | 31 |
| Dilate tear duct opening CPT 68801 | not published | not published | $384.53 – $821.13 | 31 |
| Dilate urethra stricture CPT 53600 | not published | not published | $234.36 – $500.47 | 31 |
| Dilate urethra stricture CPT 53601 | not published | not published | $124.21 – $265.25 | 31 |
| Dilate urethra stricture CPT 53621 | not published | not published | $234.36 – $500.47 | 31 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $150.77 – $321.95 | 31 |
| Dilation of salivary duct CPT 42660 | not published | not published | $490.72 – $1,047.90 | 31 |
| Dilation of urethra CPT 53661 | not published | not published | $124.21 – $265.25 | 31 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $643.19 – $1,373.48 | 31 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $50.20 | $135.67 | $0.81 – $1.10 | 4 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | $12.21 | $33.00 | $20.52 – $187.65 | 6 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $37.82 – $80.77 | 33 |
| Disability dlco CPT 94727 | $369.08 | $997.50 | $76.43 – $321.95 | 33 |
| Disaccharidases CPT 82657 | $29.60 | $80.00 | $19.51 – $55.43 | 35 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $182.98 – $4,139.17 | 2 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $938.25 – $938.25 | 2 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $56.25 – $56.25 | 2 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $245.52 – $697.50 | 35 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $120.56 – $342.50 | 35 |
| Dna antibody native/double stranded CPT 86225 | not published | not published | $12.09 – $34.35 | 35 |
| Dna gardnerella CPT 87510 | not published | not published | $17.64 – $50.13 | 35 |
| Dna probe chlamydia CPT 87490 | not published | not published | $20.02 – $56.88 | 35 |
| Dna probe gc CPT 87590 | not published | not published | $23.65 – $67.20 | 35 |
| Dna trichomonas CPT 87660 | $6.75 | $18.25 | $17.64 – $50.13 | 35 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $47.28 | $127.78 | $9.94 – $11.09 | 4 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $28.87 | $78.04 | $0.74 – $1.07 | 4 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $9.66 | $26.10 | $0.87 – $1.16 | 4 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.