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 |
|---|---|---|---|---|
| Doppler echo complete CPT 93320 | $503.85 | $1,361.75 | $74.93 – $1,636.00 | 3 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $409.60 – $409.60 | 2 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $515.50 | $1,393.25 | $150.77 – $1,146.00 | 34 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $437.99 | $1,183.75 | $124.21 – $1,146.00 | 34 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $30.68 | $82.91 | $4.98 – $4.98 | 3 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $715.22 | $1,933.04 | $183.50 – $953.50 | 7 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $0.80 | $2.16 | $0.15 – $0.15 | 1 |
| Dpyd gene common variants CPT 81232 | not published | not published | $153.83 – $437.03 | 35 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $678.00 – $1,447.81 | 31 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $678.00 – $1,447.81 | 31 |
| Drainage external ear simple 69000 CPT 69000 | not published | not published | $678.00 – $1,447.81 | 31 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $223.78 – $477.85 | 31 |
| Drainage of kidney lesion CPT 50390 | not published | not published | $678.00 – $1,447.81 | 31 |
| Drainage of mouth lesion CPT 41005 | not published | not published | $223.78 – $477.85 | 31 |
| Drainage of mouth lesion CPT 41009 | not published | not published | $490.72 – $1,047.90 | 31 |
| Drainage of mouth lesion CPT 41015 | not published | not published | $490.72 – $1,047.90 | 31 |
| Drainage of nose lesion int 30000 CPT 30000 | not published | not published | $223.78 – $477.85 | 31 |
| Drainage of nose lesion sept 30020 CPT 30020 | not published | not published | $490.72 – $1,047.90 | 31 |
| Drainage of rectal abscess CPT 45005 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Drainage of rectal abscess 45020 CPT 45020 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Drainage of salivary gland CPT 42320 | not published | not published | $490.72 – $1,047.90 | 31 |
| Drainage of urinary leakage CPT 53080 | not published | not published | $643.19 – $1,373.48 | 31 |
| Drain blood from under nail 11740 CPT 11740 | not published | not published | $124.21 – $265.25 | 31 |
| Drain cerebro spinal fluid 62272 CPT 62272 | not published | not published | $667.33 – $1,425.04 | 31 |
| Drain finger abscess;simple 26010 CPT 26010 | not published | not published | $191.47 – $408.87 | 31 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | not published | not published | $191.47 – $408.87 | 31 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | not published | not published | $191.47 – $408.87 | 31 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | not published | not published | $385.00 – $822.13 | 31 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $589.86 – $1,259.60 | 31 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $6,438.00 | $17,400.00 | $61.59 – $126.19 | 6 |
| Drng of eyelid abscess 67700 CPT 67700 | not published | not published | $288.06 – $615.12 | 31 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $678.00 – $1,447.81 | 31 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $490.72 – $1,047.90 | 31 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $490.72 – $1,047.90 | 31 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $48.29 | $130.50 | $14.82 – $14.82 | 3 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $568.14 | $1,535.50 | $14.65 – $30.03 | 6 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $3,800.18 | $10,270.75 | $11.09 – $22.73 | 6 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $7,868.14 | $21,265.25 | $60.74 – $124.48 | 6 |
| Drug admin & hemodynmic meas CPT 93463 | $330.32 | $892.75 | $234.68 – $234.68 | 2 |
| Drug assay caffeine CPT 80155 | not published | not published | $33.94 – $96.43 | 35 |
| Drug assay posaconazole CPT 80187 | not published | not published | $23.86 – $67.78 | 35 |
| Drug assay rufinamide CPT 80210 | not published | not published | $26.03 – $67.78 | 34 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $33.94 – $96.43 | 35 |
| Drug assay voriconazole CPT 80285 | not published | not published | $23.86 – $67.78 | 35 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $17.89 – $46.60 | 34 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $11.09 – $31.50 | 35 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $23.86 – $67.78 | 35 |
| Drug test prsmv instrmnt CPT 80306 | not published | not published | $15.08 – $42.85 | 35 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $349.65 | $945.00 | $54.68 – $155.35 | 35 |
| Drvvt confirm - quest CPT 85597 | $29.60 | $80.00 | $15.82 – $44.95 | 35 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $385.00 – $822.13 | 31 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $385.00 – $822.13 | 31 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $589.86 – $1,259.60 | 31 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $589.86 – $1,259.60 | 31 |
| Ductogram sgl duct CPT 77053 | not published | not published | $112.88 – $525.31 | 33 |
| Duodenal motility study CPT 91022 | not published | not published | $231.18 – $1,091.85 | 33 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $232.92 – $1,146.00 | 34 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $102.47 – $1,146.00 | 34 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $663.78 | $1,794.00 | $102.47 – $1,146.00 | 34 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $515.50 | $1,393.25 | $150.77 – $1,146.00 | 34 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $852.57 | $2,304.25 | $232.92 – $1,146.00 | 34 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $115.02 | $310.87 | $102.32 – $183.70 | 5 |
| Dxa bone density axl vrt fx CPT 77085 | $245.68 | $664.00 | $102.47 – $235.69 | 33 |
| Dx aly aud oi snd prcsr 1st CPT 92622 | not published | not published | $150.77 – $321.95 | 33 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Dx dark adaptation exam i&r CPT 92284 | not published | not published | $69.60 – $821.13 | 33 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $903.46 – $1,929.25 | 31 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $903.46 – $1,929.25 | 31 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $300.08 – $640.79 | 31 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $150.77 – $321.95 | 31 |
| Dx laryngoscopy newborn CPT 31520 | not published | not published | $374.19 – $5,618.00 | 32 |
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $234.36 – $500.47 | 31 |
| Dynamic surface emg CPT 96002 | not published | not published | $51.93 – $640.79 | 33 |
| Ear and throat examination CPT 92502 | not published | not published | $229.00 – $1,047.90 | 33 |
| Ear irrigation 69209 CPT 69209 | not published | not published | $57.24 – $122.22 | 31 |
| Ear protector evaluation CPT 92596 | not published | not published | $37.82 – $182.85 | 33 |
| Ecg 12 lead tracing only CPT 93005 | $195.36 | $528.00 | $14.88 – $1,636.00 | 34 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | not published | not published | $16.35 – $1,636.00 | 3 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $85.29 | $230.50 | $15.63 – $1,636.00 | 34 |
| Ecg < 30 days transmission & analysis CPT 93271 | not published | not published | $88.45 – $1,636.00 | 34 |
| Ecg external < 48 hours recording CPT 93225 | $456.12 | $1,232.75 | $41.48 – $1,636.00 | 34 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $114.70 | $310.00 | $57.24 – $1,636.00 | 34 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $305.44 | $825.50 | $27.03 – $1,636.00 | 34 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $280.46 | $758.00 | $27.03 – $1,636.00 | 34 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $2,144.15 | $5,795.00 | $289.38 – $1,636.00 | 34 |
| Echocardiography doppler color flow mapping CPT 93325 | $423.28 | $1,144.00 | $44.85 – $1,636.00 | 3 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $472.95 | $1,278.25 | $167.33 – $1,636.00 | 34 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $462.32 | $1,249.50 | $40.28 – $1,636.00 | 3 |
| Echo exam of eye CPT 76516 | not published | not published | $73.69 – $235.69 | 33 |
| Echo exam of eye CPT 76519 | not published | not published | $102.47 – $235.69 | 33 |
| Echo exam of eye CPT 76529 | not published | not published | $84.84 – $194.81 | 33 |
| Echo exam of eye thickness CPT 76514 | not published | not published | $11.84 – $63.83 | 33 |
| Echo exam of fetal heart CPT 76825 | $439.65 | $1,188.25 | $528.36 – $1,182.67 | 33 |
| Echo exam of fetal heart CPT 76826 | $274.91 | $743.00 | $232.92 – $525.31 | 33 |
| Echo exam of fetal heart CPT 76827 | $283.42 | $766.00 | $102.47 – $235.69 | 33 |
| Echo exam of fetal heart CPT 76828 | $273.80 | $740.00 | $70.60 – $235.69 | 33 |
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.