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 |
|---|---|---|---|---|
| Encephalitis, st louis igg/igm CPT 86653 | $4.44 | $12.00 | $11.61 – $32.98 | 35 |
| Encephalitis, western equine igg/igm CPT 86654 | $4.44 | $12.00 | $11.61 – $32.98 | 35 |
| Endocerv curettage w/scope 57456 CPT 57456 | not published | not published | $293.13 – $5,618.00 | 32 |
| Endocervical curettage 57505 CPT 57505 | not published | not published | $839.07 – $1,791.76 | 31 |
| Endo cholangiopancreatograph CPT 43261 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endo cholangiopancreatograph CPT 43262 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoluminl ivus oct c 1st CPT 92978 | not published | not published | $355.90 – $355.90 | 2 |
| Endoluminl ivus oct c ea CPT 92979 | not published | not published | $173.53 – $173.53 | 2 |
| Endoscopic pancreatoscopy CPT 43273 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoscopic Ultrasound exam esoph CPT 43237 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoscopic vein harvest 33508 CPT 33508 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoscopy bowel pouch/biop CPT 44386 | not published | not published | $878.55 – $5,618.00 | 32 |
| Endoscopy ligate perf veins 37500 CPT 37500 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoscopy maxillary sinus CPT 31267 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoscopy of bowel pouch 44385 CPT 44385 | not published | not published | $878.55 – $5,618.00 | 32 |
| Endoscopy of ureter CPT 50951 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoscopy of ureter CPT 50953 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Endoscopy swallow (fees) vid CPT 92612 | not published | not published | $177.73 – $462.85 | 33 |
| Endoscpy nsl/sns w/cntrl nsl hmrrgh CPT 31238 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Enfortumab vedotin-ejfv 20 mg intravenous solution HCPCS J9177 | $130.38 | $352.38 | $44.70 – $80.26 | 5 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $16.05 | $43.37 | $0.63 – $0.84 | 4 |
| Entamoeba histolytica ag eia - sendout CPT 87337 | not published | not published | $10.54 – $29.95 | 35 |
| Enzyme cell activity ra CPT 82658 | not published | not published | $38.75 – $110.08 | 35 |
| Enzyme histochemistry CPT 88319 | $31.27 | $84.50 | $71.35 – $1,680.98 | 35 |
| Ep & ablate supravent arrhyt CPT 93653 | not published | not published | $2,076.13 – $39,982.00 | 3 |
| Ep & ablate ventric tachy CPT 93654 | not published | not published | $2,503.03 – $39,982.00 | 3 |
| Epidural lysis mult sessions CPT 62263 | not published | not published | $857.91 – $1,832.00 | 31 |
| Epidural lysis on single day 62264 CPT 62264 | not published | not published | $857.91 – $1,832.00 | 31 |
| Epilepsy gen seq alys panel CPT 81419 | not published | not published | $2,448.56 – $6,121.40 | 3 |
| Ep induct arrhy by elect pacing CPT 93618 | not published | not published | $516.00 – $24,882.00 | 3 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $23.97 | $64.77 | $8.63 – $26.01 | 7 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $165.17 | $446.39 | $8.64 – $14.15 | 5 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | $50.75 | $137.17 | $19.62 – $24.66 | 4 |
| Epstein barr early antigen antibody CPT 86663 | $19.42 | $52.48 | $11.55 – $32.80 | 35 |
| Epstein barr nuclear antigen antibody CPT 86664 | $22.63 | $61.16 | $13.46 – $38.23 | 35 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $26.85 | $72.56 | $15.96 – $45.35 | 35 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $87.23 | $235.75 | $16.26 – $27.83 | 4 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp ea duct/ampulla dilate CPT 43277 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp lithotripsy calculi CPT 43265 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp remove duct calculi 43264 CPT 43264 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp remove forgn body duct 43275 CPT 43275 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp sphincter pressure meas CPT 43263 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp stent exchange w/dilate CPT 43276 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Ercp w/specimen collection CPT 43260 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $202.70 | $547.85 | $144.88 – $291.97 | 5 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $124.29 | $335.91 | $16.52 – $16.52 | 3 |
| ER Visit (level 1, minor) CPT 99281 | $211.73 | $572.25 | $28.33 – $181.18 | 33 |
| ER Visit (level 2) CPT 99282 | not published | not published | $152.60 – $325.87 | 31 |
| ER Visit (level 3) CPT 99283 | not published | not published | $266.82 – $569.78 | 31 |
| ER Visit (level 4) CPT 99284 | not published | not published | $410.33 – $876.23 | 31 |
| ER Visit (level 5, high severity) CPT 99285 | not published | not published | $590.80 – $1,261.61 | 31 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $110.82 | $299.50 | $80.47 – $93.21 | 4 |
| Esophageal motility CPT 78258 | not published | not published | $387.22 – $884.18 | 33 |
| Esophageal recording CPT 93615 | not published | not published | $70.30 – $24,882.00 | 3 |
| Esophageal recording CPT 93616 | not published | not published | $87.38 – $24,882.00 | 3 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $903.46 – $5,618.00 | 32 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy balloon <30mm CPT 43220 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy flex biopsy CPT 43202 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | not published | not published | $903.46 – $5,618.00 | 32 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $903.46 – $5,618.00 | 32 |
| Esophagoscopy flex remove fb CPT 43215 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophagus motility study CPT 91010 | not published | not published | $349.00 – $1,091.85 | 33 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $511.31 – $1,091.85 | 33 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esoph endoscopy dilation CPT 43226 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $36.48 – $36.48 | 2 |
| Esoph imped function test CPT 91037 | not published | not published | $267.65 – $640.79 | 33 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $511.31 – $1,091.85 | 33 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Established Patient Office Visit (level 1) CPT 99211 | $80.57 | $217.75 | $54.50 – $54.50 | 2 |
| Established Patient Office Visit (level 2) CPT 99212 | $107.12 | $289.50 | $134.75 – $134.75 | 2 |
| Established Patient Office Visit (level 3) CPT 99213 | $153.64 | $415.25 | $219.60 – $219.60 | 2 |
| Established Patient Office Visit (level 4) CPT 99214 | $155.12 | $419.25 | $309.88 – $309.88 | 2 |
| Established Patient Office Visit (level 5) CPT 99215 | $347.43 | $939.00 | $435.30 – $435.30 | 2 |
| Estradiol total CPT 82670 | $75.11 | $203.00 | $24.59 – $69.85 | 35 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $16.10 | $43.50 | $11.91 – $11.91 | 3 |
| Estrogens total-sendout CPT 82672 | not published | not published | $19.10 – $54.25 | 35 |
| Ethylene glycol -sendout CPT 82693 | not published | not published | $13.11 – $37.25 | 35 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $2.69 | $7.26 | $1.31 – $1.47 | 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.