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 |
|---|---|---|---|---|
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $73.35 | $198.25 | $141.60 – $141.60 | 2 |
| Ghs musc test done w/n test comp CPT 95886 | not published | not published | $111.75 – $111.75 | 2 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | not published | not published | $95.03 – $95.03 | 2 |
| Ghs musc tst done w/n tst non ext CPT 95887 | not published | not published | $102.63 – $102.63 | 2 |
| Ghs myocardial strain img spckl track CPT 93356 | $503.85 | $1,361.75 | $84.88 – $84.88 | 2 |
| Ghs nailbed repair/nail removal CPT 11760 | not published | not published | $589.86 – $1,259.60 | 31 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | not published | not published | $857.91 – $1,832.00 | 31 |
| Ghs nerve blk intercostal, single level CPT 64420 | not published | not published | $667.33 – $1,425.04 | 31 |
| Ghs nerve block axillary nerve CPT 64417 | not published | not published | $857.91 – $1,832.00 | 31 |
| Ghs nerve block brachial plexus CPT 64415 | not published | not published | $857.91 – $1,832.00 | 31 |
| Ghs nerve block celiac plexus CPT 64530 | not published | not published | $857.91 – $1,832.00 | 31 |
| Ghs nerve block interscaline CPT 64510 | not published | not published | $857.91 – $1,832.00 | 31 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | not published | not published | $857.91 – $1,832.00 | 31 |
| Ghs nerve block sciatic nerve CPT 64445 | not published | not published | $667.33 – $1,425.04 | 31 |
| Ghs nerve block suprascapular CPT 64418 | not published | not published | $667.33 – $1,425.04 | 31 |
| Ghs ng placement w fluoro guidance CPT 43752 | not published | not published | $384.53 – $821.13 | 31 |
| Ghs o2 saturation CPT 82810 | not published | not published | $8.60 – $24.43 | 35 |
| Ghs o2 uptake rest & exercise CPT 94680 | not published | not published | $92.83 – $321.95 | 33 |
| Ghs o2 uptake rest & indirect CPT 94690 | $228.20 | $616.75 | $57.24 – $122.22 | 33 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | not published | not published | $44.46 – $94.94 | 31 |
| Ghs opcc repair cvp without subq port CPT 36575 | not published | not published | $595.78 – $1,272.23 | 31 |
| Ghs optokenetic CPT 92544 | not published | not published | $8.78 – $321.95 | 33 |
| Ghs oscillating trac CPT 92545 | not published | not published | $8.78 – $640.79 | 33 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | not published | not published | $24.38 – $74.98 | 33 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | not published | not published | $24.38 – $108.53 | 33 |
| Ghs ot dds rom CPT 95851 | not published | not published | $21.77 – $56.70 | 33 |
| Ghs ot group caregiver training CPT 97552 | not published | not published | $20.44 – $53.23 | 33 |
| Ghs ot prosthetic training/15 min CPT 97761 | $52.08 | $140.75 | $37.58 – $292.00 | 34 |
| Ghs ot sensory integrative tech/15min CPT 97533 | not published | not published | $55.64 – $144.90 | 33 |
| Ghs ot work hardening-additional hours CPT 97546 | not published | not published | $156.55 – $156.55 | 2 |
| Ghs pacing - transcutaneous CPT 92953 | not published | not published | $2.75 – $1,346.54 | 33 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $48.10 | $130.00 | $22.52 – $58.70 | 4 |
| Ghs peritonsillar abscess i andd CPT 42700 | not published | not published | $223.78 – $477.85 | 31 |
| Ghs phenylketonurid CPT 84030 | not published | not published | $4.84 – $13.75 | 35 |
| Ghs plngl fx pm cl CPT 26725 | not published | not published | $231.16 – $493.62 | 31 |
| Ghs plt ct-manual CPT 85032 | not published | not published | $3.79 – $10.78 | 35 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $2,547.54 | $6,885.25 | $1,953.35 – $4,031.00 | 3 |
| Ghs pos nystagmus CPT 92542 | not published | not published | $9.55 – $265.25 | 33 |
| Ghs ppd (tb intradermal) CPT 86580 | $11.66 | $31.50 | $7.96 – $50.39 | 35 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $49.77 | $134.50 | $8.50 – $24.15 | 35 |
| Ghs protein, misc fluid CPT 84160 | not published | not published | $4.94 – $14.03 | 35 |
| Ghs protoporphyrins fract CPT 84202 | not published | not published | $12.63 – $35.88 | 35 |
| Ghs pr without cont pulse ox CPT 94625 | not published | not published | $57.24 – $179.80 | 33 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | not published | not published | $10.78 – $30.63 | 35 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $153.18 | $414.00 | $394.70 – $394.70 | 2 |
| Ghs quinidine CPT 80194 | not published | not published | $12.85 – $36.50 | 35 |
| Ghs refill of implantable pump CPT 95990 | not published | not published | $200.10 – $682.53 | 33 |
| Ghs removal intranasal foreign body CPT 30300 | not published | not published | $124.21 – $265.25 | 31 |
| Ghs removal pharyngeal foreign body CPT 42809 | not published | not published | $384.53 – $821.13 | 31 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $16.65 | $45.00 | $13.98 – $39.73 | 35 |
| Ghs reticulocyte count CPT 85044 | $24.24 | $65.50 | $3.79 – $10.78 | 35 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | not published | not published | $12.24 – $34.78 | 35 |
| Ghs sedimentation rate CPT 85651 | $17.48 | $47.25 | $3.76 – $10.68 | 35 |
| Ghs semen analysis fert CPT 89320 | $54.76 | $148.00 | $10.83 – $30.78 | 35 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $8.66 – $24.60 | 35 |
| Ghs sensitivity (per antimicro) CPT 87184 | $23.77 | $64.25 | $6.58 – $18.70 | 35 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $385.00 – $822.13 | 31 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $385.00 – $822.13 | 31 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $385.00 – $822.13 | 31 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $385.00 – $822.13 | 31 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $191.47 – $408.87 | 31 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $191.47 – $408.87 | 31 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $191.47 – $408.87 | 31 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $191.47 – $408.87 | 31 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $191.47 – $408.87 | 31 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $150.77 – $4,031.00 | 34 |
| Ghs somatosensory testing lower extremit CPT 95926 | $947.48 | $2,560.75 | $262.00 – $640.79 | 33 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $511.31 – $1,091.85 | 33 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $62.07 | $167.75 | $44.54 – $116.00 | 33 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $284.46 – $607.44 | 31 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $10.30 – $265.25 | 33 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $130.98 | $354.00 | $94.52 – $246.15 | 33 |
| Ghs st - eval for alt comm CPT 92567 | $57.72 | $156.00 | $37.82 – $80.77 | 33 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $124.21 – $265.25 | 31 |
| Ghs st - re-eval for alt comm CPT 92597 | $138.38 | $374.00 | $67.22 – $175.05 | 33 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $69.28 | $187.25 | $38.55 – $94.94 | 33 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $333.83 | $902.25 | $203.03 – $433.55 | 33 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $589.86 – $1,259.60 | 31 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $385.00 – $822.13 | 31 |
| Ghs trypsin (fecal) CPT 84488 | $12.95 | $35.00 | $6.43 – $18.25 | 35 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $231.16 – $493.62 | 31 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $231.16 – $493.62 | 31 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $21.39 – $60.75 | 35 |
| Ghs urine, porphyrins quant CPT 84120 | $8.14 | $22.00 | $12.94 – $36.78 | 35 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | $1,511.45 | $4,085.00 | $511.31 – $2,591.15 | 33 |
| Ghs windowing of cast CPT 29730 | not published | not published | $152.05 – $324.70 | 31 |
| Giardia lamblia antibody CPT 86674 | $23.31 | $63.00 | $12.95 – $36.80 | 35 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $232.92 – $525.31 | 32 |
| Gi inhouse confirmation CPT 87045 | $146.06 | $394.75 | $8.31 – $23.60 | 35 |
| Gi protein loss CPT 78282 | not published | not published | $387.22 – $884.18 | 32 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $903.46 – $1,929.25 | 33 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $878.55 – $1,876.08 | 33 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $903.46 – $1,929.25 | 33 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $903.46 – $3,238.30 | 33 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $88.99 – $252.80 | 35 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $54.14 – $153.80 | 35 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $30.80 – $87.50 | 35 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $190.24 | $514.16 | $232.73 – $403.35 | 5 |
| Glucagon plasma - sendout CPT 82943 | $6.94 | $18.75 | $12.58 – $35.73 | 35 |
| Glucose 1 hr post dose CPT 82950 | $29.14 | $78.75 | $4.18 – $11.88 | 35 |
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.