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 |
|---|---|---|---|---|
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,448.56 – $6,121.40 | 3 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $300.08 – $640.79 | 33 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $28.55 – $80.77 | 33 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $17.95 – $122.22 | 33 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $11.13 – $50.39 | 33 |
| Idarubicin hcl injection HCPCS J9211 | $36.58 | $98.85 | $70.20 – $70.20 | 3 |
| Identify sperm tissue CPT 89264 | not published | not published | $49.47 – $109.94 | 32 |
| Idh1 common variants CPT 81120 | not published | not published | $170.06 – $483.13 | 35 |
| Idh2 common variants CPT 81121 | not published | not published | $260.29 – $739.48 | 35 |
| I&d lacrimal gland CPT 68400 | not published | not published | $933.31 – $1,993.01 | 31 |
| Ifnl3 gene CPT 81283 | not published | not published | $64.57 – $183.43 | 35 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | $49.40 | $133.50 | $30.04 – $37.61 | 4 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $199.02 – $518.28 | 34 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $60.32 – $171.38 | 35 |
| Igh gene rearrange amp meth CPT 81261 | not published | not published | $174.23 – $494.98 | 35 |
| Igh@ var region somatic mutation analy CPT 81263 | $143.84 | $388.75 | $259.18 – $736.30 | 35 |
| Igk rearrangeabn clonal pop CPT 81264 | not published | not published | $152.00 – $431.83 | 35 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $915.29 | $2,473.75 | $53.78 – $157.35 | 4 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $134.03 | $362.25 | $112.81 – $740.21 | 35 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $915.29 | $2,473.75 | $58.73 – $352.62 | 35 |
| Ikbkap gene CPT 81260 | not published | not published | $34.59 – $98.28 | 35 |
| Img rta detcj/mntr ds staff CPT 92227 | not published | not published | $40.73 – $122.22 | 33 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | not published | not published | $30.83 – $80.77 | 33 |
| Img rta detc/mntr ds poc aly CPT 92229 | not published | not published | $57.24 – $122.22 | 33 |
| Immune complex assay CPT 86332 | not published | not published | $21.45 – $60.93 | 35 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $1,221.89 | $3,302.40 | $55.06 – $101.75 | 5 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $64.25 | $173.65 | $98.83 – $122.15 | 4 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | $3,132.49 | $8,466.18 | $58.63 – $107.97 | 5 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $72.88 – $183.60 | 6 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $39.59 | $107.00 | $18.31 – $52.03 | 35 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $51.62 | $139.50 | $18.31 – $52.03 | 35 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $22.50 – $63.93 | 35 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $17.73 | $47.92 | $10.54 – $29.95 | 35 |
| Immunodiffusion nes CPT 86329 | $22.20 | $60.00 | $12.36 – $35.13 | 35 |
| Immunofixation electrophoresis serum CPT 86334 | $116.18 | $314.00 | $19.66 – $55.85 | 35 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | not published | not published | $53.32 – $188.18 | 4 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $36.08 | $97.50 | $75.86 – $352.62 | 35 |
| Immunoglobulin assay CPT 86023 | $12.58 | $34.00 | $10.97 – $31.15 | 35 |
| Immunology procedure CPT 86849 | not published | not published | not published | 0 |
| Impedence cardiogram CPT 93701 | $116.74 | $315.50 | $60.48 – $265.25 | 33 |
| Implant hormone pellet(s) 11980 CPT 11980 | not published | not published | $384.53 – $821.13 | 31 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $223.78 – $477.85 | 31 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $5,930.36 | $16,028.00 | $942.62 – $5,809.75 | 6 |
| In-111 pentetreotide HCPCS A9572 | $10,737.22 | $29,019.50 | $11,610.00 – $11,610.00 | 2 |
| Incise/drain eyelid lining CPT 68020 | not published | not published | $933.31 – $1,993.01 | 31 |
| Incise inner eye adhesions CPT 65860 | not published | not published | $528.64 – $1,128.87 | 31 |
| Incise tear duct opening 68440 CPT 68440 | not published | not published | $288.06 – $615.12 | 31 |
| Incision of burn scab initi CPT 16035 | not published | not published | $385.00 – $822.13 | 31 |
| Incision of eardrum CPT 69420 | not published | not published | $223.78 – $477.85 | 31 |
| Incision of eyelid CPT 67710 | not published | not published | $933.31 – $1,993.01 | 31 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $67.39 – $175.50 | 34 |
| Infect ag drug suscept pheno predict CPT 87900 | $46.25 | $125.00 | $114.71 – $325.88 | 35 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $13.20 – $37.50 | 35 |
| Infect ag eia influenza a or b ea CPT 87400 | $44.31 | $119.75 | $12.44 – $35.33 | 35 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $226.56 – $643.63 | 35 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $226.56 – $643.63 | 35 |
| Infect ag genotype na hiv-1 other region CPT 87906 | $46.25 | $125.00 | $113.28 – $321.83 | 35 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $138.75 | $375.00 | $226.56 – $643.63 | 35 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $28.84 – $81.93 | 35 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $31.06 – $88.23 | 35 |
| Infect ag ia optc obs influenza CPT 87804 | $24.33 | $65.75 | $14.56 – $41.38 | 35 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $10.54 – $29.95 | 35 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $16.16 – $45.90 | 35 |
| Infect ag if influenza a CPT 87276 | not published | not published | $14.14 – $40.18 | 35 |
| Infect ag if influenza b CPT 87275 | not published | not published | $10.78 – $30.63 | 35 |
| Infect ag if legionella pneumophila CPT 87278 | $12.21 | $33.00 | $13.73 – $39.00 | 35 |
| Infect ag if nos ea CPT 87299 | $12.21 | $33.00 | $14.17 – $40.25 | 35 |
| Infect ag if pneumocystis carinii CPT 87281 | $9.62 | $26.00 | $10.54 – $29.95 | 35 |
| Infect ag if varicella zoster CPT 87290 | $17.39 | $47.00 | $11.81 – $33.55 | 35 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $47.05 – $133.68 | 35 |
| Infect ag na hep b amp CPT 87516 | $34.78 | $94.00 | $30.88 – $87.73 | 35 |
| Infect ag na herpes simplex quant CPT 87530 | $57.35 | $155.00 | $37.70 – $107.10 | 35 |
| Infect ag na hpv high-risk types CPT 87624 | $62.99 | $170.25 | $30.88 – $87.73 | 35 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $186.48 | $504.00 | $84.30 – $239.50 | 35 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $45.15 – $128.28 | 35 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $31.45 | $85.00 | $49.26 – $128.28 | 34 |
| Infect ag na resp virus 12-25 targets CPT 87633 | not published | not published | $366.77 – $1,041.95 | 35 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $430.02 – $1,221.65 | 35 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $36.63 | $99.00 | $22.94 – $65.18 | 35 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $39.72 – $103.45 | 34 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $31.64 | $85.50 | $10.54 – $29.95 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $11.81 – $33.55 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $43.48 | $117.50 | $12.16 – $34.55 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $43.48 | $117.50 | $10.54 – $29.95 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $16.28 | $44.00 | $12.66 – $35.95 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $32.47 | $87.75 | $9.09 – $25.83 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $6.29 | $17.00 | $9.09 – $25.83 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $40.79 | $110.25 | $21.19 – $60.20 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $51.43 | $139.00 | $10.54 – $29.95 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $54.02 | $146.00 | $10.54 – $29.95 | 35 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $10.92 | $29.50 | $10.54 – $29.95 | 35 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $117.29 | $317.00 | $30.88 – $87.73 | 35 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $49.21 | $133.00 | $30.88 – $87.73 | 35 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $68.73 | $185.75 | $32.80 – $93.18 | 35 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | not published | not published | $366.77 – $1,041.95 | 35 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $361.58 | $977.25 | $30.88 – $87.73 | 35 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $54.39 | $147.00 | $30.88 – $87.73 | 35 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $63.73 | $172.25 | $36.68 – $104.20 | 35 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $49.21 | $133.00 | $30.88 – $87.73 | 35 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $25.53 | $69.00 | $35.09 – $105.19 | 44 |
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.