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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | not published | not published | $136.92 – $356.58 | 34 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $211.09 | $570.50 | $136.92 – $356.58 | 34 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | $62.35 | $168.50 | $30.88 – $87.73 | 35 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $51.80 | $140.00 | $30.88 – $87.73 | 35 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | not published | not published | $73.70 – $191.93 | 34 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | not published | not published | $366.77 – $1,041.95 | 35 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $122.10 | $330.00 | $112.90 – $320.73 | 35 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | $467.13 | $1,262.50 | $231.43 – $657.48 | 35 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $131.72 | $356.00 | $37.70 – $107.10 | 35 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $35.89 | $97.00 | $37.70 – $107.10 | 35 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $156.14 | $422.00 | $37.70 – $107.10 | 35 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $36.63 | $99.00 | $74.89 – $212.75 | 35 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $303.59 | $820.50 | $125.51 – $356.58 | 35 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $133.60 | $361.08 | $37.23 – $66.86 | 5 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | $57.05 | $154.20 | $24.10 – $49.37 | 7 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $209.12 | $565.18 | $17.33 – $132.03 | 7 |
| Influenza dna amp prob addl CPT 87503 | $54.85 | $148.25 | $25.72 – $73.05 | 35 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $101.86 – $208.73 | 6 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $35.22 – $72.18 | 6 |
| Infuse radioactive materials CPT 77750 | not published | not published | $253.41 – $541.14 | 32 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $204.95 – $204.95 | 2 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $293.70 – $1,091.85 | 33 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | $205.35 | $555.00 | $76.00 – $418.53 | 33 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $815.75 – $815.75 | 2 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $320.73 – $320.73 | 2 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $438.35 – $438.35 | 2 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $194.83 – $194.83 | 2 |
| Initiation & management bipap/cpap initial day CPT 94660 | $340.22 | $919.50 | $154.80 – $418.53 | 33 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $25.34 | $68.49 | $21.69 – $38.89 | 5 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $164.97 | $445.86 | $199.23 – $363.30 | 5 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $4.83 | $13.05 | $1.52 – $1.52 | 3 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $2.60 | $7.02 | $2.78 – $4.99 | 5 |
| Inj ceftolozane tazobactam HCPCS J0695 | $164.87 | $445.60 | $9.81 – $17.85 | 5 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $284.46 – $607.44 | 31 |
| Inj, durolane 1 mg HCPCS J7318 | $38.18 | $103.20 | $10.05 – $10.05 | 3 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $667.33 – $1,425.04 | 31 |
| Injection, cangrelor HCPCS C9460 | $34.86 | $94.21 | $22.83 – $29.21 | 4 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $284.46 – $607.44 | 31 |
| Injection, daratumumab 10 mg HCPCS J9145 | $66.71 | $180.30 | $82.51 – $143.05 | 5 |
| Injection, doxercalciferol HCPCS J1270 | $12.03 | $32.53 | $0.57 – $0.57 | 3 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $93.83 – $93.83 | 2 |
| Injection epidural blood patch or clot CPT 62273 | not published | not published | $667.33 – $1,425.04 | 31 |
| Injection eye drug CPT 67028 | not published | not published | $319.62 – $682.53 | 31 |
| Injection, fulvestrant HCPCS J9395 | $152.32 | $411.67 | $8.42 – $14.59 | 5 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $32.79 | $88.63 | $14.97 – $26.89 | 5 |
| Injection into brain canal CPT 61026 | not published | not published | $667.33 – $1,425.04 | 31 |
| Injection into brain canal CPT 61055 | not published | not published | $284.46 – $607.44 | 31 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $878.55 – $1,876.08 | 31 |
| Injection into spinal artery CPT 62294 | not published | not published | $857.91 – $1,832.00 | 31 |
| Injection into vocal cord CPT 31513 | not published | not published | $374.19 – $5,618.00 | 32 |
| Injection,onabotulinumtoxina HCPCS J0585 | $17.78 | $48.06 | $7.91 – $14.17 | 5 |
| Injection px peyronie ds CPT 54200 | not published | not published | $234.36 – $500.47 | 31 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | not published | not published | $387.22 – $826.87 | 31 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | not published | not published | $667.33 – $1,425.04 | 31 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | not published | not published | $667.33 – $1,425.04 | 31 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | not published | not published | $857.91 – $1,832.00 | 31 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | not published | not published | $857.91 – $1,832.00 | 31 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | not published | not published | $857.91 – $1,832.00 | 31 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $667.33 – $1,425.04 | 31 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | not published | not published | $667.33 – $1,425.04 | 31 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | not published | not published | $284.46 – $607.44 | 31 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | not published | not published | $284.46 – $607.44 | 31 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | not published | not published | $284.46 – $607.44 | 31 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $287.40 | $776.75 | $34.35 – $94.94 | 33 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $57.17 | $154.50 | $22.15 – $22.15 | 2 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $310.62 | $839.50 | $81.55 – $433.55 | 33 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $157.25 | $425.00 | $33.93 – $146.45 | 33 |
| Injection torsemide 10 mg/ml HCPCS J3265 | $9.66 | $26.10 | $3.29 – $3.29 | 3 |
| Injection treatment of nerve CPT 64681 | not published | not published | $857.91 – $1,832.00 | 31 |
| Injection treatment of nose CPT 30200 | not published | not published | $490.72 – $1,047.90 | 31 |
| Inject/treat eye socket CPT 67500 | not published | not published | $288.06 – $615.12 | 31 |
| Inject/treat eye socket CPT 67505 | not published | not published | $288.06 – $615.12 | 31 |
| Inject/treat eye socket CPT 67515 | not published | not published | $288.06 – $615.12 | 31 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $667.33 – $1,425.04 | 31 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $857.91 – $1,832.00 | 31 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | $64.12 | $173.30 | $76.76 – $138.10 | 5 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | not published | not published | $116.08 – $116.08 | 2 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $126.45 – $126.45 | 2 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $137.95 – $137.95 | 2 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | $900.86 | $2,434.75 | $68.78 – $68.78 | 2 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $63.60 – $63.60 | 2 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $857.91 – $1,832.00 | 31 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $191.47 – $408.87 | 31 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $191.47 – $408.87 | 31 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $87.51 | $236.50 | $38.34 – $38.34 | 3 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $16.10 | $43.50 | $4.43 – $5.33 | 4 |
| Inj., meropenem, vaborbactam HCPCS J2186 | $183.71 | $496.52 | $2.57 – $5.67 | 5 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | not published | not published | $643.19 – $1,373.48 | 31 |
| Inj ogivri 10 mg HCPCS Q5114 | $4,606.83 | $12,450.90 | $57.12 – $230.76 | 7 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | $507.78 | $1,372.37 | $30.15 – $922.76 | 7 |
| Inj scleros sol mult veins CPT 36471 | not published | not published | $385.00 – $822.13 | 31 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $385.00 – $822.13 | 31 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | not published | not published | $385.00 – $822.13 | 31 |
| Inj, tyenne, 1 mg HCPCS Q5135 | $64.34 | $173.89 | $4.97 – $10.16 | 6 |
| Inj w/fluor eval cv device CPT 36598 | not published | not published | $203.03 – $433.55 | 31 |
| Ins cerv dilator (sep proc) CPT 59200 | not published | not published | $293.13 – $625.95 | 31 |
| Insemination of oocytes CPT 89268 | not published | not published | $143.50 – $352.62 | 32 |
| Insert drug delivery implant CPT 11981 | not published | not published | $124.21 – $265.25 | 31 |
| Insertion catheter bladder non indwelling CPT 51701 | not published | not published | $124.21 – $265.25 | 31 |
| Insertion catheter bladder temporary simple CPT 51702 | not published | not published | $124.21 – $265.25 | 31 |
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.