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 |
|---|---|---|---|---|
| Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular CPT 33208 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Insertion of new/replacement ppm w/transvenous electrode(s) ventricular CPT 33207 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator CPT 33225 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber CPT 33249 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Insert pessary/other device CPT 57160 | not published | not published | $193.85 – $413.96 | 31 |
| Insert/repl sq defib w/eltrd CPT 33270 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Insert sq defib electrode CPT 33271 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Insert swan-ganz cath CPT 93503 | not published | not published | $213.08 – $213.08 | 2 |
| Ins icd gen exist mlt leads CPT 33231 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Ins icd gen exist sgl lead CPT 33240 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Insitu hybridization auto CPT 88367 | $49.95 | $135.00 | $66.24 – $740.21 | 35 |
| Insitu hybridization (fish) CPT 88366 | not published | not published | $165.13 – $476.38 | 35 |
| Insitu hybridization manual CPT 88368 | $130.33 | $352.25 | $75.70 – $740.21 | 35 |
| In situ hybridization per specimen each additional single probe stain CPT 88364 | not published | not published | $86.97 – $220.10 | 4 |
| In situ hybridization per specimen initial single probe stain CPT 88365 | $80.29 | $217.00 | $115.35 – $352.62 | 35 |
| Ins lv lead exist pm/icd CPT 33224 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Ins picc wo subq prt/pmp w image guidnc <5yr CPT 36572 | not published | not published | $595.78 – $1,272.23 | 31 |
| Ins pm gen exist dual lead CPT 33230 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Ins pm gen w/exist mlt leads CPT 33221 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Ins/rpl pm gen exist dual lead CPT 33213 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Ins/rpl pm gen exist sgl lead CPT 33212 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Ins/rpl pm w/tv ld atrl CPT 33206 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Inst fibrinolysis agent ini day CPT 32561 | not published | not published | $595.78 – $1,272.23 | 31 |
| Inst fibrinolysis agent sbsq d CPT 32562 | not published | not published | $595.78 – $1,272.23 | 31 |
| Insti hexaminolevulinate hcl HCPCS A9589 | $2,370.59 | $6,407.00 | $1,681.66 – $3,446.03 | 6 |
| Instillation anticarcinogenic agent bladder CPT 51720 | not published | not published | $101.11 – $1,373.48 | 32 |
| Instll rx agnt into rnal tub CPT 50391 | not published | not published | $234.36 – $500.47 | 31 |
| Inst via cath agent pleurds CPT 32560 | not published | not published | $595.78 – $1,272.23 | 31 |
| Insulin total CPT 83525 | $31.45 | $85.00 | $10.06 – $28.58 | 35 |
| Ins vag brachytx device CPT 57156 | not published | not published | $293.13 – $625.95 | 31 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $6,866.28 | $18,557.50 | $2,400.92 – $3,735.87 | 5 |
| Integra meshed bil wound mat HCPCS C9363 | $7,357.17 | $19,884.25 | $97.80 – $97.80 | 3 |
| Interdiscal perq aspir dx CPT 62267 | not published | not published | $678.00 – $1,447.81 | 31 |
| Intermediate visual field xm CPT 92082 | not published | not published | $57.24 – $122.22 | 33 |
| Interrogate subq defib CPT 93261 | not published | not published | $35.93 – $1,636.00 | 34 |
| Interrogation vad in person CPT 93750 | not published | not published | $88.45 – $188.89 | 33 |
| Interrog dev eval icpms ip CPT 93290 | $106.01 | $286.50 | $35.93 – $1,636.00 | 34 |
| Interrog dev eval scrms ip CPT 93291 | not published | not published | $23.60 – $1,636.00 | 34 |
| Interrog device eval heart CPT 93289 | not published | not published | $35.93 – $1,636.00 | 34 |
| Interrog evl pm/ldls pm ip CPT 93288 | $129.13 | $349.00 | $35.93 – $1,636.00 | 34 |
| Interrog&prgrmg ipnss CPT 93151 | not published | not published | $88.45 – $1,636.00 | 34 |
| Interrog without prgrmg ipnss CPT 93153 | not published | not published | $88.45 – $1,636.00 | 34 |
| Interstitial brachy inter CPT 77799 | not published | not published | $105.51 – $225.32 | 31 |
| Intra-atrial pacing CPT 93610 | not published | not published | $8,499.18 – $24,882.00 | 3 |
| Intra-atrial recording CPT 93602 | not published | not published | $8,613.73 – $24,882.00 | 3 |
| Intracard echo interv w/s&i CPT 93662 | $4,328.45 | $11,698.50 | $754.43 – $754.43 | 2 |
| Intracranial complete study CPT 93886 | not published | not published | $232.92 – $1,146.00 | 34 |
| Intracranial limited study CPT 93888 | not published | not published | $102.47 – $1,146.00 | 34 |
| Intraop epicard/endocard/pace/map/ 93631 CPT 93631 | not published | not published | $16,815.90 – $24,882.00 | 3 |
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | not published | not published | $490.72 – $1,047.90 | 31 |
| Intrapul surf admin endo tube CPT 94610 | not published | not published | $134.03 – $418.53 | 33 |
| Intrauterine transfusion ftl CPT 36460 | not published | not published | $421.28 – $899.60 | 31 |
| Intraventricular pacing CPT 93612 | not published | not published | $8,504.68 – $24,882.00 | 3 |
| Intrinsic factor antibody CPT 86340 | $43.94 | $118.75 | $13.27 – $37.70 | 35 |
| Intrm oph exam est patient CPT 92012 | not published | not published | $124.19 – $265.19 | 33 |
| Intro long gi tube CPT 44500 | not published | not published | $903.46 – $1,929.25 | 31 |
| Intubation endotracheal emergency procedure CPT 31500 | not published | not published | $223.78 – $477.85 | 31 |
| Io anal gast n-stim subsq CPT 95981 | not published | not published | $57.24 – $122.22 | 33 |
| Io ga n-stim subsq w/reprog CPT 95982 | not published | not published | $35.93 – $145.53 | 33 |
| Ionm in operatng room 15 min CPT 95940 | not published | not published | $77.60 – $77.60 | 2 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $0.37 | $1.00 | $0.50 – $0.62 | 4 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $14.25 | $38.50 | $0.17 – $0.36 | 7 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $12,514.99 | $33,824.29 | $219.87 – $394.31 | 5 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $4.67 | $12.62 | $2.00 – $2.96 | 4 |
| Iron CPT 83540 | $43.48 | $117.50 | $5.69 – $16.18 | 35 |
| Iron binding capacity CPT 83550 | not published | not published | $7.69 – $21.85 | 35 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $50.64 | $136.87 | $21.02 – $38.11 | 5 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $6.05 – $17.20 | 35 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $34.49 | $93.22 | $0.29 – $0.35 | 4 |
| Irradiation of blood product each unit reference CPT 86945 | not published | not published | $33.43 – $80.77 | 34 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $136.72 | $369.50 | $55.35 – $122.22 | 34 |
| Irrigation vagina and/or appl medicament tx disease CPT 57150 | not published | not published | $57.24 – $122.22 | 31 |
| Ivc venogram s&i CPT 75825 | not published | not published | $204.64 – $6,833.27 | 2 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $87.88 | $237.50 | $63.68 – $146.45 | 33 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $806.88 | $2,180.75 | $44.58 – $44.58 | 2 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $119.70 | $323.50 | $44.46 – $94.94 | 33 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $754.71 | $2,039.75 | $138.80 – $433.55 | 33 |
| IV inj ra drug dx study CPT 78808 | not published | not published | $119.59 – $884.18 | 33 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $384.53 – $821.13 | 31 |
| Ivp w/nephrotomography CPT 74415 | not published | not published | $171.54 – $393.89 | 33 |
| Ivp w/wo kub w/wo tomography CPT 74400 | not published | not published | $171.54 – $393.89 | 33 |
| Jak2 targeted sequence analysis CPT 81279 | not published | not published | $177.79 – $463.00 | 34 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| John cunningham antibody CPT 86711 | not published | not published | $14.86 – $42.23 | 35 |
| Ketamine and metabolite screen - quest CPT 80357 | not published | not published | $56.25 – $56.25 | 2 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $13.61 – $38.68 | 35 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $17.85 | $48.25 | $7.19 – $20.43 | 35 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $47.66 | $128.82 | $0.61 – $1.64 | 5 |
| Kidney endoscopy CPT 50551 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy CPT 50553 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy CPT 50570 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy CPT 50575 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy & biopsy CPT 50555 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy & biopsy CPT 50574 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy & treatment CPT 50561 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Kidney function study CPT 78725 | not published | not published | $268.51 – $884.18 | 33 |
| Kidney imaging morphology CPT 78700 | not published | not published | $387.22 – $884.18 | 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.