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 |
|---|---|---|---|---|
| Kidney imag w/bld flow multi CPT 78709 | not published | not published | $518.69 – $1,158.73 | 33 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,550.95 | $4,191.75 | $518.69 – $1,158.73 | 33 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $565.36 | $1,528.00 | $102.47 – $235.69 | 33 |
| Kit gene analys d816 variant CPT 81273 | not published | not published | $109.88 – $312.18 | 35 |
| Knee MRI (with and without contrast) CPT 73723 | $654.35 | $1,768.50 | $344.14 – $1,111.00 | 33 |
| Knee MRI (with contrast) CPT 73722 | $622.25 | $1,681.75 | $761.33 – $1,716.48 | 33 |
| Knee MRI (without contrast) CPT 73721 | $590.15 | $1,595.00 | $232.92 – $1,111.00 | 33 |
| Knee X-ray CPT 73564 | $275.74 | $745.25 | $94.31 – $235.69 | 33 |
| Kras gene addl variants CPT 81276 | not published | not published | $170.06 – $483.13 | 35 |
| Kras gene variants exon 2 CPT 81275 | $144.30 | $390.00 | $170.06 – $483.13 | 35 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $0.66 | $1.79 | $0.30 – $0.30 | 3 |
| Lactate dehydrogenase (ldh) CPT 83615 | $61.88 | $167.25 | $5.32 – $15.10 | 35 |
| Lactated ringers intravenous solution HCPCS J7120 | $108.63 | $293.59 | $2.81 – $3.62 | 4 |
| Lactic acid CPT 83605 | $56.33 | $152.25 | $10.18 – $28.93 | 35 |
| Lactoferrin fecal qualitative CPT 83630 | $57.81 | $156.25 | $17.34 – $49.25 | 35 |
| Lactoferrin fecal quant CPT 83631 | not published | not published | $17.27 – $49.08 | 35 |
| Lanreotide 120 mg/0.5 ml subcutaneous syringe HCPCS J1930 | $196.00 | $529.74 | $48.25 – $98.51 | 5 |
| Lap gastric bypass/roux-en-y CPT 43644 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Lap place gastr adj device CPT 43770 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Lap replace gastr adj device CPT 43773 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Lap rmvl gastr adj all parts CPT 43774 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Lap rmvl gastr adj device CPT 43772 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Lap sleeve gastrectomy CPT 43775 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Largsc w/laser dstrj les CPT 31572 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Largsc w/njx augmentation CPT 31574 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Largsc w/removal lesion CPT 31578 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | not published | not published | $374.19 – $5,618.00 | 32 |
| Largsc w/ther injection CPT 31573 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngeal function studies CPT 92520 | not published | not published | $124.21 – $265.25 | 33 |
| Laryngoplasty laryngeal sten CPT 31551 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoplasty laryngeal sten CPT 31552 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoplasty laryngeal sten CPT 31553 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoplasty laryngeal sten CPT 31554 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscope w/vc inj CPT 31570 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopic sensory vid CPT 92614 | not published | not published | $135.00 – $351.55 | 33 |
| Laryngoscop w/arytenoidectom CPT 31560 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscop w/vc inj + scope CPT 31571 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy and dilation CPT 31528 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy and dilation CPT 31529 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy for treatment CPT 31527 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy telescopic CPT 31579 | not published | not published | $374.19 – $5,618.00 | 32 |
| Laryngoscopy w/biopsy CPT 31535 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy w/bx & op scope CPT 31536 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy w/exc of tumor CPT 31540 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy w/fb & op scope CPT 31531 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy w/fb removal CPT 31530 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | not published | not published | $374.19 – $5,618.00 | 32 |
| Larynscop remve cart + scop CPT 31561 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Laser surgery eye strands CPT 67031 | not published | not published | $528.64 – $1,128.87 | 31 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $223.78 – $477.85 | 31 |
| Lead capillary CPT 83655 | $39.96 | $108.00 | $10.66 – $30.28 | 35 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,088.26 | $2,941.25 | $232.92 – $1,146.00 | 34 |
| Leishmania antibody CPT 86717 | not published | not published | $10.78 – $30.63 | 35 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $9.58 | $25.89 | $4.28 – $6.24 | 4 |
| Leukacyte transfusion CPT 86950 | not published | not published | $124.68 – $352.62 | 34 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $9.14 – $25.98 | 35 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $2,050.48 | $5,541.85 | $210.19 – $395.93 | 5 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $1,440.90 | $3,894.33 | $2,037.77 – $3,650.25 | 5 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $27.06 | $73.13 | $0.06 – $0.08 | 4 |
| Levetiracetam therapeutic drug level CPT 80177 | $19.61 | $53.00 | $11.66 – $33.13 | 35 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $77.82 | $210.32 | $1.26 – $2.84 | 4 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $21.31 | $57.60 | $8.09 – $8.09 | 3 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $610.45 – $610.45 | 2 |
| Lidocaine therapeutic drug level CPT 80176 | $9.62 | $26.00 | $12.93 – $36.73 | 35 |
| Limb exercise test CPT 95875 | not published | not published | $143.35 – $321.95 | 33 |
| Limited visual field xm CPT 92081 | not published | not published | $40.73 – $122.22 | 33 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $49.15 | $132.83 | $4.23 – $4.47 | 4 |
| Lipase CPT 83690 | $66.79 | $180.50 | $6.06 – $17.23 | 35 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $29.80 – $84.65 | 35 |
| Lipoprotein blood quant CPT 83704 | $29.69 | $80.25 | $30.09 – $85.48 | 35 |
| Lipoprotein direct measurement hdl CPT 83718 | $45.88 | $124.00 | $7.21 – $20.48 | 35 |
| Lipoprotein direct measurement ldl CPT 83721 | $21.37 | $57.75 | $9.24 – $26.25 | 35 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $30.09 – $85.48 | 35 |
| Lip surgery procedure CPT 40799 | not published | not published | $223.78 – $477.85 | 31 |
| Listeria monocytogenes CPT 86723 | not published | not published | $11.61 – $32.98 | 35 |
| Lithium therapeutic drug level CPT 80178 | $80.38 | $217.25 | $5.82 – $16.53 | 35 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $2,496.21 | $6,746.50 | $353.98 – $353.98 | 2 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $169.14 – $440.48 | 34 |
| Liver elastography 91200 CPT 91200 | not published | not published | $46.05 – $321.95 | 33 |
| Liver Function Test CPT 80076 | $50.14 | $135.50 | $7.19 – $20.43 | 35 |
| Liver imaging CPT 78201 | not published | not published | $503.55 – $1,158.73 | 33 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $518.69 – $1,158.73 | 33 |
| Liver/spleen imag static only CPT 78215 | $1,550.95 | $4,191.75 | $387.22 – $884.18 | 33 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $303.51 – $884.18 | 33 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $173.45 – $173.45 | 2 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $38.99 | $105.39 | $1.92 – $2.03 | 4 |
| Loudness balance test CPT 92562 | not published | not published | $113.68 – $640.79 | 33 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $693.10 | $1,873.25 | $171.54 – $783.00 | 33 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $647.32 | $1,749.50 | $344.14 – $824.45 | 33 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $601.44 | $1,625.50 | $102.47 – $783.00 | 33 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $654.35 | $1,768.50 | $344.14 – $1,111.00 | 33 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $622.25 | $1,681.75 | $344.14 – $1,111.00 | 33 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,136.27 | $3,071.00 | $232.92 – $1,111.00 | 33 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $327.27 | $884.50 | $77.83 – $235.69 | 33 |
| Low frequency non-thermal Ultrasound CPT 97610 | $352.89 | $953.75 | $191.47 – $935.83 | 33 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $19.35 – $54.98 | 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.