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 |
|---|---|---|---|---|
| Intubation endotracheal emergency procedure CPT 31500 | not published | not published | $223.78 – $477.85 | 31 |
| Io anal gast n-stim init CPT 95980 | not published | not published | $113.40 – $113.40 | 2 |
| 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 |
| Io radiation tx management CPT 77469 | not published | not published | $992.70 – $992.70 | 1 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $12,514.99 | $33,824.29 | $219.87 – $394.31 | 5 |
| Ip/obs cnsltj new/est low 45 CPT 99253 | not published | not published | $241.00 – $241.00 | 2 |
| Ip/obs cnsltj new/est mod 60 CPT 99254 | not published | not published | $332.43 – $332.43 | 2 |
| Ip/obs consltj new/est hi 80 CPT 99255 | not published | not published | $447.70 – $447.70 | 2 |
| Ip/obs consltj new/est sf 35 CPT 99252 | $73.26 | $198.00 | $170.33 – $170.33 | 2 |
| 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 |
| 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 |
| Lab pathology consultation CPT 80500 | not published | not published | $17.74 – $55.25 | 3 |
| Lab pathology consultation CPT 80502 | not published | not published | $64.12 – $180.05 | 3 |
| 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 gastr bypass incl smll i CPT 43645 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Lap gastric bypass/roux-en-y CPT 43644 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Lap ins device for right CPT 49327 | not published | not published | $5,618.00 – $5,618.00 | 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 revise gastr adj device CPT 43771 | 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 i&r CPT 92615 | not published | not published | $78.50 – $78.50 | 2 |
| 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 |
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.