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Ascension St. Vincent's Southside (St. Luke's-St. Vincent's HealthCare, Inc.)

4201 Belfort Rd, Jacksonville, FL · Ascension · · NPI 1396926747

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 7, 2026

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
Ocular instrumnt screen bil CPT 99177 $52.91 $143.00 $11.83 – $11.83 2
Ocular photodynamic ther CPT 67221 not published not published $528.64 – $1,128.87 31
Office consultation CPT 99241 not published not published $115.20 – $115.20 2
Office emergency care CPT 99058 not published not published $49.70 – $49.70 2
Off/op cnsltj new/est low 30 CPT 99243 not published not published $270.78 – $270.78 2
Off/op cnsltj new/est mod 40 CPT 99244 not published not published $385.50 – $385.50 2
Off/op consltj new/est hi 55 CPT 99245 not published not published $504.18 – $504.18 2
Off/op consltj new/est sf 20 CPT 99242 $73.26 $198.00 $178.08 – $178.08 2
Olanzapine 10 mg intramuscular solution HCPCS J2359 $4.69 $12.68 $1.13 – $1.13 4
Olanzapine long-acting inj HCPCS J2358 $33.74 $91.19 $3.56 – $6.39 5
Ol dig e/m svc 11-20 min CPT 99422 not published not published $71.03 – $71.03 2
Ol dig e/m svc 21+ min CPT 99423 not published not published $111.25 – $111.25 2
Ol dig e/m svc 5-10 min CPT 99421 not published not published $36.28 – $36.28 2
Onc breast mrna 12 genes CPT 81522 not published not published $3,408.24 – $9,682.50 4
Onc breast mrna 58 genes CPT 81520 not published not published $2,208.99 – $6,275.53 4
Onc breast mrna 70 genes CPT 81521 not published not published $3,408.24 – $9,682.50 4
Onc brst mrna 11 genes CPT 81518 not published not published $3,408.24 – $9,682.50 4
Onc brst mrna 70 cnt 31 gene CPT 81523 not published not published $3,873.00 – $9,682.50 3
Onc cutan mlnma mrna 31 gene CPT 81529 not published not published $7,193.00 – $17,982.50 3
Oncology colon mrna CPT 81525 not published not published $2,742.08 – $7,790.00 4
Oncology colorectal scr CPT 81528 not published not published $447.80 – $1,272.18 35
Oncology gynecologic CPT 81535 not published not published $509.93 – $1,448.65 35
Oncology gynecologic CPT 81536 not published not published $156.25 – $443.90 35
Oncology lung CPT 81538 not published not published $2,526.48 – $7,177.50 4
Oncology prostate prob score CPT 81539 not published not published $668.80 – $1,900.00 35
Oncology thyroid CPT 81545 not published not published $9,000.00 – $9,000.00 2
Oncology tissue of origin CPT 81504 not published not published $457.60 – $1,300.00 35
Oncology tum unknown origin CPT 81540 not published not published $3,300.00 – $9,375.00 4
Onco (ovar) five proteins CPT 81503 not published not published $789.36 – $2,242.50 35
Onco (ovar) two proteins CPT 81500 not published not published $229.24 – $651.25 35
Oncoprotein dcp CPT 83951 not published not published $56.68 – $161.03 35
Oncoprotein her-2/neu CPT 83950 not published not published $56.68 – $161.03 35
Onc prostate 3 genes CPT 81551 not published not published $1,786.40 – $5,075.00 4
Onc prostate mrna 22 cnt gen CPT 81542 not published not published $3,873.00 – $9,682.50 3
Onc prostate mrna 46 genes CPT 81541 not published not published $3,408.24 – $9,682.50 4
Onc thyr mrna 10,196 gen alg CPT 81546 not published not published $3,600.00 – $9,000.00 3
Onc uveal mlnma mrna 15 gene CPT 81552 not published not published $7,776.00 – $19,440.00 3
Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 $13.12 $35.47 $0.11 – $1.22 4
Oocyte identification CPT 89254 not published not published $143.50 – $352.62 32
Ophthalmic biometry CPT 92136 not published not published $39.95 – $265.25 33
Ophthalmodynamometry CPT 92260 not published not published $37.82 – $80.77 33
Ophth Ultrasound b & quant a CPT 76510 not published not published $124.21 – $273.85 33
Oph Ultrasound dx ant sgm Ultrasound uni/bi CPT 76513 not published not published $102.47 – $235.69 33
Oph Ultrasound dx quan a-scan only CPT 76511 not published not published $75.77 – $235.69 33
Opioids & opiate analogs 3/4 CPT 80363 not published not published $53.08 – $53.08 2
Opscpy extnd on/mac draw CPT 92202 not published not published $36.65 – $122.22 33
Opscpy extnd rta draw uni/bi CPT 92201 not published not published $57.24 – $122.22 33
Optical endomicroscpy interp CPT 88375 not published not published $44.94 – $111.78 4
Optokinetic nystagmus test CPT 92534 not published not published $46.63 – $46.63 2
Oral aprepitant HCPCS J8501 $4.31 $11.66 $3.71 – $4.29 4
Organic acids total quant ea spec CPT 83918 not published not published $20.77 – $59.00 35
Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 $47.08 $127.24 $15.04 – $20.99 4
Orthopantogram CPT 70355 not published not published $25.25 – $194.81 33
Orthop traing pfrmd phys/qhp CPT 92065 not published not published $16.73 – $16.73 2
Orthop traing supvj phys/qhp CPT 92066 not published not published $57.24 – $122.22 33
Orthovisc inj per dose HCPCS J7324 $57.35 $155.00 $138.21 – $138.21 3
Oscillation chest wall mechanical per session CPT 94669 $135.88 $367.25 $48.75 – $418.53 33
Osmolality blood CPT 83930 $40.79 $110.25 $5.82 – $16.53 35
Osmolality urine CPT 83935 $38.48 $104.00 $6.00 – $17.05 35
Osteopath manip tx/5-6 body region 98927 CPT 98927 not published not published $24.38 – $141.33 33
Osteopath manip tx/7-8 body region 98928 CPT 98928 not published not published $24.38 – $171.85 33
Osteopath manip tx/9-10 body region98929 CPT 98929 not published not published $24.38 – $202.38 33
Ot evaluation high complexity patient/family CPT 97167 not published not published $94.30 – $245.58 33
Ot evaluation low complexity patient/family CPT 97165 not published not published $94.30 – $245.58 33
Ot evaluation moderate complexity patient/family CPT 97166 not published not published $94.30 – $245.58 33
Other immunoelectrophoresis CPT 86325 not published not published $20.36 – $57.83 35
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 not published not published $46.30 – $120.58 33
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 not published not published $42.55 – $292.00 34
Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 $36.26 $98.00 $25.49 – $66.38 33
Otolaryngo binocular microscopy 92504 CPT 92504 not published not published $66.68 – $66.68 2
Ot re-evaluation patient/family CPT 97168 not published not published $65.04 – $169.38 33
Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 not published not published $32.22 – $83.90 33
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 $24.88 $67.25 $19.74 – $51.40 33
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 $24.88 $67.25 $20.65 – $53.78 33
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 $32.10 $86.75 $26.98 – $70.25 33
Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 $39.59 $107.00 $29.99 – $78.10 33
Ot training self care/home management direct contact each 15 minutes CPT 97535 not published not published $29.90 – $77.88 33
Out of office emerg med serv CPT 99060 not published not published $57.13 – $57.13 2
Ovulation tests CPT 84830 not published not published $11.18 – $31.75 35
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 $80.22 $216.80 $0.78 – $1.61 4
Oxaliplatin 5 mg/ml desensitization HCPCS J9263 $2.89 $7.81 $0.06 – $0.12 4
Oxytocin 10 unit/ml injection solution HCPCS J2590 $45.86 $123.95 $2.15 – $2.45 4
Pabpn1 gene detc abnor allel CPT 81312 not published not published $120.56 – $342.50 35
Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 $0.50 $1.34 $0.16 – $0.17 4
Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 $15.22 $41.13 $15.93 – $29.65 5
Palb2 gene full gene seq CPT 81307 not published not published $248.93 – $1,691.25 35
Palb2 gene known famil vrnt CPT 81308 not published not published $265.19 – $753.38 35
Palivizumab 50 mg/0.5 ml inj CPT 90378 $2,233.24 $6,035.78 $691.08 – $4,464.55 37
Palonosetron hcl HCPCS J2469 $29.86 $80.70 $0.61 – $0.86 4
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 $37.62 $101.67 $16.93 – $18.87 4
Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 $133.18 $359.95 $201.20 – $248.57 4
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 $48.08 $129.94 $6.96 – $6.96 3
Papaverin hcl injection HCPCS J2440 $50.14 $135.50 $56.05 – $57.38 4
Parathormone (pth) intact CPT 83970 $104.90 $283.50 $36.33 – $103.20 35
Parathyrd planar w/spect&ct CPT 78072 not published not published $518.69 – $1,158.73 33
Parathyroid planar imaging CPT 78070 $1,550.95 $4,191.75 $387.22 – $884.18 33
Parathyroid planar img w/tomo spect CPT 78071 $1,723.28 $4,657.50 $387.22 – $884.18 33
Paring/cutting benign hyperkeratotic lesion single CPT 11055 not published not published $191.47 – $408.87 31
Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 $5,094.99 $13,770.25 $3.81 – $6.38 5
Path clin consltj high 41-60 CPT 80505 not published not published $152.32 – $352.62 34

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.