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 |
|---|---|---|---|---|
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $29.69 | $80.25 | $26.98 – $70.25 | 33 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $65.95 | $178.25 | $27.67 – $72.05 | 33 |
| Pt wheelchair management each 15 minutes CPT 97542 | $40.15 | $108.50 | $28.79 – $74.98 | 33 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $1,565.35 – $1,565.35 | 2 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $793.25 – $793.25 | 2 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,500.00 – $13,612.50 | 3 |
| Pulmonary vent imaging CPT 78579 | not published | not published | $387.22 – $884.18 | 33 |
| Pulse ox continuous overnight monitoring CPT 94762 | $118.22 | $319.50 | $56.68 – $321.95 | 33 |
| Pulse ox multiple CPT 94761 | $216.36 | $584.75 | $9.55 – $9.55 | 2 |
| Pulse ox single CPT 94760 | $24.24 | $65.50 | $8.80 – $8.80 | 2 |
| Punc of shunt for asp or inj CPT 61070 | not published | not published | $667.33 – $1,425.04 | 31 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | not published | not published | $124.21 – $265.25 | 31 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | not published | not published | $385.00 – $822.13 | 31 |
| Puncture spinal lumbar diagnostic CPT 62270 | not published | not published | $667.33 – $1,425.04 | 31 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $667.33 – $1,425.04 | 31 |
| Pvb thoracic single inj site CPT 64461 | not published | not published | $667.33 – $1,425.04 | 31 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $44.70 | $120.82 | $15.34 – $23.67 | 4 |
| Pyruvate CPT 84210 | $31.45 | $85.00 | $12.74 – $36.20 | 35 |
| Pyruvate kinase CPT 84220 | not published | not published | $8.31 – $23.60 | 35 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $14.88 – $265.25 | 33 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | not published | not published | $518.69 – $1,158.73 | 33 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,550.95 | $4,191.75 | $387.22 – $884.18 | 33 |
| Quest t3 uptake CPT 84479 | $74.19 | $200.50 | $5.69 – $16.18 | 35 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $333.43 – $1,199.30 | 37 |
| Rabies ig ht&sol human im/sc CPT 90377 | $313.12 | $846.26 | $231.50 – $626.31 | 37 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $540.11 | $1,459.75 | $278.31 – $700.93 | 37 |
| Rabies vaccine id CPT 90676 | not published | not published | $253.89 – $585.00 | 34 |
| Radiation physics consult CPT 77336 | not published | not published | $127.94 – $273.20 | 32 |
| Radiation therapy dose plan CPT 77300 | not published | not published | $98.45 – $273.20 | 32 |
| Radiation therapy management CPT 77431 | not published | not published | $328.39 – $328.39 | 1 |
| Radiation treatment aid(s) CPT 77332 | not published | not published | $68.56 – $273.20 | 32 |
| Radiation treatment aid(s) CPT 77333 | not published | not published | $127.94 – $273.20 | 32 |
| Radiation treatment aid(s) CPT 77334 | not published | not published | $193.31 – $753.27 | 32 |
| Radiation treatment delivery CPT 77401 | not published | not published | $71.63 – $225.32 | 32 |
| Radiation treatment delivery CPT 77402 | not published | not published | $105.51 – $225.32 | 31 |
| Radiation treatment delivery CPT 77412 | not published | not published | $253.41 – $541.14 | 31 |
| Radiation tx management x5 CPT 77427 | not published | not published | $592.98 – $592.98 | 1 |
| Radiesse injection HCPCS Q2026 | $1,348.00 | $3,643.25 | $406.77 – $406.77 | 1 |
| Radiology port images(s) CPT 77417 | not published | not published | $33.49 – $33.49 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | not published | not published | $4,346.20 – $4,346.20 | 1 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,608.39 | $4,347.00 | $810.81 – $3,044.09 | 2 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $1,608.39 | $4,347.00 | $1,805.66 – $3,044.09 | 2 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $1,845.88 – $3,044.09 | 2 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,493.51 | $4,036.50 | $995.36 – $3,044.09 | 2 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $387.22 – $884.18 | 33 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $238.67 – $238.67 | 1 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $77.41 | $209.22 | $89.51 – $159.67 | 5 |
| Range of motion measurements CPT 95852 | not published | not published | $18.47 – $48.10 | 33 |
| Rapid desensitization CPT 95180 | not published | not published | $331.23 – $821.13 | 33 |
| Rapid Strep Test CPT 87880 | $27.94 | $75.50 | $14.55 – $41.33 | 35 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $674.82 | $1,823.83 | $451.96 – $810.23 | 5 |
| Rbc count only automated CPT 85041 | $4.47 | $12.08 | $2.66 – $7.55 | 35 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $421.28 – $899.60 | 31 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $7.57 – $21.50 | 35 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $6.57 – $18.68 | 35 |
| Rbc serum pretx incubj drugs CPT 86975 | $30.53 | $82.50 | $51.70 – $821.13 | 34 |
| Rcm img acquisj&i&r 1st les CPT 96931 | not published | not published | $385.65 – $385.65 | 2 |
| Rcm img acquisj&i&r ea addl CPT 96934 | not published | not published | $273.30 – $273.30 | 2 |
| Rcm img acquisj only 1st les CPT 96932 | not published | not published | $282.45 – $282.45 | 2 |
| Rcm img acquisj only ea addl CPT 96935 | not published | not published | $173.33 – $173.33 | 2 |
| Rcm i&r only 1st lesion CPT 96933 | not published | not published | $103.23 – $103.23 | 2 |
| Rcm i&r only ea addl lesion CPT 96936 | not published | not published | $99.98 – $99.98 | 2 |
| Rectal sensation test CPT 91120 | not published | not published | $300.08 – $981.00 | 33 |
| Red cell mass multiple CPT 78121 | not published | not published | $191.19 – $1,158.73 | 33 |
| Red cell mass single CPT 78120 | not published | not published | $182.92 – $884.18 | 33 |
| Red cell sequestration CPT 78140 | not published | not published | $256.09 – $884.18 | 33 |
| Red cell survival study CPT 78130 | not published | not published | $297.32 – $884.18 | 33 |
| Reduction of procidentia 45900 CPT 45900 | not published | not published | $878.55 – $1,876.08 | 31 |
| Refill maint impl spine pump CPT 95991 | not published | not published | $255.70 – $607.44 | 33 |
| Refill/maint pump/resvr syst CPT 96522 | $499.50 | $1,350.00 | $203.03 – $433.55 | 34 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $115.07 | $311.00 | $5.38 – $5.72 | 4 |
| Rem/biv cast full arm/leg CPT 29705 | not published | not published | $255.92 – $546.49 | 31 |
| Rem/biv cast shldr/hip spica CPT 29710 | not published | not published | $255.92 – $546.49 | 31 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $1,169.76 | $3,161.50 | $7.75 – $13.91 | 5 |
| Rem interrog dev eval icpms CPT 93297 | not published | not published | $35.93 – $1,636.00 | 34 |
| Rem interrog dev eval scrms CPT 93298 | not published | not published | $35.93 – $1,636.00 | 34 |
| Rem interrog evl pm/ids CPT 93296 | $119.79 | $323.75 | $35.93 – $1,636.00 | 34 |
| Rem interrog evl pm/ldls pm CPT 93294 | not published | not published | $70.75 – $1,636.00 | 3 |
| Rem mntr physiol 1st dev supply ea 30 days CPT 99454 | not published | not published | $35.93 – $101.53 | 33 |
| Rem mntr physiol 1st set up pt educaj eqp CPT 99453 | not published | not published | $47.23 – $265.19 | 33 |
| Rem mntr wrls p-art prs snr CPT 93264 | not published | not published | $35.93 – $1,636.00 | 34 |
| Remote 30 day ecg rev/report CPT 93228 | not published | not published | $60.63 – $1,636.00 | 3 |
| Remote 30 day ecg tech supp CPT 93229 | not published | not published | $300.08 – $1,753.25 | 34 |
| Removal biliary drg cath CPT 47537 | not published | not published | $903.46 – $1,929.25 | 31 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | not published | not published | $595.78 – $1,272.23 | 31 |
| Removal cerclage without anes CPT 59899 | not published | not published | $193.85 – $413.96 | 31 |
| Removal cerumen impacted (both sides) CPT 69210 | not published | not published | $57.24 – $122.22 | 31 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $352.89 | $953.75 | $191.47 – $408.87 | 33 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | not published | not published | $903.46 – $1,929.25 | 31 |
| Removal foreign body foot subcutaneous right CPT 28190 | not published | not published | $678.00 – $1,447.81 | 31 |
| Removal foreign body mouth CPT 40805 | not published | not published | $490.72 – $1,047.90 | 31 |
| Removal of eye lesion CPT 65400 | not published | not published | $933.31 – $1,993.01 | 31 |
| Removal of inner eye lesion CPT 66770 | not published | not published | $528.64 – $1,128.87 | 31 |
| Removal of larynx lesion 31512 CPT 31512 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Removal of vein clot CPT 34471 | not published | not published | $595.78 – $1,272.23 | 31 |
| Removal/replacement ppm generator dual lead system CPT 33228 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | not published | not published | $191.47 – $408.87 | 31 |
| Removal w/reinsrt nonbiogrdble CPT 11983 | not published | not published | $384.53 – $821.13 | 31 |
| Remove bladder stone CPT 52317 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Remove bladder stone CPT 52318 | 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.