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 |
|---|---|---|---|---|
| Remove brain canal fluid CPT 61050 | not published | not published | $284.46 – $607.44 | 31 |
| Remove cartilage for graft CPT 20910 | not published | not published | $589.86 – $1,259.60 | 31 |
| Remove cranial cavity fluid CPT 61001 | not published | not published | $667.33 – $1,425.04 | 31 |
| Remove cva lumen obstruct CPT 75902 | not published | not published | $192.25 – $192.25 | 1 |
| Remove eyelid lesion CPT 67800 | not published | not published | $288.06 – $615.12 | 31 |
| Remove eyelid lesion CPT 67840 | not published | not published | $933.31 – $1,993.01 | 31 |
| Remove eyelid lesions CPT 67801 | not published | not published | $933.31 – $1,993.01 | 31 |
| Remove eyelid lesions CPT 67805 | not published | not published | $288.06 – $615.12 | 31 |
| Remove gastric port open 43887 CPT 43887 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Remove renal tube w/fluoro CPT 50389 | not published | not published | $643.19 – $1,373.48 | 31 |
| Remove vc lesion scope/graft CPT 31546 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Remove vc lesion w/scope 31545 CPT 31545 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Renal cyst study s&i CPT 74470 | not published | not published | $528.36 – $1,182.67 | 32 |
| Renal endoscopy 50572 CPT 50572 | not published | not published | $643.19 – $5,618.00 | 32 |
| Renal function panel CPT 80069 | $77.70 | $210.00 | $7.64 – $21.70 | 35 |
| Renal scope w/tumor resect CPT 50562 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Renal venogram bil s&i CPT 75833 | $4,043.45 | $10,928.25 | $247.40 – $6,833.27 | 2 |
| Renin stimulation panel CPT 80416 | not published | not published | $184.20 – $523.30 | 35 |
| Renin stimulation panel CPT 80417 | not published | not published | $38.71 – $109.98 | 35 |
| Repair blood vessel dir lower extr CPT 35226 | not published | not published | $678.00 – $1,447.81 | 31 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | not published | not published | $589.86 – $1,259.60 | 31 |
| Repair dental ellis ii fx CPT 41899 | not published | not published | $223.78 – $477.85 | 31 |
| Repair detached retina pc CPT 67105 | not published | not published | $528.64 – $1,128.87 | 31 |
| Repair lac palate<2 cm CPT 42180 | not published | not published | $490.72 – $1,047.90 | 31 |
| Repair lip full thkns =<one-half vert height CPT 40652 | not published | not published | $490.72 – $1,047.90 | 31 |
| Repair of body cast CPT 29720 | not published | not published | $152.05 – $324.70 | 31 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | not published | not published | $223.78 – $477.85 | 31 |
| Repair rpr lip full thickness vermilion only CPT 40650 | not published | not published | $490.72 – $1,047.90 | 31 |
| Repair tongue lac <2.5cm past 1/3 tongue 41251 CPT 41251 | not published | not published | $223.78 – $477.85 | 31 |
| Replace duod/jej tube perc CPT 49451 | not published | not published | $903.46 – $1,929.25 | 31 |
| Replace g/c tube perc CPT 49450 | not published | not published | $903.46 – $1,929.25 | 31 |
| Replace g-j tube perc CPT 49452 | not published | not published | $903.46 – $1,929.25 | 31 |
| Replacement of contact lens CPT 92326 | not published | not published | $57.24 – $122.22 | 33 |
| Reprogram cochlear implt <7 CPT 92602 | not published | not published | $150.77 – $321.95 | 33 |
| Reprogram cochlear implt 7/> CPT 92604 | not published | not published | $150.77 – $321.95 | 33 |
| Reptilase test CPT 85635 | $14.80 | $40.00 | $8.67 – $24.63 | 35 |
| Respirator motion mgmt simul CPT 77293 | not published | not published | $1,005.72 – $1,005.72 | 1 |
| #resp virpnl dfa-adenovirus CPT 87260 | not published | not published | $12.70 – $36.08 | 35 |
| #resp virpnl dfa-parainfluenza CPT 87279 | not published | not published | $14.46 – $41.08 | 35 |
| Resp virus 6-11 targets CPT 87632 | not published | not published | $191.89 – $545.15 | 35 |
| Resuscitation cardiopulmonary CPT 92950 | $510.32 | $1,379.25 | $300.08 – $765.43 | 33 |
| Resuscitation delivery/birthing room CPT 99465 | not published | not published | $341.25 – $1,346.54 | 33 |
| Reticulated platelet assay CPT 85055 | not published | not published | $31.45 – $89.35 | 35 |
| Reticulocyte automated CPT 85045 | $30.34 | $82.00 | $3.51 – $9.98 | 35 |
| Reticulocyte direct measurement automated CPT 85046 | not published | not published | $4.90 – $13.93 | 35 |
| Retrieval of oocyte CPT 58970 | not published | not published | $839.07 – $1,791.76 | 31 |
| Retrograde ejaculation anal CPT 89331 | not published | not published | $17.24 – $48.98 | 35 |
| Revise eyelashes CPT 67825 | not published | not published | $288.06 – $615.12 | 31 |
| Revise gastric port open 43886 CPT 43886 | not published | not published | $25,708.00 – $25,708.00 | 1 |
| Revision of heart chamber CPT 92992 | not published | not published | $4,083.45 – $4,083.45 | 2 |
| Revision of iris CPT 66761 | not published | not published | $528.64 – $1,128.87 | 31 |
| Revision of iris CPT 66762 | not published | not published | $528.64 – $1,128.87 | 31 |
| Revision of neck muscle CPT 21725 | not published | not published | $678.00 – $1,447.81 | 31 |
| Rheumatoid factor qualitative CPT 86430 | not published | not published | $5.40 – $15.35 | 35 |
| Rheumatoid factor quantitative CPT 86431 | $13.23 | $35.75 | $4.99 – $14.18 | 35 |
| Rh ig IV CPT 90386 | not published | not published | $16.82 – $808.53 | 6 |
| Rh ig minidose im CPT 90385 | not published | not published | $50.13 – $73.52 | 6 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $444.00 | $1,200.00 | $5.95 – $10.71 | 5 |
| Rho d immune globulin inj HCPCS J2790 | $511.70 | $1,382.96 | $125.04 – $125.04 | 3 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | $167.98 | $454.00 | $139.16 – $365.10 | 6 |
| R hrt cath chd abnl nt cnj CPT 93594 | not published | not published | $685.85 – $685.85 | 2 |
| R hrt cath chd nml nt cnj CPT 93593 | not published | not published | $447.30 – $447.30 | 2 |
| Rhythm ecg with report CPT 93040 | not published | not published | $31.98 – $1,636.00 | 3 |
| Right heart cath congenital CPT 93530 | not published | not published | $1,792.93 – $1,792.93 | 2 |
| Right ventric recording CPT 93603 | not published | not published | $8,613.73 – $24,882.00 | 3 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | $25.64 | $69.29 | $22.62 – $22.62 | 3 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $590.84 | $1,596.86 | $93.24 – $168.04 | 5 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $48.63 | $131.44 | $45.79 – $80.11 | 5 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $79.80 | $215.68 | $42.41 – $86.90 | 7 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | $2,373.00 | $6,413.50 | $40.37 – $82.72 | 7 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | $670.81 | $1,813.00 | $30.43 – $62.36 | 7 |
| R & l heart cath congenital CPT 93531 | not published | not published | $4,962.90 – $4,962.90 | 2 |
| R & l heart cath congenital CPT 93532 | not published | not published | $4,744.10 – $4,744.10 | 2 |
| R & l heart cath congenital CPT 93533 | not published | not published | $4,726.40 – $4,726.40 | 2 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | not published | not published | $3,777.35 – $3,777.35 | 2 |
| R&l hrt cath chd nml nt cnj CPT 93596 | not published | not published | $2,181.85 – $2,181.85 | 2 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | not published | not published | $678.00 – $1,447.81 | 31 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Rmvl ndwellg tun pleural cath CPT 32552 | not published | not published | $595.78 – $1,272.23 | 31 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | not published | not published | $17,570.00 – $17,570.00 | 1 |
| Rmvl sq defib electrode CPT 33272 | not published | not published | $70,611.00 – $70,611.00 | 1 |
| Rmvl subq card rhythm mntr CPT 33286 | not published | not published | $678.00 – $1,447.81 | 31 |
| Rmvl tongs/halo anthr indiv CPT 20665 | not published | not published | $384.53 – $821.13 | 31 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $2,025.75 | $5,475.00 | $14.02 – $25.16 | 5 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $1.21 | $3.26 | $0.07 – $0.11 | 4 |
| Rotavirus antibody CPT 86759 | not published | not published | $16.04 – $45.58 | 35 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $1,493.51 | $4,036.50 | $387.22 – $884.18 | 33 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | not published | not published | $1,242.82 – $3,044.09 | 2 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | $3,064.53 | $8,282.50 | $2,435.63 – $3,353.85 | 2 |
| Rpm tx mgmt 1st 20 min CPT 99457 | not published | not published | $117.18 – $117.18 | 2 |
| Rpm tx mgmt ea addl 20 min CPT 99458 | not published | not published | $95.13 – $95.13 | 2 |
| Rpr&refitg spect xcp aphakia CPT 92370 | not published | not published | $71.58 – $71.58 | 2 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $27.80 – $122.22 | 33 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $215.98 – $533.34 | 32 |
| Rsv assay w/optic CPT 87807 | $43.48 | $117.50 | $11.53 – $32.75 | 35 |
| Rsv vacc mrna lipid nano im CPT 90683 | not published | not published | $424.56 – $487.20 | 4 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | $228.85 | $618.50 | $47.23 – $265.19 | 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.