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 |
|---|---|---|---|---|
| Storage/year embryo(s) CPT 89342 | not published | not published | $143.50 – $352.62 | 32 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $165.13 – $352.62 | 32 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $143.50 – $352.62 | 32 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $143.50 – $352.62 | 32 |
| Strapping of ankle and/or ft 29540 CPT 29540 | not published | not published | $152.05 – $324.70 | 31 |
| Strapping of chest CPT 29200 | not published | not published | $152.05 – $324.70 | 31 |
| Strapping of elbow or wrist 29260 CPT 29260 | not published | not published | $57.24 – $122.22 | 31 |
| Strapping of hand or finger CPT 29280 | not published | not published | $57.24 – $122.22 | 31 |
| Strapping of hip CPT 29520 | not published | not published | $124.21 – $265.25 | 31 |
| Strapping of knee CPT 29530 | not published | not published | $124.21 – $265.25 | 31 |
| Strapping of toes 29550 CPT 29550 | not published | not published | $57.24 – $122.22 | 31 |
| Strep a ag ia CPT 87430 | $54.39 | $147.00 | $14.79 – $42.03 | 35 |
| Strep a dna dir probe CPT 87650 | not published | not published | $17.64 – $50.13 | 35 |
| Strep a dna quant CPT 87652 | not published | not published | $36.75 – $104.40 | 35 |
| Strep b assay w/optic CPT 87802 | not published | not published | $11.20 – $31.83 | 35 |
| Strep b dna amp probe CPT 87653 | $68.82 | $186.00 | $30.88 – $87.73 | 35 |
| Streptokinase antibody CPT 86590 | not published | not published | $11.14 – $31.65 | 35 |
| Streptozocin injection HCPCS J9320 | $272.69 | $737.00 | $534.33 – $534.33 | 3 |
| Stress test pulmonary CPT 94618 | $358.90 | $970.00 | $29.30 – $265.25 | 33 |
| Stress tte complete CPT 93351 | $3,220.20 | $8,703.25 | $340.73 – $1,636.00 | 34 |
| Str markers spec anal addl CPT 81266 | not published | not published | $268.23 – $762.03 | 35 |
| Str markers specimen anal CPT 81265 | not published | not published | $205.10 – $582.68 | 35 |
| St treatment speech individual CPT 92507 | $255.30 | $690.00 | $70.64 – $183.95 | 33 |
| St treatment swallow dysfunction/oral CPT 92526 | not published | not published | $77.71 – $202.38 | 33 |
| Subdural tap fontanelle/sutur infant init 61000 CPT 61000 | not published | not published | $667.33 – $1,425.04 | 31 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | not published | not published | $929.10 – $929.10 | 2 |
| Subq njx filling matrl 1cc/< CPT 11950 | not published | not published | $191.47 – $408.87 | 31 |
| Subq njx fil matrl 5.1-10cc CPT 11952 | not published | not published | $589.86 – $1,259.60 | 31 |
| Subsequent intensive care infant 1500-2500 grams 99479 CPT 99479 | not published | not published | $289.55 – $289.55 | 2 |
| Subsequent intensive care infant 2501-5000 grams 99480 CPT 99480 | not published | not published | $279.20 – $279.20 | 2 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $19.30 | $52.17 | $1.23 – $1.93 | 4 |
| Sugars multiple quant CPT 84379 | not published | not published | $10.15 – $28.83 | 35 |
| Sugars single quant CPT 84378 | $9.99 | $27.00 | $10.15 – $28.83 | 35 |
| Sulfonylurea screen qn-sendout CPT 80377 | not published | not published | $56.25 – $56.25 | 2 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $48.14 | $130.10 | $74.97 – $74.97 | 3 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $37.98 – $94.94 | 33 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $175.65 – $175.65 | 2 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $152.20 – $152.20 | 2 |
| Surgical opening of stomach CPT 43510 | not published | not published | $903.46 – $1,929.25 | 31 |
| Surgical pathology level 1 gross examination only CPT 88300 | $12.86 | $34.75 | $9.46 – $50.39 | 35 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $22.11 | $59.75 | $20.28 – $80.77 | 35 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $25.25 | $68.25 | $25.08 – $109.94 | 35 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $43.11 | $116.50 | $26.88 – $109.94 | 35 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $74.74 | $202.00 | $162.67 – $740.21 | 35 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $187.59 | $507.00 | $229.36 – $1,680.98 | 35 |
| Surgigraft, 1 sq cm HCPCS Q4183 | $8,041.03 | $21,732.50 | $127.50 – $212.50 | 6 |
| Susceptibility agar dilution per agent CPT 87181 | $19.98 | $54.00 | $4.18 – $11.88 | 35 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $13.23 | $35.75 | $4.18 – $11.88 | 35 |
| Susceptibility mic per plate CPT 87186 | $39.78 | $107.50 | $7.61 – $21.63 | 35 |
| Suscept studies macrobroth dilution ea CPT 87188 | $62.72 | $169.50 | $5.84 – $16.60 | 35 |
| Svc venogram s&i CPT 75827 | not published | not published | $218.05 – $3,433.34 | 2 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $2.24 – $109.94 | 35 |
| Synch audio-only est high 40 CPT 98015 | not published | not published | $326.53 – $326.53 | 2 |
| Synch audio-only est low 20 CPT 98013 | not published | not published | $152.80 – $152.80 | 2 |
| Synch audio-only est mod 30 CPT 98014 | not published | not published | $224.93 – $224.93 | 2 |
| Synch audio-only est sf 10 CPT 98012 | not published | not published | $87.73 – $87.73 | 2 |
| Synch audio-only new high 60 CPT 98011 | not published | not published | $395.68 – $395.68 | 2 |
| Synch audio-only new low 30 CPT 98009 | not published | not published | $194.88 – $194.88 | 2 |
| Synch audio-only new mod 45 CPT 98010 | not published | not published | $305.13 – $305.13 | 2 |
| Synch audio-only new sf 15 CPT 98008 | not published | not published | $117.05 – $117.05 | 2 |
| Synthetic sentence id test CPT 92576 | not published | not published | $37.82 – $103.80 | 33 |
| Synvisc or synvisc-one HCPCS J7325 | $14.43 | $39.00 | $11.29 – $13.74 | 4 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $11.19 | $30.25 | $3.87 – $11.00 | 35 |
| T3 (triiodothyronine) free CPT 84481 | $16.28 | $44.00 | $14.91 – $42.35 | 35 |
| T3 (triiodothyronine) total CPT 84480 | $145.69 | $393.75 | $12.48 – $35.45 | 35 |
| T4 (thyroxine) free CPT 84439 | $128.95 | $348.50 | $7.94 – $22.55 | 35 |
| T4 (thyroxine) total CPT 84436 | $137.18 | $370.75 | $6.04 – $17.18 | 35 |
| Tacrol astagraf ex rel oral HCPCS J7508 | $0.44 | $1.20 | $0.86 – $0.86 | 3 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $2.80 | $7.57 | $0.27 – $0.27 | 3 |
| Tacrolimus therapeutic drug level CPT 80197 | $61.42 | $166.00 | $12.08 – $34.33 | 35 |
| Target gsa panel hmtlmph neop CPT 81450 | $888.00 | $2,400.00 | $668.39 – $1,898.83 | 35 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,569.25 – $7,299.00 | 4 |
| Target gsa panel organ neop CPT 81445 | $518.00 | $1,400.00 | $526.16 – $1,494.78 | 35 |
| Tattooing/intraderm 6.1-20.0 sq cm 11921 CPT 11921 | not published | not published | $589.86 – $1,259.60 | 31 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $0.69 | $1.88 | $0.45 – $0.88 | 5 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $120.56 – $342.50 | 35 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $89.15 – $89.15 | 1 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $21.38 – $21.38 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $84.84 – $194.81 | 32 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $84.84 – $194.81 | 32 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $88.00 – $250.00 | 35 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $110.08 | $297.50 | $54.54 – $154.95 | 35 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $5,342.71 | $14,439.75 | $1,269.19 – $5,141.90 | 6 |
| Tc-99m labeled rbc HCPCS A9560 | $174.64 | $472.00 | $128.65 – $280.20 | 6 |
| Tc-99m maa HCPCS A9540 | $394.05 | $1,065.00 | $35.92 – $90.00 | 6 |
| Tc-99m mebrofenin HCPCS A9537 | $146.52 | $396.00 | $22.88 – $84.63 | 5 |
| Tc-99m medronate HCPCS A9503 | $117.75 | $318.25 | $19.89 – $72.21 | 6 |
| Tc-99m mertiatide HCPCS A9562 | $862.19 | $2,330.25 | $937.24 – $1,424.15 | 3 |
| Tc-99m oxidronate HCPCS A9561 | $108.04 | $292.00 | $67.32 – $121.45 | 5 |
| Tc-99m pentetate dtpa HCPCS A9539 | $512.08 | $1,384.00 | $47.94 – $94.00 | 5 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $1.48 | $4.00 | $2.60 – $2.60 | 3 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $198.04 | $535.25 | $98.00 – $192.15 | 5 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $107.49 | $290.50 | $140.66 – $140.66 | 3 |
| Tc-99m sulfur colloid HCPCS A9541 | $356.68 | $964.00 | $409.07 – $802.10 | 5 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $116.55 | $315.00 | $130.47 – $313.80 | 6 |
| Tc-99m tilmanocept diag HCPCS A9520 | $1,656.03 | $4,475.75 | $1,012.22 – $1,296.65 | 5 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $589.86 – $1,259.60 | 31 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $102.47 – $1,146.00 | 34 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $102.47 – $1,146.00 | 34 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $550.45 – $1,146.00 | 3 |
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.