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 |
|---|---|---|---|---|
| T-cell depletion of harvest CPT 38210 | not published | not published | $421.28 – $899.60 | 31 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | not published | not published | $41.34 – $117.45 | 35 |
| T cells absolute cd 4 count CPT 86361 | $47.55 | $128.50 | $23.57 – $66.95 | 35 |
| T cells total count CPT 86359 | not published | not published | $33.20 – $94.33 | 35 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $300.08 – $640.79 | 33 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $300.08 – $708.10 | 33 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $300.08 – $640.79 | 33 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $84.25 – $84.25 | 2 |
| Team conf without pat by phys CPT 99367 | not published | not published | $128.75 – $128.75 | 2 |
| Team conf w/pat by hc prof CPT 99366 | not published | not published | $97.65 – $97.65 | 2 |
| Telethx isodose plan cplx CPT 77307 | not published | not published | $352.75 – $753.27 | 32 |
| Telethx isodose plan simple CPT 77306 | not published | not published | $219.56 – $753.27 | 32 |
| Temperature gradient studies CPT 93740 | not published | not published | $18.68 – $321.95 | 33 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $280.13 | $757.11 | $198.20 – $355.72 | 5 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $48.29 | $130.50 | $1.72 – $3.21 | 4 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $162.98 – $463.00 | 35 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $5.29 – $15.03 | 35 |
| Test for porphobilinogen CPT 84106 | not published | not published | $5.12 – $14.55 | 35 |
| Test for urine cystines CPT 82615 | not published | not published | $8.40 – $23.88 | 35 |
| Testicular imaging w/vasc flow CPT 78761 | not published | not published | $387.22 – $884.18 | 33 |
| Testosterone response panel CPT 80414 | not published | not published | $45.44 – $129.10 | 35 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $41.53 | $112.25 | $35.50 – $35.50 | 1 |
| Test stress cardiovascular tracing only CPT 93017 | $1,382.69 | $3,737.00 | $88.28 – $1,636.00 | 34 |
| Test urine for lactose CPT 83633 | not published | not published | $9.90 – $28.13 | 35 |
| Test urine for porphyrins CPT 84119 | not published | not published | $11.76 – $33.40 | 35 |
| Test urine urobilinogen CPT 84578 | not published | not published | $3.93 – $11.18 | 35 |
| Tetanus ig im CPT 90389 | not published | not published | $950.38 – $1,338.53 | 6 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $22.17 | $59.92 | $21.68 – $39.77 | 5 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $120.56 – $342.50 | 35 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $729.15 – $1,898.83 | 34 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $2,919.60 – $7,299.00 | 3 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $573.99 – $1,494.78 | 34 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $143.50 – $352.62 | 32 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $143.50 – $352.62 | 32 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $143.50 – $352.62 | 32 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $49.47 – $109.94 | 32 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $421.28 – $899.60 | 31 |
| Theophylline therapeutic drug level CPT 80198 | $63.73 | $172.25 | $12.44 – $35.35 | 35 |
| Therapy activation ipnss CPT 93150 | not published | not published | $88.45 – $1,636.00 | 34 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | not published | not published | $33.26 – $86.63 | 33 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | not published | not published | $29.02 – $75.58 | 33 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $191.47 – $408.87 | 33 |
| Ther nma rdctj intus/obstrcj CPT 74283 | not published | not published | $171.54 – $419.09 | 33 |
| Ther/proph/diag inj ia CPT 96373 | $333.83 | $902.25 | $44.58 – $433.55 | 33 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $527.75 – $527.75 | 1 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $336.73 – $336.73 | 1 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $222.39 – $222.39 | 1 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $44.24 | $119.56 | $2.15 – $2.64 | 4 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | not published | not published | $595.78 – $1,272.23 | 31 |
| Thoracoscopy diagnostic 32601 CPT 32601 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Thoracoscopy/thoracic sympathectomy32664 CPT 32664 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Thoracoscopy w/bx med space CPT 32606 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Thoracoscopy wbx sac CPT 32604 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Thorcscpy w/biop pleura CPT 32609 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Thrcspy w/diag bp lng inf uni CPT 32607 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Thrcspy w/diag bp lng nod uni CPT 32608 | not published | not published | $5,618.00 – $5,618.00 | 1 |
| Throat x-ray & fluoroscopy CPT 70370 | not published | not published | $84.84 – $213.91 | 33 |
| Thrombectmy crnry perq mechanical CPT 92973 | not published | not published | $438.50 – $438.50 | 2 |
| Thrombin time CPT 85670 | $37.65 | $101.75 | $5.08 – $14.43 | 35 |
| Thrombin time titer CPT 85675 | not published | not published | $6.03 – $17.13 | 35 |
| Thrombomodulin CPT 85337 | not published | not published | $15.20 – $43.18 | 35 |
| Thromboplastin inhibition CPT 85705 | not published | not published | $8.47 – $24.08 | 35 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $40.79 | $110.25 | $5.69 – $16.18 | 35 |
| Thromboxane urine CPT 84431 | not published | not published | $30.90 – $87.78 | 35 |
| Thyroglobulin antibody CPT 86800 | $41.16 | $111.25 | $14.00 – $39.78 | 35 |
| Thyroid imaging CPT 78013 | not published | not published | $387.22 – $884.18 | 33 |
| Thyroid met imaging CPT 78015 | not published | not published | $387.22 – $884.18 | 33 |
| Thyroid met imaging/studies CPT 78016 | not published | not published | $387.22 – $884.18 | 33 |
| Thyroid mets imag whole body CPT 78018 | $1,665.83 | $4,502.25 | $518.69 – $1,158.73 | 33 |
| Thyroid met uptake CPT 78020 | not published | not published | $163.90 – $163.90 | 1 |
| Thyroid (TSH) Test CPT 84443 | $36.17 | $97.75 | $14.78 – $42.00 | 35 |
| Thyroid Ultrasound CPT 76536 | $656.01 | $1,773.00 | $102.47 – $255.16 | 33 |
| Thyroid uptake measurement CPT 78012 | not published | not published | $213.87 – $884.18 | 33 |
| Thyrotropin releasing hormone CPT 80438 | not published | not published | $44.36 – $126.03 | 35 |
| Thyroxine binding globulin (tbg) CPT 84442 | $5.18 | $14.00 | $13.01 – $36.95 | 35 |
| Tic-brn enceph vac 0.25ml im CPT 90626 | not published | not published | $486.24 – $486.24 | 3 |
| Tic-brn enceph vac 0.5ml im CPT 90627 | not published | not published | $486.24 – $486.24 | 3 |
| Tigecycline injection HCPCS J3243 | $7.44 | $20.12 | $0.37 – $0.95 | 4 |
| Tilt table study CPT 93660 | not published | not published | $171.55 – $1,091.85 | 33 |
| Tiss ex molecul study add-on CPT 88388 | not published | not published | $31.73 – $31.73 | 2 |
| Tissue culture placenta CPT 88235 | $66.23 | $179.00 | $132.27 – $375.75 | 35 |
| Tissue culture skin/biopsy CPT 88233 | $61.05 | $165.00 | $123.84 – $351.83 | 35 |
| Tissue culture tumor CPT 88239 | $93.98 | $254.00 | $129.82 – $368.80 | 35 |
| Tissue exam koh skin/hair/nails CPT 87220 | $22.11 | $59.75 | $3.76 – $10.68 | 35 |
| Tissue transglutaminase iga CPT 86364 | $17.06 | $46.12 | $11.07 – $28.83 | 34 |
| Tl-201 thallium diag per mci HCPCS A9505 | $137.09 | $370.50 | $49.97 – $186.98 | 5 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $54.10 | $146.21 | $1.95 – $2.96 | 4 |
| Tobramycin peak therapeutic drug level CPT 80200 | $86.67 | $234.25 | $14.20 – $40.33 | 35 |
| Tocilizumab 162 mg/0.9 ml subcutaneous pen injector HCPCS J3262 | $26.07 | $70.45 | $7.17 – $13.07 | 5 |
| Tocilizumab for covid-19 HCPCS Q0249 | $17.57 | $47.49 | $10.16 – $18.93 | 5 |
| Tomosynthesis breast screen bilateral CPT 77063 | $114.15 | $308.50 | $21.01 – $72.18 | 33 |
| Tone decay hearing test CPT 92563 | not published | not published | $37.82 – $81.75 | 33 |
| Topotecan 4 mg/4 ml (1 mg/ml) intravenous solution HCPCS J9351 | $12.26 | $33.13 | $1.55 – $2.67 | 4 |
| Total Hip Replacement CPT 27130 | not published | not published | $26,877.00 – $32,093.00 | 3 |
| Total Knee Replacement CPT 27447 | not published | not published | $26,877.00 – $32,093.00 | 3 |
| Total tau CPT 84394 | not published | not published | not published | 0 |
| Tot estradiol response panel CPT 80415 | not published | not published | $49.18 – $139.73 | 35 |
| Toxoplasma antibody igg CPT 86777 | $21.30 | $57.56 | $12.66 – $35.98 | 35 |
| Toxoplasma antibody igm CPT 86778 | not published | not published | $12.68 – $36.03 | 35 |
| Tp53 gene full gene sequence CPT 81351 | not published | not published | $616.18 – $1,604.63 | 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.