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 |
|---|---|---|---|---|
| Chemodener muscle larynx emg CPT 64617 | not published | not published | $667.33 – $1,425.04 | 31 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | not published | not published | $667.33 – $1,425.04 | 31 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | not published | not published | $667.33 – $1,425.04 | 31 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | not published | not published | $284.46 – $607.44 | 31 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $288.06 – $615.12 | 31 |
| Chemodenerv eccrine glands CPT 64653 | not published | not published | $284.46 – $607.44 | 31 |
| Chemodenerv eccrine glands 64650 CPT 64650 | not published | not published | $284.46 – $607.44 | 31 |
| Chemodenerv musc migraine 64615 CPT 64615 | not published | not published | $284.46 – $607.44 | 31 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | not published | not published | $284.46 – $607.44 | 31 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | not published | not published | $284.46 – $607.44 | 31 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | not published | not published | $667.33 – $1,425.04 | 31 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | not published | not published | $667.33 – $1,425.04 | 31 |
| Chemo extend IV infus w/pump HCPCS G0498 | $535.76 | $1,448.00 | $339.98 – $339.98 | 2 |
| Chemo ia infuse each addl hr CPT 96423 | $66.42 | $179.50 | $44.46 – $169.59 | 34 |
| Chemo ia infusion up to 1 hr CPT 96422 | $519.67 | $1,404.50 | $319.62 – $682.53 | 34 |
| Chemo ia push tecnique CPT 96420 | $841.57 | $2,274.50 | $223.01 – $682.53 | 34 |
| Chemo intralesional over 7 CPT 96406 | $499.50 | $1,350.00 | $103.50 – $433.55 | 34 |
| Chemo intralesional up to 7 96405 CPT 96405 | $164.37 | $444.25 | $66.09 – $190.80 | 34 |
| Chemotaxis assay CPT 86155 | not published | not published | $14.07 – $39.98 | 35 |
| Chemotherapy injection 96542 CPT 96542 | $207.94 | $562.00 | $96.51 – $682.53 | 34 |
| Chemotx admn pertl cav impl CPT 96446 | $421.43 | $1,139.00 | $61.85 – $682.53 | 34 |
| Chest 2 vws w oblique CPT 71048 | $214.23 | $579.00 | $82.99 – $235.69 | 33 |
| Chest apical lordotic proj CPT 71047 | $195.73 | $529.00 | $79.88 – $194.81 | 33 |
| Chest CT scan (with and without contrast) CPT 71270 | $738.98 | $1,997.25 | $171.54 – $783.00 | 33 |
| Chest CT scan (with contrast) CPT 71260 | $693.10 | $1,873.25 | $171.54 – $783.00 | 33 |
| Chest CT scan (without contrast) CPT 71250 | $647.32 | $1,749.50 | $102.47 – $783.00 | 33 |
| Chest X-ray CPT 71046 | $177.42 | $479.50 | $63.39 – $194.81 | 33 |
| Chest X-ray (single view) CPT 71045 | $163.73 | $442.50 | $47.93 – $194.81 | 33 |
| Chg pr pul rehab for copd patients CPT 94626 | not published | not published | $57.24 – $195.98 | 33 |
| Chg radiologic exam esophagus double contrast CPT 74221 | not published | not published | $171.54 – $393.89 | 33 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $182.57 – $518.65 | 35 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $229.49 – $651.98 | 35 |
| Chlamydia culture CPT 87110 | $37.00 | $100.00 | $17.25 – $49.00 | 35 |
| Chlamydia trachomatis ag if CPT 87270 | not published | not published | $10.54 – $29.95 | 35 |
| Chlamydia type CPT 87140 | $21.37 | $57.75 | $4.90 – $13.93 | 35 |
| Chloride CPT 82435 | $5.83 | $15.75 | $4.05 – $11.50 | 35 |
| Chloride 24 hour urine CPT 82436 | $34.60 | $93.50 | $5.06 – $14.38 | 35 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $723.91 | $1,956.50 | $39.63 – $90.69 | 4 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $48.29 | $130.50 | $35.43 – $45.72 | 4 |
| Chmotx admn plrl cav thrcnts CPT 96440 | $316.54 | $855.50 | $293.04 – $1,644.90 | 34 |
| Cholesterol CPT 82465 | $47.82 | $129.25 | $3.83 – $10.88 | 35 |
| Cholesterol body fluid CPT 84999 | $31.08 | $84.00 | $6.63 – $6.63 | 1 |
| Cholesterol (Lipid) Test CPT 80061 | $156.97 | $424.25 | $11.78 – $33.48 | 35 |
| Cholinesterase CPT 82480 | $3.70 | $10.00 | $6.92 – $19.68 | 35 |
| Cholinesterase challenge CPT 95857 | not published | not published | $148.70 – $640.79 | 33 |
| Chorion biopsy CPT 59015 | not published | not published | $839.07 – $1,791.76 | 31 |
| Chrom analysis CPT 88273 | not published | not published | $30.63 – $87.03 | 35 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $34.32 – $97.50 | 35 |
| Chromatography CPT 83021 | $25.53 | $69.00 | $15.89 – $45.15 | 35 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $10.46 – $29.73 | 35 |
| Chromo high res and frag x - sendout CPT 81243 | $36.63 | $99.00 | $50.20 – $142.60 | 35 |
| Chromosome analys amniotic CPT 88269 | not published | not published | $152.82 – $434.15 | 35 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $152.39 – $432.93 | 35 |
| Chromosome analysis 15-20 cell count CPT 88262 | $130.24 | $352.00 | $110.43 – $313.73 | 35 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $152.39 – $432.93 | 35 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $132.26 – $375.73 | 35 |
| Chromosome analysis 5 CPT 88261 | not published | not published | $232.62 – $660.85 | 35 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $152.39 – $432.93 | 35 |
| Chromosome analys placenta CPT 88267 | $66.23 | $179.00 | $165.94 – $471.43 | 35 |
| Chromosome banding study CPT 88283 | not published | not published | $60.37 – $171.50 | 35 |
| Chromosome count additional CPT 88285 | not published | not published | $23.68 – $67.28 | 35 |
| Chromosome karyotype study CPT 88280 | $13.69 | $37.00 | $29.45 – $83.68 | 35 |
| Chromosome study additional CPT 88289 | not published | not published | $30.30 – $86.08 | 35 |
| Chronic urticaria - sendout CPT 86343 | $55.50 | $150.00 | $10.97 – $31.15 | 35 |
| Chylomicron screen, bf - sendout CPT 82664 | not published | not published | $54.12 – $153.75 | 35 |
| Cidofovir injection HCPCS J0740 | $714.52 | $1,931.13 | $451.65 – $659.41 | 5 |
| Cinacalcet 30 mg tablet HCPCS J0604 | $22.76 | $61.50 | $0.03 – $1.21 | 4 |
| Cine/video x-rays CPT 76120 | not published | not published | $102.47 – $260.33 | 33 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $76.86 | $207.72 | $1.25 – $1.25 | 3 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $643.19 – $1,373.48 | 31 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $27.63 | $74.67 | $4.04 – $4.04 | 3 |
| C-kit mutation liquid tumor - sendout CPT 81272 | not published | not published | $289.97 – $823.78 | 35 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $490.72 – $1,047.90 | 31 |
| Clearance of airways CPT 31720 | not published | not published | $195.99 – $418.53 | 31 |
| Clearance of tear duct CPT 68530 | not published | not published | $288.06 – $615.12 | 31 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $124.21 – $265.25 | 33 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $124.21 – $265.25 | 33 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $124.21 – $265.25 | 33 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $37.82 – $197.20 | 33 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | not published | not published | $231.16 – $493.62 | 31 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | not published | not published | $231.16 – $493.62 | 31 |
| Closed tx humerus fx without manip 23600 CPT 23600 | not published | not published | $231.16 – $493.62 | 31 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | not published | not published | $231.16 – $493.62 | 31 |
| Closed tx orbit without manipulj CPT 21400 | not published | not published | $490.72 – $1,047.90 | 31 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $231.16 – $493.62 | 31 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | not published | not published | $231.16 – $493.62 | 31 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | not published | not published | $223.78 – $477.85 | 31 |
| Close tear duct opening CPT 68760 | not published | not published | $288.06 – $615.12 | 31 |
| Close tear duct opening CPT 68761 | not published | not published | $288.06 – $615.12 | 31 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $14.08 – $40.00 | 35 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | not published | not published | $490.72 – $1,047.90 | 31 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $933.31 – $1,993.01 | 31 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $595.78 – $1,272.23 | 31 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $16.66 – $47.33 | 35 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $17.97 – $51.05 | 35 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $16.66 – $47.33 | 35 |
| Clot factor xii hageman CPT 85280 | $46.25 | $125.00 | $17.03 – $48.38 | 35 |
| Clot factor xiii fibrin scrn CPT 85291 | $9.25 | $25.00 | $8.02 – $22.78 | 35 |
| Clot factor xiii fibrin stab CPT 85290 | $44.40 | $120.00 | $14.38 – $40.85 | 35 |
| Clotting assay whole blood CPT 85396 | not published | not published | $18.35 – $45.98 | 4 |
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.