Ascension Sacred Heart Gulf (Sacred Heart Health System, Inc.)
3801 US-98 Port St, Joe, FL · Ascension · · NPI 1083941678
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 |
|---|---|---|---|---|
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $1.60 | $4.00 | $0.08 – $0.17 | 4 |
| Levetiracetam therapeutic drug level CPT 80177 | not published | not published | $13.25 – $49.72 | 16 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $55.28 | $138.20 | $1.70 – $6.26 | 4 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $13.60 | $34.00 | $8.09 – $17.84 | 4 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | not published | $0.02 | $0.02 – $0.02 | 3 |
| Lidocaine therapeutic drug level CPT 80176 | $146.64 | $366.60 | $14.69 – $54.80 | 16 |
| Limb exercise test CPT 95875 | not published | not published | $168.20 – $311.17 | 12 |
| Limited visual field xm CPT 92081 | not published | not published | $63.86 – $118.14 | 12 |
| Lincomycin injection HCPCS J2010 | $6.93 | $17.33 | $10.10 – $10.30 | 3 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $85.54 | $213.86 | $4.47 – $9.86 | 4 |
| Lipase CPT 83690 | $59.92 | $149.80 | $6.89 – $25.52 | 16 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $33.86 – $127.44 | 16 |
| Lipoprotein blood quant CPT 83704 | not published | not published | $34.19 – $128.72 | 16 |
| Lipoprotein direct measurement hdl CPT 83718 | $45.73 | $114.33 | $8.19 – $30.60 | 16 |
| Lipoprotein direct measurement ldl CPT 83721 | $52.09 | $130.22 | $10.50 – $39.52 | 16 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $128.72 | 16 |
| Lip surgery procedure CPT 40799 | not published | not published | $249.65 – $461.85 | 12 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.19 – $49.72 | 16 |
| Lithium therapeutic drug level CPT 80178 | $46.94 | $117.35 | $6.61 – $25.52 | 16 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $325.95 | 14 |
| Liver elastography 91200 CPT 91200 | not published | not published | $168.20 – $311.17 | 12 |
| Liver Function Test CPT 80076 | $48.68 | $121.70 | $8.17 – $30.60 | 16 |
| Liver imaging CPT 78201 | not published | not published | $550.24 – $1,158.73 | 15 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $578.67 – $1,158.73 | 15 |
| Liver/spleen imag static only CPT 78215 | $1,740.80 | $4,352.00 | $431.99 – $884.18 | 15 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,301.60 | $3,254.00 | $331.65 – $884.18 | 15 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $3.47 | $8.67 | $1.53 – $2.38 | 4 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $15.80 | $39.50 | $2.03 – $4.47 | 4 |
| Loudness balance test CPT 92562 | not published | not published | $334.77 – $619.32 | 12 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,635.20 | $4,088.00 | $191.38 – $525.56 | 15 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,373.60 | $3,434.00 | $383.93 – $824.45 | 15 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,246.00 | $3,115.00 | $114.32 – $331.78 | 15 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,009.60 | $2,524.00 | $383.93 – $824.45 | 15 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,278.00 | $3,195.00 | $383.93 – $824.45 | 15 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,009.60 | $2,524.00 | $259.86 – $525.31 | 15 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $226.80 | $567.00 | $85.04 – $235.69 | 15 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $213.61 – $395.18 | 12 |
| L/s ratio fetal lung CPT 83661 | $21.55 | $53.87 | $21.99 – $82.84 | 16 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $204.47 – $4,139.17 | 3 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $63.86 – $118.14 | 12 |
| Lung Function Test (Spirometry) CPT 94010 | not published | not published | $168.20 – $311.17 | 12 |
| Lung perfusion imaging CPT 78580 | $693.60 | $1,734.00 | $431.99 – $884.18 | 15 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $26.33 – $48.71 | 12 |
| Lymphatics/lymph node imaging CPT 78195 | $2,392.00 | $5,980.00 | $578.67 – $1,158.73 | 15 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $36.56 – $137.64 | 16 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $49.03 – $184.76 | 16 |
| Lymphocytotoxicity assay CPT 86805 | $102.34 | $255.84 | $189.51 – $712.28 | 16 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $664.66 – $1,346.74 | 14 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $3,433.34 – $3,433.34 | 2 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $6,833.27 – $6,833.27 | 2 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $6,833.27 – $6,833.27 | 2 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $547.47 – $1,012.82 | 12 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $7.22 – $30.00 | 4 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $4.27 – $16.56 | 16 |
| Macroscopic exam parasite CPT 87169 | $35.52 | $88.81 | $4.31 – $16.56 | 16 |
| Magnesium CPT 83735 | $46.14 | $115.36 | $6.70 – $25.52 | 16 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $7.20 | $18.00 | $0.74 – $1.62 | 4 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $259.86 – $728.87 | 15 |
| Makena, 10 mg HCPCS J1726 | $120.48 | $301.20 | $22.80 – $80.30 | 3 |
| Malaria antibody CPT 86750 | not published | not published | $13.19 – $49.72 | 16 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | not published | not published | $138.57 – $256.35 | 12 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | not published | not published | $138.57 – $256.35 | 12 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $257.88 – $477.08 | 12 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $47.70 | $119.26 | $3.73 – $8.41 | 4 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $5.07 – $19.12 | 16 |
| Map tachycard site(s) CPT 93609 | not published | not published | $4,115.00 – $4,572.00 | 2 |
| Mastoids complete CPT 70130 | $430.40 | $1,076.00 | $114.32 – $235.69 | 15 |
| Matrion 1 sq cm HCPCS Q4201 | $2,705.52 | $6,763.79 | $127.55 – $142.48 | 3 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $24.65 | $61.63 | $30.84 – $35.48 | 3 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $35.09 – $132.52 | 16 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $27.29 – $103.20 | 16 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $24.00 | $60.00 | $14.46 – $54.80 | 16 |
| Mayo aathr protein s free CPT 85306 | $291.47 | $728.67 | $15.32 – $57.36 | 16 |
| Mayo activated protein c resistance assay CPT 85307 | $25.51 | $63.77 | $15.32 – $57.36 | 16 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $96.00 | $240.00 | $38.57 – $145.28 | 16 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $127.20 | $317.99 | $90.48 – $90.48 | 1 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $6.00 | $15.00 | $14.78 – $56.08 | 16 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | not published | not published | $90.48 – $90.48 | 1 |
| Mayo alpha 1 antitrypsin CPT 82103 | $22.40 | $56.00 | $13.44 – $50.96 | 16 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $142.96 | $357.39 | $15.08 – $57.36 | 16 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $90.48 – $90.48 | 1 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $202.40 | $506.00 | $121.63 – $457.44 | 16 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $152.80 | $382.00 | $91.66 – $344.04 | 16 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | not published | not published | $137.00 – $514.80 | 16 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $658.00 | $1,645.00 | $1,160.00 – $4,361.44 | 4 |
| Mayo androstenedione CPT 82157 | not published | not published | $29.28 – $109.60 | 16 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $33.18 | $82.95 | $14.60 – $54.80 | 16 |
| Mayo antithrombin iii antigen CPT 85301 | $5.20 | $13.00 | $10.81 – $40.80 | 16 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $64.93 | $162.32 | $15.05 – $56.08 | 16 |
| Mayo avwpr vw factor activity CPT 85397 | $26.00 | $65.00 | $30.86 – $115.96 | 16 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | not published | not published | $35.09 – $132.52 | 15 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $78.27 | $195.67 | $90.48 – $90.48 | 1 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $115.50 | $288.75 | $10.18 – $38.24 | 16 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $382.93 | $957.33 | $144.84 – $544.08 | 16 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $110.00 | $275.00 | $214.62 – $806.56 | 16 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | not published | not published | $12.90 – $48.44 | 16 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | $59.20 | $148.00 | $90.48 – $90.48 | 1 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $13.02 | $32.55 | $13.19 – $49.72 | 16 |
| Mayo brcmg brucella antibody igm CPT 86622 | $5.09 | $12.73 | $8.93 – $33.16 | 16 |
| Mayo c1 esterase inhibitor CPT 83883 | $35.96 | $89.90 | $13.60 – $50.96 | 16 |
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.