Ascension St. Vincent's St. Johns County (St. Vincent's Health System, Inc.)
205 Trinity Way, Saint Johns, FL · Ascension · · NPI 1861078651
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 |
|---|---|---|---|---|
| Leukacyte transfusion CPT 86950 | not published | not published | $124.68 – $352.62 | 30 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $9.14 – $25.98 | 31 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $41.80 | $112.98 | $0.08 – $0.08 | 3 |
| Levetiracetam therapeutic drug level CPT 80177 | $19.61 | $53.00 | $11.66 – $33.13 | 31 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $39.96 | $108.00 | $1.26 – $2.84 | 4 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $21.57 | $58.30 | $8.09 – $8.09 | 3 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $610.45 – $610.45 | 2 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $48.29 | $130.50 | $0.02 – $0.07 | 4 |
| Lidocaine therapeutic drug level CPT 80176 | $9.62 | $26.00 | $12.93 – $36.73 | 31 |
| Limb exercise test CPT 95875 | not published | not published | $143.35 – $321.95 | 29 |
| Limited autopsy CPT 88036 | not published | not published | $103.58 – $238.68 | 3 |
| Limited autopsy CPT 88037 | not published | not published | $92.03 – $212.08 | 3 |
| Limited visual field xm CPT 92081 | not published | not published | $40.73 – $122.22 | 29 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $48.64 | $131.47 | $4.23 – $4.47 | 4 |
| Lipase CPT 83690 | $66.79 | $180.50 | $6.06 – $17.23 | 31 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $29.80 – $84.65 | 31 |
| Lipoprotein blood quant CPT 83704 | $29.69 | $80.25 | $30.09 – $85.48 | 31 |
| Lipoprotein direct measurement hdl CPT 83718 | $45.88 | $124.00 | $7.21 – $20.48 | 31 |
| Lipoprotein direct measurement ldl CPT 83721 | $21.37 | $57.75 | $9.24 – $26.25 | 31 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $30.09 – $85.48 | 31 |
| Lip surgery procedure CPT 40799 | not published | not published | $228.44 – $477.85 | 27 |
| Listeria monocytogenes CPT 86723 | not published | not published | $11.61 – $32.98 | 31 |
| Lithium therapeutic drug level CPT 80178 | $80.38 | $217.25 | $5.82 – $16.53 | 31 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $2,496.21 | $6,746.50 | $353.98 – $353.98 | 2 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $172.67 – $440.48 | 30 |
| Liver elastography 91200 CPT 91200 | not published | not published | $46.05 – $321.95 | 29 |
| Liver Function Test CPT 80076 | $50.14 | $135.50 | $7.19 – $20.43 | 31 |
| Liver imaging CPT 78201 | not published | not published | $503.55 – $1,158.73 | 29 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $529.49 – $1,158.73 | 29 |
| Liver/spleen imag static only CPT 78215 | $1,550.95 | $4,191.75 | $395.28 – $884.18 | 29 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $303.51 – $884.18 | 29 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $173.45 – $173.45 | 2 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $36.99 | $99.96 | $1.92 – $2.03 | 4 |
| Loudness balance test CPT 92562 | not published | not published | $113.68 – $640.79 | 29 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $693.10 | $1,873.25 | $175.12 – $783.00 | 29 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $647.32 | $1,749.50 | $351.31 – $824.45 | 29 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $601.44 | $1,625.50 | $104.61 – $783.00 | 29 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $934.81 | $2,526.50 | $351.31 – $824.45 | 29 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $888.93 | $2,402.50 | $351.31 – $824.45 | 29 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,136.27 | $3,071.00 | $237.78 – $525.31 | 29 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $327.27 | $884.50 | $77.83 – $235.69 | 29 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $195.46 – $935.83 | 29 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $19.35 – $54.98 | 31 |
| Lumbar diskogram s&i CPT 72295 | $2,805.80 | $7,583.25 | $187.12 – $4,139.17 | 2 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $28.55 – $122.22 | 29 |
| Lung Function Test (Spirometry) CPT 94010 | $233.56 | $631.25 | $44.50 – $321.95 | 29 |
| Lung perfusion imaging CPT 78580 | $1,550.95 | $4,191.75 | $395.28 – $884.18 | 29 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $24.09 – $50.39 | 27 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $17.64 – $50.13 | 31 |
| Lymphatics/lymph node imaging CPT 78195 | $1,550.95 | $4,191.75 | $529.49 – $1,158.73 | 29 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $32.17 – $91.40 | 31 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $43.15 – $122.58 | 31 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $166.77 – $473.78 | 31 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $41.88 – $118.98 | 31 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $608.19 – $1,346.74 | 28 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $3,433.34 – $3,433.34 | 1 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $6,833.27 – $6,833.27 | 1 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $6,833.27 – $6,833.27 | 1 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $500.95 – $1,047.90 | 27 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $6.15 – $17.15 | 4 |
| Macroscopic exam arthropod CPT 87168 | $25.25 | $68.25 | $3.76 – $10.68 | 31 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $3.79 – $10.78 | 31 |
| Magnesium CPT 83735 | $40.05 | $108.25 | $5.90 – $16.75 | 31 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $24.14 | $65.25 | $0.60 – $0.74 | 4 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $237.78 – $667.03 | 29 |
| Malaria antibody CPT 86750 | not published | not published | $11.61 – $32.98 | 31 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $97.59 | $263.75 | $89.03 – $265.25 | 29 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $95.83 | $259.00 | $58.63 – $265.25 | 29 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $235.97 – $493.62 | 27 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $48.29 | $130.50 | $2.76 – $3.81 | 4 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $4.46 – $12.68 | 31 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $254.75 – $254.75 | 2 |
| Map tachycard site(s) CPT 93609 | not published | not published | $4,669.75 – $21,907.00 | 3 |
| Mastoids complete CPT 70130 | $217.19 | $587.00 | $104.61 – $235.69 | 29 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $4,371.37 | $11,814.50 | $26.23 – $53.74 | 6 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $30.88 – $87.73 | 31 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $24.02 – $68.23 | 31 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $37.70 – $107.10 | 31 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $15.54 | $42.00 | $12.73 – $36.15 | 31 |
| Mayo aathr protein s free CPT 85306 | $43.48 | $117.50 | $13.48 – $38.30 | 31 |
| Mayo activated protein c resistance assay CPT 85307 | $35.71 | $96.50 | $13.48 – $38.30 | 31 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $57.08 | $154.28 | $33.94 – $96.43 | 31 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | not published | not published | $33.68 – $33.68 | 2 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $62.16 | $168.00 | $56.25 – $56.25 | 2 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $5.55 | $15.00 | $13.01 – $36.95 | 31 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $25.90 | $70.00 | $56.25 – $56.25 | 2 |
| Mayo alpha 1 antitrypsin CPT 82103 | $15.73 | $42.50 | $11.83 – $33.60 | 31 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $80.38 | $217.25 | $13.27 – $37.70 | 31 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $32.50 – $32.50 | 2 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $56.25 – $56.25 | 2 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $172.05 | $465.00 | $107.03 – $304.08 | 31 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $96.57 | $261.00 | $80.66 – $229.15 | 31 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $202.76 | $548.00 | $120.56 – $342.50 | 31 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | not published | not published | $1,020.80 – $2,900.00 | 4 |
| Mayo androstenedione CPT 82157 | not published | not published | $25.77 – $73.20 | 31 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $4.81 | $13.00 | $12.85 – $36.50 | 31 |
| Mayo antithrombin iii antigen CPT 85301 | $18.50 | $50.00 | $9.51 – $27.03 | 31 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $22.27 | $60.20 | $13.24 – $37.63 | 31 |
| Mayo avwpr vw factor activity CPT 85397 | $74.00 | $200.00 | $27.16 – $77.15 | 31 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | not published | not published | $34.39 – $87.73 | 30 |
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.