LEWISGALE HOSPITAL-MONTGOMERY
1145 W Main St, CHRISTIANSBURG, VA · HCA Virginia · · NPI 1275570376
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 |
|---|---|---|---|---|
| Urinalysis microscopic only CPT 81015 | not published | not published | $2.65 – $3.26 | 16 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $1.89 – $2.32 | 16 |
| Urinalysis (with microscopy) CPT 81001 | $206.00 | $206.00 | $2.76 – $3.39 | 16 |
| Urinalysis (without microscopy) CPT 81003 | not published | not published | $1.95 – $2.41 | 16 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $32.87 – $32.87 | 1 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $3.30 – $4.15 | 16 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $7.28 – $9.17 | 16 |
| Urinary suspensory HCPCS A5105 | not published | not published | $41.98 – $52.85 | 16 |
| Urine Culture Test CPT 87086 | $397.00 | $397.00 | $7.02 – $8.63 | 16 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $7.90 – $9.94 | 16 |
| Urine pregnancy test CPT 81025 | $215.00 | $215.00 | $7.49 – $9.21 | 16 |
| Urine screen for bacteria CPT 81007 | not published | not published | $26.09 – $32.08 | 16 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $3.00 – $9.99 | 13 |
| Urography, antegrade CPT 74425 | not published | not published | $100.08 – $828.27 | 2 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $97.67 – $401.74 | 2 |
| Use 1st target lesion CPT 76982 | not published | not published | $118.70 – $245.18 | 2 |
| User adjustable heel height HCPCS L5990 | not published | not published | $1,853.35 – $2,333.04 | 16 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $9,738.00 | $9,738.00 | $10.89 – $33.10 | 4 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $1,080.43 – $1,080.43 | 1 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $137.40 – $428.37 | 4 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $125.00 – $389.71 | 4 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $132.52 – $446.18 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $74.61 – $251.22 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $55.72 – $173.50 | 4 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $27.02 – $98.16 | 4 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $93.36 – $351.66 | 4 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $57.66 – $208.53 | 4 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $141.19 – $529.81 | 4 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $108.18 – $374.37 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $27.55 – $99.69 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $1,187.00 | $1,187.00 | $11.97 – $43.25 | 4 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $61.34 – $194.88 | 4 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $119.32 – $449.49 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $35.13 – $113.98 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $83.21 – $83.21 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $63.88 – $199.15 | 4 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $59.82 – $199.15 | 4 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $150.93 – $470.53 | 4 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $26.92 – $87.98 | 4 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $986.90 | $986.90 | $277.16 – $1,046.11 | 4 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $300.06 – $300.06 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $258.00 | $258.00 | $70.97 – $260.12 | 4 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $70.97 – $260.12 | 4 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | $178.00 | $178.00 | $18.58 – $58.49 | 4 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $19.00 – $61.53 | 4 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $31.32 – $131.18 | 4 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $9.29 – $29.23 | 4 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $213.65 – $798.76 | 4 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $665.00 | $665.00 | $171.43 – $717.99 | 4 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $562.81 – $562.81 | 1 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $152.59 – $561.54 | 4 |
| Vaccine mmr live subcutaneous CPT 90707 | $1,155.00 | $1,155.00 | $85.77 – $310.42 | 4 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $250.62 – $917.96 | 4 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $113.45 – $353.70 | 4 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $219.29 – $683.30 | 4 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $221.98 – $713.67 | 4 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $265.96 – $829.19 | 4 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $38.42 – $151.63 | 4 |
| Vaccine rabies im CPT 90675 | $3,524.00 | $3,524.00 | $270.02 – $847.34 | 4 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $265.79 – $1,014.63 | 4 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $468.30 – $1,892.29 | 4 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $468.30 – $1,892.29 | 4 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $264.89 – $974.19 | 4 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $132.46 – $495.05 | 4 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $89.04 – $326.32 | 4 |
| Vaccine tdap >=7 years im CPT 90715 | $409.00 | $409.00 | $33.21 – $105.18 | 4 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $161.00 | $161.00 | $28.87 – $103.27 | 4 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $440.93 – $440.93 | 1 |
| Vaccine varicella live subcutaneous CPT 90716 | not published | not published | $164.88 – $610.53 | 4 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $815.14 – $815.14 | 1 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.03 – $0.03 | 1 |
| Vacuum drain bottle/tube kit HCPCS A7048 | not published | not published | $50.03 – $62.98 | 16 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | not published | not published | $478.24 – $602.02 | 16 |
| Vad cable power module dc input HCPCS Q0478 | not published | not published | $187.74 – $236.33 | 16 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | not published | not published | $4,267.14 – $5,371.57 | 16 |
| Vag inser rectal control sys HCPCS A4563 | not published | not published | $1,394.25 – $1,755.12 | 16 |
| Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 | $156.00 | $156.00 | $0.13 – $0.13 | 1 |
| Valproic acid total therapeutic drug level CPT 80164 | $293.00 | $293.00 | $11.78 – $14.49 | 16 |
| Valrubicin injection HCPCS J9357 | not published | not published | $1,227.87 – $3,453.85 | 4 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | not published | not published | $0.08 – $0.08 | 1 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | not published | not published | $0.27 – $0.27 | 1 |
| Vancomycin hcl injection HCPCS J3370 | not published | not published | $1.66 – $1.89 | 3 |
| Vancomycin peak therapeutic drug level CPT 80202 | not published | not published | $11.78 – $14.49 | 16 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $30.54 – $37.55 | 16 |
| Vantas implant HCPCS J9225 | not published | not published | $12,480.25 – $12,480.25 | 1 |
| Variable concentration mask HCPCS A4620 | not published | not published | $0.73 – $0.92 | 16 |
| Varicella zoster antibody igg CPT 86787 | not published | not published | $11.21 – $13.78 | 16 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | $6,262.98 – $6,262.98 | 1 |
| Varus/valgus strap padded/li HCPCS L2270 | not published | not published | $53.92 – $67.88 | 16 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | not published | not published | $1.21 – $1.40 | 4 |
| Vedolizumab 300 mg intravenous solution HCPCS J3380 | $34,895.00 | $34,895.00 | $17.99 – $56.63 | 4 |
| Vein x-ray adrenal gland CPT 75840 | not published | not published | $221.14 – $6,438.74 | 2 |
| Vein x-ray eye socket CPT 75880 | not published | not published | $136.77 – $1,218.65 | 2 |
| Vein x-ray kidney CPT 75831 | $9,678.00 | $9,678.00 | $210.00 – $6,438.74 | 2 |
| Vein x-ray liver CPT 75891 | not published | not published | $212.25 – $6,438.74 | 2 |
| Vein x-ray liver w/hemodynam CPT 75885 | not published | not published | $266.19 – $6,438.74 | 2 |
| Vein x-ray liver w/hemodynam CPT 75889 | not published | not published | $210.79 – $6,438.74 | 2 |
| Vein x-ray liver without hemodyn CPT 75887 | not published | not published | $266.19 – $6,438.74 | 2 |
| Vein x-ray skull CPT 75870 | not published | not published | $259.54 – $6,438.74 | 2 |
| Vein x-ray skull epidural CPT 75872 | not published | not published | $221.14 – $1,218.65 | 2 |
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.