Dickenson Community Hospital
312 HOSPITAL DR., CLINTWOOD, VA · Balladhealth · · NPI 1285685727
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 |
|---|---|---|---|---|
| MRI orbit/face/neck without & w/contrast CPT 70543 | $656.19 | $2,853.00 | $480.63 – $786.00 | 6 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $593.63 | $2,581.00 | $304.57 – $786.00 | 6 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $656.19 | $2,853.00 | $480.63 – $786.00 | 6 |
| Mr safety determination physician/other qhp CPT 76016 | $39.10 | $170.00 | $79.25 – $170.00 | 3 |
| Mr safety implant elec prepj CPT 76018 | $38.87 | $169.00 | $82.61 – $169.00 | 3 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $5.52 | $24.00 | $24.00 – $24.00 | 2 |
| Mr safety implt pos&/immoblj CPT 76019 | $25.30 | $110.00 | $53.46 – $110.00 | 3 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $10.81 | $47.00 | $22.04 – $47.00 | 3 |
| Mr sfty med physics xm cstmz CPT 76017 | $102.35 | $445.00 | $217.55 – $445.00 | 3 |
| Msh2 gene dup/delete variant CPT 81297 | $116.84 | $508.00 | $136.54 – $469.88 | 6 |
| Msh2 gene full seq CPT 81295 | $2,268.72 | $9,864.00 | $136.54 – $841.59 | 6 |
| Msh6 gene dup/delete variant CPT 81300 | $124.89 | $543.00 | $145.51 – $524.73 | 6 |
| Msh6 gene full seq CPT 81298 | $2,550.93 | $11,091.00 | $259.05 – $1,414.69 | 6 |
| Msh6 gene known variants CPT 81299 | $203.09 | $883.00 | $145.12 – $679.19 | 6 |
| Mthfr gene analy common variants CPT 81291 | $75.21 | $327.00 | $53.60 – $144.36 | 6 |
| Mucopolysaccharides CPT 83864 | $34.27 | $149.00 | $25.38 – $62.79 | 6 |
| Mumps antibody igg CPT 86735 | $22.31 | $97.00 | $13.05 – $28.87 | 6 |
| Mycophenolate mofetil 250 mg capsule HCPCS J7517 | $2.33 | $10.13 | $0.28 – $2.79 | 2 |
| Mycoplasma antibody igm CPT 86738 | $23.00 | $100.00 | $13.24 – $28.87 | 6 |
| Myd88 gene p.leu265pro vrnt CPT 81305 | $221.03 | $961.00 | $157.86 – $386.87 | 6 |
| Myeloperoxidase ab multi step qualitative/semiquantitative CPT 83516 | $19.55 | $85.00 | $11.53 – $25.26 | 6 |
| Naloxone 0.4 mg/ml injection (wrapper) HCPCS J2312 | $443.48 | $1,928.16 | $0.14 – $0.14 | 1 |
| Natriuretic peptide CPT 83880 | $58.42 | $254.00 | $39.26 – $86.61 | 6 |
| Natural killer cells total count CPT 86357 | $64.63 | $281.00 | $37.73 – $83.00 | 6 |
| Neck (Cervical Spine) CT scan (with contrast) CPT 72126 | $549.24 | $2,388.00 | $270.44 – $606.37 | 6 |
| Neck (Cervical Spine) CT scan (without contrast) CPT 72125 | $521.87 | $2,269.00 | $172.70 – $427.00 | 6 |
| Neck (Cervical Spine) MRI (with and without contrast) CPT 72156 | $656.19 | $2,853.00 | $480.63 – $786.00 | 6 |
| Neck (Cervical Spine) MRI (with contrast) CPT 72142 | $624.68 | $2,716.00 | $392.26 – $786.00 | 6 |
| Neck (Cervical Spine) MRI (without contrast) CPT 72141 | $593.63 | $2,581.00 | $304.57 – $786.00 | 6 |
| Neck MRA (blood vessel MRI, with and without contrast) CPT 70549 | $656.19 | $2,853.00 | $480.63 – $965.96 | 6 |
| Neck MRA (blood vessel MRI, without contrast) CPT 70547 | $593.63 | $2,581.00 | $304.57 – $965.96 | 6 |
| Neisseria meningitidis CPT 86741 | $21.85 | $95.00 | $13.19 – $28.87 | 6 |
| Nerobehav stas exam by psy/md f2f 1st hr CPT 96116 | $196.88 | $856.00 | $83.00 – $1,161.15 | 6 |
| Neuromuscular junction testing ea nerve any 1 method CPT 95937 | $53.59 | $233.00 | $12.30 – $253.55 | 6 |
| New Patient Office Visit (level 2) CPT 99202 | $27.37 | $119.00 | $46.53 – $54.78 | 2 |
| New Patient Office Visit (level 3) CPT 99203 | $38.64 | $168.00 | $65.69 – $77.03 | 2 |
| New Patient Office Visit (level 4) CPT 99204 | $50.14 | $218.00 | $85.24 – $110.04 | 2 |
| New Patient Office Visit (level 5) CPT 99205 | $64.17 | $279.00 | $109.09 – $143.16 | 2 |
| Nfct ds bv&vaginitis dna alg CPT 81514 | $156.17 | $679.00 | $236.69 – $579.59 | 6 |
| N.gonorrhoeae dna quant CPT 87592 | $45.08 | $196.00 | $42.84 – $94.55 | 6 |
| N-invas est c ffr sw aly cta CPT 75580 | $1,346.88 | $5,856.00 | $718.37 – $747.10 | 5 |
| Nitrogen n-13 ammonia HCPCS A9526 | $604.21 | $2,627.00 | $1,301.34 – $1,301.34 | 1 |
| Njx cath slct p angrph mapca CPT 93575 | $39.79 | $173.00 | $173.00 – $653.93 | 5 |
| Njx cath slct p-art angrp bi CPT 93573 | $99.59 | $433.00 | $433.00 – $653.93 | 5 |
| Njx cath slct pulm vn angrph CPT 93574 | $66.47 | $289.00 | $289.00 – $653.93 | 5 |
| Njx cth slct p-art angrp uni CPT 93569 | $66.47 | $289.00 | $289.00 – $653.93 | 5 |
| Nm imaging bone/joint 3 phase study CPT 78315 | $443.90 | $1,930.00 | $222.25 – $697.93 | 6 |
| Nm imaging bone/joint whole body CPT 78306 | $443.90 | $1,930.00 | $222.25 – $697.93 | 6 |
| Nm imaging cardiac blood pooling planar single study at rest or stress CPT 78472 | $422.74 | $1,838.00 | $267.82 – $697.93 | 6 |
| Nm imaging gastric emptying study CPT 78264 | $443.90 | $1,930.00 | $219.31 – $697.93 | 6 |
| Nm imaging hepatobiliary system w/pharmacologic intervention CPT 78227 | $443.90 | $1,930.00 | $264.02 – $697.93 | 6 |
| Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention CPT 78708 | $443.90 | $1,930.00 | $224.25 – $697.93 | 6 |
| Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s) CPT 78014 | $443.90 | $1,930.00 | $209.65 – $697.93 | 6 |
| Ntrk1 translocation analysis CPT 81191 | $261.28 | $1,136.00 | $186.58 – $456.89 | 6 |
| Ntrk2 translocation analysis CPT 81192 | $261.28 | $1,136.00 | $186.58 – $456.89 | 6 |
| Ntrk3 translocation analysis CPT 81193 | $261.28 | $1,136.00 | $186.58 – $456.89 | 6 |
| Ntrk translocation analysis CPT 81194 | $652.74 | $2,838.00 | $466.45 – $1,142.58 | 6 |
| Nuclear Stress Test (Heart) CPT 78452 | $443.90 | $1,930.00 | $340.93 – $1,720.07 | 6 |
| Nudt15 gene common variants CPT 81306 | $247.71 | $1,077.00 | $240.04 – $642.38 | 6 |
| Observation per hour HCPCS G0378 | $10.81 | $47.00 | $47.00 – $47.00 | 1 |
| Obstetrics panel CPT 80055 | $70.61 | $307.00 | $13.59 – $105.38 | 6 |
| Obtaining screen pap smear HCPCS Q0091 | $5.29 | $23.00 | $8.24 – $31.82 | 5 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $160.79 | $699.09 | $1.07 – $4.14 | 2 |
| Onc cutan mlnma mrna 31 gene CPT 81529 | $9,058.78 | $39,386.00 | $3,518.37 – $15,855.33 | 6 |
| Oncology tum unknown origin CPT 81540 | $2,483.08 | $10,796.00 | $2,628.27 – $8,265.82 | 6 |
| Oncoprotein her-2/neu CPT 83950 | $67.62 | $294.00 | $42.09 – $142.19 | 6 |
| Onc thyr mrna 10,196 gen alg CPT 81546 | $4,533.76 | $19,712.00 | $3,240.00 – $7,935.24 | 6 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $8.44 | $36.68 | $1.44 – $4.61 | 2 |
| Opioids & opiate analogs 3/4 CPT 80363 | $29.21 | $127.00 | $20.77 – $21.60 | 5 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $58.50 | $254.33 | $3.38 – $19.69 | 2 |
| Osmolality blood CPT 83930 | $11.27 | $49.00 | $6.61 – $14.44 | 6 |
| Osmolality urine CPT 83935 | $11.50 | $50.00 | $6.82 – $15.16 | 6 |
| Ot evaluation high complexity patient/family CPT 97167 | $77.74 | $338.00 | $46.00 – $482.75 | 5 |
| Ot evaluation low complexity patient/family CPT 97165 | $70.38 | $306.00 | $46.00 – $482.75 | 5 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $74.06 | $322.00 | $46.00 – $482.75 | 5 |
| Oth resp proc, indiv HCPCS G0238 | $77.51 | $337.00 | $14.83 – $64.91 | 5 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $45.31 | $197.00 | $46.00 – $66.86 | 5 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $35.65 | $155.00 | $45.50 – $66.86 | 5 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $28.52 | $124.00 | $27.40 – $66.86 | 5 |
| Ot re-evaluation patient/family CPT 97168 | $44.85 | $195.00 | $46.00 – $482.75 | 5 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $33.12 | $144.00 | $34.63 – $66.86 | 5 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $30.36 | $132.00 | $28.73 – $66.86 | 5 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $31.74 | $138.00 | $32.37 – $66.86 | 5 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $33.12 | $144.00 | $32.01 – $52.97 | 5 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $13.50 | $58.69 | $1.23 – $2.52 | 2 |
| Palb2 gene full gene seq CPT 81307 | $218.04 | $948.00 | $254.59 – $1,018.46 | 6 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $132.18 | $574.68 | $16.97 – $178.98 | 2 |
| Parathormone (pth) intact CPT 83970 | $71.07 | $309.00 | $41.28 – $90.94 | 6 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $38.64 | $168.00 | $22.64 – $329.95 | 5 |
| Partial removal finger bone CPT 26236 | $679.42 | $2,954.00 | $2,423.76 – $2,520.71 | 5 |
| Partial removal foot fascia CPT 28060 | $1,347.34 | $5,858.00 | $3,972.28 – $4,131.17 | 5 |
| Passy muir valve metal trach HCPCS L8501 | $1,046.49 | $4,549.97 | $147.88 – $147.88 | 1 |
| Path clin consltj sf 5-20 CPT 80503 | $21.85 | $95.00 | $33.47 – $181.06 | 6 |
| Pcv21 vaccine im CPT 90684 | $636.35 | $2,766.72 | $223.47 – $595.50 | 6 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $10,895.37 | $47,371.18 | $55.13 – $3,290.10 | 6 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $635.95 | $2,765.00 | $300.68 – $606.37 | 6 |
| Pelvic CT scan (with contrast) CPT 72193 | $605.36 | $2,632.00 | $270.44 – $606.37 | 6 |
| Pelvic CT scan (without contrast) CPT 72192 | $576.61 | $2,507.00 | $172.70 – $427.00 | 6 |
| Pelvic MRI (with and without contrast) CPT 72197 | $656.19 | $2,853.00 | $480.63 – $786.00 | 6 |
| Pelvic MRI (without contrast) CPT 72195 | $593.63 | $2,581.00 | $304.57 – $786.00 | 6 |
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.