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 |
|---|---|---|---|---|
| T cells absolute cd 4 count CPT 86361 | $46.00 | $200.00 | $26.78 – $63.53 | 6 |
| T cells total count CPT 86359 | $64.63 | $281.00 | $37.73 – $83.00 | 6 |
| Telehealth original site facility fee HCPCS Q3014 | $22.54 | $98.00 | $21.43 – $22.29 | 5 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $11,418.53 | $49,645.79 | $46.74 – $9,060.46 | 6 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $67.46 | $293.29 | $2.15 – $13.01 | 2 |
| Test for chlorohydrocarbons CPT 82441 | $6.44 | $28.00 | $6.01 – $18.96 | 6 |
| Test for urine cystines CPT 82615 | $8.74 | $38.00 | $8.17 – $20.93 | 6 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $32.20 | $140.00 | $22.95 – $91.67 | 6 |
| Test stress cardiovascular tracing only CPT 93017 | $219.88 | $956.00 | $71.73 – $323.06 | 6 |
| Tgsap so/hl 51/< rna alys CPT 81456 | $947.83 | $4,121.00 | $2,627.64 – $4,121.00 | 6 |
| Theophylline therapeutic drug level CPT 80198 | $24.38 | $106.00 | $14.14 – $31.04 | 6 |
| Therapeutic procd strg endur HCPCS G0237 | $77.51 | $337.00 | $15.84 – $64.91 | 5 |
| Ther/proph/diag inj ia CPT 96373 | $52.67 | $229.00 | $16.51 – $97.66 | 6 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $9.33 | $40.55 | $0.89 – $3.20 | 2 |
| Thoracotomy with cardiac massage CPT 32160 | $1,877.49 | $8,163.00 | $508.26 – $9,647.99 | 5 |
| Thrombin time CPT 85670 | $9.89 | $43.00 | $5.77 – $12.99 | 6 |
| Thromboplastin inhibition CPT 85705 | $16.56 | $72.00 | $6.63 – $20.93 | 6 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $11.04 | $48.00 | $6.47 – $14.44 | 6 |
| Thyroglobulin antibody CPT 86800 | $27.37 | $119.00 | $15.91 – $35.37 | 6 |
| Thyroid (TSH) Test CPT 84443 | $28.98 | $126.00 | $16.80 – $36.81 | 6 |
| Thyroid Ultrasound CPT 76536 | $99.82 | $434.00 | $78.52 – $206.11 | 6 |
| Tissue culture skin/biopsy CPT 88233 | $128.34 | $558.00 | $140.73 – $314.79 | 6 |
| Tissue exam koh skin/hair/nails CPT 87220 | $6.90 | $30.00 | $4.27 – $15.39 | 6 |
| Tissue transglutaminase iga CPT 86364 | $72.91 | $317.00 | $10.38 – $25.26 | 6 |
| Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr HCPCS J3260 | $12.71 | $55.27 | $4.17 – $7.99 | 2 |
| Tobramycin peak therapeutic drug level CPT 80200 | $27.60 | $120.00 | $16.13 – $35.37 | 6 |
| Tomosynthesis breast screen bilateral CPT 77063 | $72.68 | $316.00 | $22.98 – $88.58 | 6 |
| Total tau CPT 84394 | $50.14 | $218.00 | $128.92 – $128.92 | 1 |
| Toxoplasma antibody igg CPT 86777 | $24.61 | $107.00 | $14.39 – $31.76 | 6 |
| Toxoplasma antibody igm CPT 86778 | $24.61 | $107.00 | $14.41 – $31.76 | 6 |
| Tp53 gene full gene sequence CPT 81351 | $808.22 | $3,514.00 | $577.67 – $1,414.69 | 6 |
| Tp53 gene known famil vrnt CPT 81353 | $388.01 | $1,687.00 | $240.04 – $679.19 | 6 |
| Tp53 gene trgt sequence alys CPT 81352 | $414.92 | $1,804.00 | $240.04 – $726.11 | 6 |
| Tpmt gene com vrnts CPT 81335 | $220.11 | $957.00 | $157.33 – $385.43 | 6 |
| Tracheobrnchsc thru est trachs incisn CPT 31615 | $264.50 | $1,150.00 | $172.01 – $3,462.54 | 5 |
| Training self management diabetes individual outpatient department per 30 minutes HCPCS G0108 | $20.47 | $89.00 | $44.38 – $130.63 | 5 |
| Tranexamic acid 1,000 mg/10 ml (100 mg/ml) intravenous solution HCPCS J3290 | $19.39 | $84.29 | $0.05 – $0.05 | 1 |
| Transferrin CPT 84466 | $21.39 | $93.00 | $12.76 – $28.15 | 6 |
| Transfusion blood/blood component(s) CPT 36430 | $117.07 | $509.00 | $45.17 – $821.43 | 5 |
| Tray bonemarrw oncontrol 102mm HCPCS C1830 | $894.50 | $3,889.13 | $215.91 – $215.91 | 1 |
| Treat elbow dislocation CPT 24605 | $710.01 | $3,087.00 | $324.07 – $1,915.84 | 5 |
| Treat elbow fracture CPT 24620 | $710.01 | $3,087.00 | $444.39 – $919.89 | 5 |
| Treat finger fracture each CPT 26742 | $62.10 | $270.00 | $245.96 – $919.89 | 5 |
| Treat foot dislocation CPT 28570 | $99.82 | $434.00 | $434.00 – $919.89 | 5 |
| Treat fracture of radius CPT 25505 | $201.94 | $878.00 | $345.71 – $919.89 | 5 |
| Treat fracture of ulna CPT 25535 | $207.92 | $904.00 | $340.52 – $919.89 | 5 |
| Treat hip dislocation CPT 27252 | $676.20 | $2,940.00 | $596.62 – $1,915.84 | 5 |
| Treat humerus fracture CPT 24565 | $278.76 | $1,212.00 | $405.54 – $919.89 | 5 |
| Treat knee dislocation CPT 27552 | $646.99 | $2,813.00 | $620.72 – $1,915.84 | 5 |
| Treat knee fracture 27530 CPT 27530 | $106.95 | $465.00 | $192.45 – $919.89 | 5 |
| Treatment inhalation continuous aerosol medication acute airway obstruction 1st hour CPT 94644 | $42.55 | $185.00 | $31.19 – $120.89 | 6 |
| Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour CPT 94645 | $38.87 | $169.00 | $11.82 – $109.72 | 6 |
| Treatment inhalation pressurized/nonpressurized acute airway obstruction CPT 94640 | $96.60 | $420.00 | $16.11 – $109.72 | 6 |
| Treatment of ankle fracture CPT 27814 | $3,023.58 | $13,146.00 | $9,885.14 – $10,280.55 | 5 |
| Treatment of fibula fracture 27780 CPT 27780 | $217.35 | $945.00 | $193.83 – $919.89 | 5 |
| Treatment of thigh fracture CPT 27503 | $617.55 | $2,685.00 | $884.51 – $919.89 | 5 |
| Treat midfoot fracture each CPT 28455 | $74.52 | $324.00 | $177.32 – $919.89 | 5 |
| Treat thigh fx growth plate CPT 27516 | $94.99 | $413.00 | $152.18 – $919.89 | 5 |
| Treat ulnar fracture CPT 24675 | $207.92 | $904.00 | $370.92 – $919.89 | 5 |
| Treat wrist bone fracture CPT 25635 | $207.92 | $904.00 | $309.66 – $919.89 | 5 |
| Treat wrist dislocation CPT 25675 | $207.92 | $904.00 | $286.79 – $919.89 | 5 |
| Treponema pallidum antibody CPT 86780 | $23.00 | $100.00 | $13.24 – $28.87 | 6 |
| Trg gene rearrangement anal CPT 81342 | $346.38 | $1,506.00 | $201.50 – $443.89 | 6 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $35.10 | $152.60 | $1.48 – $1.68 | 2 |
| #tricyclicantidprssnt CPT 80337 | $29.21 | $127.00 | $20.77 – $21.60 | 5 |
| Triglycerides CPT 84478 | $9.89 | $43.00 | $2.31 – $12.99 | 6 |
| Trim nail(s) HCPCS G0127 | $11.73 | $51.00 | $9.85 – $125.57 | 5 |
| Trim nondyst nails CPT 11719 | $11.73 | $51.00 | $15.88 – $125.57 | 5 |
| Troponin quantitative CPT 84484 | $17.02 | $74.00 | $12.47 – $27.43 | 6 |
| Tx closed hip disl traumatic without anes CPT 27250 | $241.50 | $1,050.00 | $410.00 – $919.89 | 5 |
| Tx closed tib shaft fx without manip CPT 27750 | $187.45 | $815.00 | $280.25 – $919.89 | 5 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | $62.10 | $270.00 | $167.67 – $919.89 | 5 |
| U2af1 gene common variants CPT 81357 | $243.34 | $1,058.00 | $173.93 – $425.85 | 6 |
| Ugt1a1 gene analy common variants CPT 81350 | $155.02 | $674.00 | $210.60 – $516.07 | 6 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $99.82 | $434.00 | $101.46 – $206.11 | 6 |
| Ultrasound breast complete CPT 76641 | $94.99 | $413.00 | $82.49 – $206.11 | 6 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $90.16 | $392.00 | $82.49 – $206.11 | 6 |
| Ultrasound chest CPT 76604 | $99.82 | $434.00 | $56.63 – $206.11 | 6 |
| Ultrasound guide tissue ablation CPT 76940 | $90.16 | $392.00 | $127.09 – $204.73 | 5 |
| Ultrasound joint complete left CPT 76881 | $99.82 | $434.00 | $20.42 – $206.11 | 6 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $99.82 | $434.00 | $9.51 – $206.11 | 6 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | $99.82 | $434.00 | $26.69 – $206.11 | 6 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $94.99 | $413.00 | $56.63 – $188.99 | 6 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $99.82 | $434.00 | $56.63 – $188.99 | 6 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $99.82 | $434.00 | $55.48 – $188.99 | 6 |
| Ultrasound retroperitoneal limited CPT 76775 | $94.76 | $412.00 | $61.14 – $206.11 | 6 |
| Ultrasound scrotum and contents CPT 76870 | $99.82 | $434.00 | $85.79 – $206.11 | 6 |
| Ultrasound transvaginal non obstetric CPT 76830 | $99.82 | $434.00 | $86.68 – $206.11 | 6 |
| Unlisted procedure microbiology CPT 87999 | $50.83 | $221.00 | $11.50 – $15.39 | 6 |
| Unlisted px casting/strpg CPT 29799 | $53.59 | $233.00 | $134.88 – $140.28 | 5 |
| Unlisted px small intestine CPT 44799 | $1,080.31 | $4,697.00 | $3,278.45 – $3,887.73 | 5 |
| Unlisted transfusion med px CPT 86999 | $11.73 | $51.00 | $6.52 – $25.80 | 6 |
| Unsched dialysis esrd pt hos HCPCS G0257 | $163.76 | $712.00 | $83.00 – $1,677.10 | 6 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $656.19 | $2,853.00 | $480.63 – $786.00 | 6 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $624.68 | $2,716.00 | $392.26 – $786.00 | 6 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $593.63 | $2,581.00 | $304.57 – $786.00 | 6 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | $418.83 | $1,821.00 | $282.31 – $1,899.63 | 5 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | $377.43 | $1,641.00 | $311.30 – $1,899.63 | 5 |
| Urea nitrogen CPT 84520 | $6.67 | $29.00 | $3.95 – $8.66 | 6 |
| Urea nitrogen 24 hour urine CPT 84540 | $8.05 | $35.00 | $5.56 – $12.27 | 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.