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 |
|---|---|---|---|---|
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $433.32 | $1,884.00 | $282.22 – $815.81 | 5 |
| Complx repair enel 2.6-7.5 cm 13152 CPT 13152 | $464.83 | $2,021.00 | $441.75 – $815.81 | 5 |
| Complx repair enel addl 5cm/< 13153 CPT 13153 | $409.40 | $1,780.00 | $136.94 – $2,344.82 | 5 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $420.90 | $1,830.00 | $232.24 – $815.81 | 5 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $422.28 | $1,836.00 | $398.14 – $815.81 | 5 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $307.05 | $1,335.00 | $127.41 – $815.81 | 5 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $379.96 | $1,652.00 | $82.30 – $815.81 | 5 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $379.96 | $1,652.00 | $69.16 – $815.81 | 5 |
| Concentration infection agents any type CPT 87015 | $11.27 | $49.00 | $6.68 – $15.39 | 6 |
| Condylomata destruction 56420 CPT 56420 | $218.27 | $949.00 | $121.96 – $412.79 | 5 |
| Consultation pathology during surgery CPT 88329 | $51.06 | $222.00 | $15.37 – $181.06 | 6 |
| Consultation/report referred material w/preparation of slides CPT 88323 | $63.94 | $278.00 | $26.61 – $181.06 | 6 |
| Consult comp w/report rfrd material CPT 88325 | $132.48 | $576.00 | $49.47 – $201.90 | 6 |
| Controller infinity pt dbs HCPCS C1787 | $3,339.46 | $14,519.40 | $5,279.69 – $5,279.69 | 1 |
| Control nosebleed pack+caut 30905 CPT 30905 | $241.50 | $1,050.00 | $117.78 – $350.29 | 5 |
| Control of nosebleed ant comp 30903 CPT 30903 | $207.92 | $904.00 | $74.84 – $350.29 | 5 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $76.13 | $331.00 | $57.60 – $350.29 | 5 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $207.92 | $904.00 | $171.14 – $2,689.36 | 5 |
| Coombs direct CPT 86880 | $16.33 | $71.00 | $5.39 – $11.55 | 6 |
| Coombs indirect titer reference CPT 86886 | $43.93 | $191.00 | $5.18 – $11.55 | 6 |
| Coronary thrombolysis/iv infusion 92977 CPT 92977 | $386.63 | $1,681.00 | $145.18 – $969.52 | 5 |
| Cortisol acth stimulation test - sendout CPT 80400 | $29.90 | $130.00 | $32.62 – $72.18 | 6 |
| Cortisol total am CPT 82533 | $28.29 | $123.00 | $16.30 – $36.09 | 6 |
| Covid-19 administration immunization im inj 1st/only component CPT 90480 | $17.48 | $76.00 | $37.37 – $75.37 | 5 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose HCPCS M0249 | $127.65 | $555.00 | $188.00 – $536.17 | 5 |
| Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose HCPCS M0250 | $127.65 | $555.00 | $188.00 – $536.17 | 5 |
| Covid-19 lab test non-cdc HCPCS U0002 | $14.72 | $64.00 | $14.80 – $64.00 | 6 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $22.31 | $97.00 | $13.03 – $28.87 | 6 |
| C-peptide CPT 84681 | $35.65 | $155.00 | $18.12 – $46.19 | 6 |
| C-reactive protein CPT 86140 | $8.97 | $39.00 | $5.18 – $17.58 | 6 |
| C-reactive protein high sensitivity CPT 86141 | $22.31 | $97.00 | $12.95 – $28.87 | 6 |
| Creatine kinase CPT 82550 | $11.04 | $48.00 | $6.51 – $14.44 | 6 |
| Creatine kinase isoenzymes CPT 82552 | $11.04 | $48.00 | $13.39 – $29.59 | 6 |
| Creatine kinase mb CPT 82553 | $19.78 | $86.00 | $11.55 – $25.26 | 6 |
| Creatine - sendout CPT 82540 | $8.05 | $35.00 | $4.64 – $10.10 | 6 |
| Creatinine CPT 82565 | $8.97 | $39.00 | $2.31 – $11.55 | 6 |
| Creatinine 24 hour urine CPT 82570 | $8.97 | $39.00 | $5.18 – $11.55 | 6 |
| Creatinine clearance urine CPT 82575 | $16.10 | $70.00 | $8.17 – $20.93 | 6 |
| #creutz-prot.,western blot CPT 84182 | $30.82 | $134.00 | $22.94 – $64.24 | 6 |
| Critical care 30-74 minutes CPT 99291 | $686.32 | $2,984.00 | $2,984.00 – $2,984.00 | 1 |
| Crotalidae poly immune fab HCPCS J0840 | $5,429.02 | $23,604.44 | $1,894.15 – $14,405.75 | 6 |
| Cryoprecipitate each unit HCPCS P9012 | $106.26 | $462.00 | $20.34 – $577.65 | 5 |
| Cryptosporidium antigen CPT 87272 | $19.78 | $86.00 | $11.98 – $26.71 | 6 |
| Crystal identification light microscopy CPT 89060 | $12.42 | $54.00 | $7.33 – $15.88 | 6 |
| Cstb gene full gene sequence CPT 81189 | $212.06 | $922.00 | $240.04 – $605.57 | 6 |
| Cta abdomen without & /or w/contrast CPT 74175 | $576.61 | $2,507.00 | $304.62 – $747.10 | 6 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $507.84 | $2,208.00 | $304.62 – $747.10 | 6 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $549.24 | $2,388.00 | $304.62 – $747.10 | 6 |
| Cta neck without &/or w/contrast CPT 70498 | $549.24 | $2,388.00 | $304.62 – $747.10 | 6 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $614.33 | $2,671.00 | $427.00 – $747.10 | 6 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $576.61 | $2,507.00 | $304.62 – $747.10 | 6 |
| CT Angiogram of the Head CPT 70496 | $549.24 | $2,388.00 | $304.62 – $747.10 | 6 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $549.24 | $2,388.00 | $304.62 – $747.10 | 6 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $7.13 | $31.00 | $31.00 – $201.28 | 6 |
| CT limited or localized follow-up study CPT 76380 | $549.24 | $2,388.00 | $96.01 – $427.00 | 6 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $549.24 | $2,388.00 | $270.44 – $606.37 | 6 |
| CT lower extremity without contrast (both sides) CPT 73700 | $521.87 | $2,269.00 | $172.70 – $427.00 | 6 |
| CT lwr extremity w/o&w/dye CPT 73702 | $576.61 | $2,507.00 | $300.68 – $606.37 | 6 |
| CT neck soft tissue w/contrast CPT 70491 | $549.24 | $2,388.00 | $270.44 – $606.37 | 6 |
| CT neck soft tissue without contrast CPT 70490 | $521.87 | $2,269.00 | $172.70 – $427.00 | 6 |
| CT neck soft tissue without & w/contrast CPT 70492 | $576.61 | $2,507.00 | $300.68 – $606.37 | 6 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $576.61 | $2,507.00 | $300.68 – $606.37 | 6 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $549.24 | $2,388.00 | $270.44 – $606.37 | 6 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $549.24 | $2,388.00 | $172.70 – $427.00 | 6 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $576.61 | $2,507.00 | $313.89 – $606.37 | 6 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $549.24 | $2,388.00 | $237.47 – $606.37 | 6 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $521.87 | $2,269.00 | $124.45 – $606.37 | 6 |
| CT thoracic spine w/contrast CPT 72129 | $549.24 | $2,388.00 | $270.44 – $606.37 | 6 |
| CT thoracic spine without contrast CPT 72128 | $521.87 | $2,269.00 | $172.70 – $427.00 | 6 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $89.47 | $389.00 | $72.81 – $389.00 | 6 |
| CT t-spine w /wo contrast CPT 72130 | $576.61 | $2,507.00 | $300.68 – $606.37 | 6 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $549.24 | $2,388.00 | $270.44 – $606.37 | 6 |
| CT upper extremity without contrast (both sides) CPT 73200 | $521.87 | $2,269.00 | $172.70 – $427.00 | 6 |
| CT uppr extremity w/o&w/dye CPT 73202 | $576.61 | $2,507.00 | $300.68 – $606.37 | 6 |
| Culture aerobic additional method definitive id each CPT 87077 | $14.03 | $61.00 | $8.08 – $18.04 | 6 |
| Culture afb any source CPT 87116 | $18.63 | $81.00 | $10.80 – $23.82 | 6 |
| Culture anaerobic additional method definitive id each CPT 87076 | $14.03 | $61.00 | $8.08 – $18.04 | 6 |
| Culture anaerobic except blood CPT 87075 | $16.10 | $70.00 | $9.47 – $20.93 | 6 |
| Culture bact stool aero addl path ea CPT 87046 | $16.10 | $70.00 | $8.66 – $20.93 | 6 |
| Culture body fluid CPT 87070 | $14.72 | $64.00 | $8.62 – $18.77 | 6 |
| Culture fungi definitive id mold CPT 87107 | $17.94 | $78.00 | $10.32 – $23.10 | 6 |
| Culture fungi definitive id yeast CPT 87106 | $17.94 | $78.00 | $10.32 – $23.10 | 6 |
| Culture fungi other (except blood) CPT 87102 | $14.49 | $63.00 | $8.41 – $18.77 | 6 |
| Culture fungi skin/hair/nail CPT 87101 | $13.34 | $58.00 | $7.71 – $17.32 | 6 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $18.86 | $82.00 | $13.95 – $32.48 | 6 |
| Culture quantitative aerobic other source CPT 87071 | $16.10 | $70.00 | $9.89 – $21.65 | 6 |
| Culture screening strep group a CPT 87081 | $11.27 | $49.00 | $6.63 – $15.39 | 6 |
| Culture typing added method CPT 87158 | $8.97 | $39.00 | $6.66 – $17.32 | 6 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $289.11 | $1,257.00 | $196.25 – $480.71 | 6 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $60.03 | $261.00 | $35.09 – $90.76 | 6 |
| Culture urine each isolate CPT 87088 | $14.03 | $61.00 | $8.09 – $18.04 | 6 |
| Cutter lead HCPCS C1773 | $15,380.61 | $66,872.21 | $125.50 – $125.50 | 1 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $26.21 | $113.96 | $0.30 – $1.76 | 2 |
| Cyclic citrullinated peptide antibody CPT 86200 | $11.73 | $51.00 | $12.95 – $28.87 | 6 |
| Cyclosporine 2 hour CPT 80158 | $30.82 | $134.00 | $18.05 – $39.70 | 6 |
| Cymetra injectable HCPCS Q4112 | $432.94 | $1,882.34 | $156.83 – $1,534.86 | 3 |
| Cyp2c9 gene com variants CPT 81227 | $220.80 | $960.00 | $157.57 – $385.43 | 6 |
| Cyp2d6 gene com variants CPT 81226 | $634.11 | $2,757.00 | $406.43 – $993.89 | 6 |
| Cystatin c CPT 82610 | $20.47 | $89.00 | $13.52 – $41.14 | 6 |
| Cystic fibrosis cftr CPT 81223 | $1,020.28 | $4,436.00 | $449.10 – $1,099.99 | 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.