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 |
|---|---|---|---|---|
| Drug test def 8-14 classes HCPCS G0481 | $155.02 | $674.00 | $110.69 – $250.80 | 5 |
| Drug test prsmv instrmnt CPT 80306 | $25.07 | $109.00 | $17.14 – $37.53 | 6 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $100.51 | $437.00 | $62.14 – $137.14 | 6 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $816.04 | $3,548.00 | $2,667.89 – $2,774.61 | 5 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $337.87 | $1,469.00 | $117.64 – $642.04 | 6 |
| Dx bronchoscope/brush 31623 CPT 31623 | $696.90 | $3,030.00 | $3,030.00 – $3,462.54 | 5 |
| Ear irrigation 69209 CPT 69209 | $47.38 | $206.00 | $117.00 – $117.00 | 1 |
| Ecg 12 lead tracing only CPT 93005 | $69.69 | $303.00 | $19.28 – $49.17 | 6 |
| Ecg external < 48 hours recording CPT 93225 | $242.65 | $1,055.00 | $52.85 – $110.98 | 6 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $242.65 | $1,055.00 | $58.85 – $119.94 | 6 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $158.93 | $691.00 | $30.46 – $110.98 | 5 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $158.93 | $691.00 | $50.09 – $110.98 | 5 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $439.99 | $1,913.00 | $170.76 – $887.49 | 6 |
| Echocardiography doppler color flow mapping CPT 93325 | $110.17 | $479.00 | $66.54 – $206.11 | 5 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $465.06 | $2,022.00 | $501.02 – $887.49 | 5 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $172.04 | $748.00 | $74.73 – $887.49 | 6 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $284.05 | $1,235.00 | $501.02 – $887.49 | 5 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $101.43 | $441.00 | $35.42 – $887.49 | 5 |
| Echo tee guidance CPT 93355 | $318.78 | $1,386.00 | $853.36 – $887.49 | 5 |
| Echo transesophageal CPT 93315 | $287.73 | $1,251.00 | $176.31 – $887.49 | 6 |
| Echo transthoracic CPT 93303 | $439.99 | $1,913.00 | $147.80 – $887.49 | 6 |
| Echo transthoracic CPT 93304 | $205.85 | $895.00 | $80.23 – $887.49 | 6 |
| Ecmo/ecls daily mgmt artery 33949 CPT 33949 | $405.72 | $1,764.00 | $1,764.00 – $15,044.28 | 5 |
| Ecmo/ecls daily mgmt-venous 33948 CPT 33948 | $405.72 | $1,764.00 | $1,764.00 – $15,044.28 | 5 |
| Ecmo/ecls insj cent cannula 0-5yrs 33955 CPT 33955 | $454.48 | $1,976.00 | $1,976.00 – $15,044.28 | 5 |
| Ecmo/ecls insj cent cannula 6yrs&older 33956 CPT 33956 | $454.48 | $1,976.00 | $1,976.00 – $15,044.28 | 5 |
| Ecmo/ecls insj prph cannula 0-5yrs opn 33953 CPT 33953 | $454.48 | $1,976.00 | $1,976.00 – $15,044.28 | 5 |
| Ecmo/ecls insj prph cannula 0-5yrs perq 33951 CPT 33951 | $454.48 | $1,976.00 | $1,976.00 – $15,044.28 | 5 |
| Ecmo/ecls insj prph cannula 6yrs&older opn 33954 CPT 33954 | $454.48 | $1,976.00 | $1,976.00 – $15,044.28 | 5 |
| Ecmo/ecls insj prph cannula 6yrs&older perq 33952 CPT 33952 | $454.48 | $1,976.00 | $1,976.00 – $15,044.28 | 5 |
| Ecmo/ecls remove cent cannula 0-5yrs 33985 CPT 33985 | $290.72 | $1,264.00 | $1,264.00 – $15,044.28 | 5 |
| Ecmo/ecls remove cent cannula 6yrs&older 33986 CPT 33986 | $290.72 | $1,264.00 | $1,264.00 – $15,044.28 | 5 |
| Ecmo/ecls remove perph cannula 0-5yrs opn 33969 CPT 33969 | $290.72 | $1,264.00 | $1,264.00 – $15,044.28 | 5 |
| Ecmo/ecls remove perph cannula 0-5yrs perq 33965 CPT 33965 | $290.72 | $1,264.00 | $1,264.00 – $15,044.28 | 5 |
| Ecmo/ecls remove prph cannula 6yrs&older open 33984 CPT 33984 | $290.72 | $1,264.00 | $1,264.00 – $15,044.28 | 5 |
| Ecmo/ecls remove prph cannula 6yrs&older perq 33966 CPT 33966 | $290.72 | $1,264.00 | $1,264.00 – $15,044.28 | 5 |
| Ecmo/ecls repos cent cnula 6yrs&older 33964 CPT 33964 | $363.63 | $1,581.00 | $1,581.00 – $15,044.28 | 5 |
| Ecmo/ecls repos cent/perph cnula 0-5yrs 33963 CPT 33963 | $363.63 | $1,581.00 | $1,581.00 – $15,044.28 | 5 |
| Ecmo/ecls repos perph cnula 0-5yrs opn 33959 CPT 33959 | $363.63 | $1,581.00 | $1,581.00 – $15,044.28 | 5 |
| Ecmo/ecls repos perph cnula 0-5yrs perq 33957 CPT 33957 | $363.63 | $1,581.00 | $1,581.00 – $15,044.28 | 5 |
| Ecmo/ecls repos perph cnula 6yrs&older opn 33962 CPT 33962 | $363.63 | $1,581.00 | $1,581.00 – $15,044.28 | 5 |
| Ecmo/ecls repos perph cnula 6yrs&older perq 33958 CPT 33958 | $363.63 | $1,581.00 | $1,581.00 – $15,044.28 | 5 |
| E equine encephalitis igg CPT 86652 | $12.19 | $53.00 | $13.19 – $28.87 | 6 |
| Egd remove foreign body CPT 43247 | $377.43 | $1,641.00 | $298.53 – $1,899.63 | 5 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $60.49 | $263.00 | $31.58 – $90.76 | 6 |
| Elec stim unattend for press HCPCS G0281 | $23.46 | $102.00 | $11.50 – $359.25 | 5 |
| Electrical stimulation/unattended 97014 CPT 97014 | $15.41 | $67.00 | $46.00 – $52.97 | 5 |
| Electrolyte panel CPT 80051 | $11.50 | $50.00 | $7.01 – $15.16 | 6 |
| Encephalitis, california igg/igm CPT 86651 | $12.19 | $53.00 | $13.19 – $28.87 | 6 |
| Encephalitis, st louis igg/igm CPT 86653 | $12.19 | $53.00 | $13.19 – $28.87 | 6 |
| Encephalitis, western equine igg/igm CPT 86654 | $23.00 | $100.00 | $13.19 – $28.87 | 6 |
| Endoluminal bx biliary tree CPT 47543 | $825.47 | $3,589.00 | $3,589.00 – $10,761.57 | 5 |
| Endoscopy swallow (fees) vid CPT 92612 | $80.73 | $351.00 | $46.00 – $350.29 | 6 |
| Endoscpy nsl/sns w/cntrl nsl hmrrgh CPT 31238 | $744.51 | $3,237.00 | $202.66 – $3,613.84 | 5 |
| Enoxaparin 30 mg/0.3 ml subcutaneous syringe HCPCS J1650 | $274.71 | $1,194.40 | $1.04 – $15.69 | 2 |
| Enterectomy small intestine single 44120 CPT 44120 | $586.96 | $2,552.00 | $2,552.00 – $7,658.05 | 5 |
| Epidrm a-grft face/nck/hf/g 15115 CPT 15115 | $694.83 | $3,021.00 | $707.41 – $3,662.90 | 5 |
| Epidrm a-grft f/n/hf/g addl CPT 15116 | $178.71 | $777.00 | $155.27 – $3,662.90 | 5 |
| Epidrm agrft t/a/l 1st 100 CPT 15110 | $694.83 | $3,021.00 | $387.11 – $3,662.90 | 5 |
| Epidrm autogrft t/a/l add-on CPT 15111 | $178.71 | $777.00 | $119.30 – $3,662.90 | 5 |
| Epilepsy gen seq alys panel CPT 81419 | $3,083.61 | $13,407.00 | $2,203.70 – $5,397.47 | 6 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | $65.62 | $285.30 | $0.84 – $0.84 | 1 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | $65.62 | $285.30 | $111.55 – $111.55 | 1 |
| Epstein barr early antigen antibody CPT 86663 | $22.54 | $98.00 | $13.12 – $28.87 | 6 |
| Epstein barr nuclear antigen antibody CPT 86664 | $13.80 | $60.00 | $15.29 – $33.92 | 6 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $29.90 | $130.00 | $16.90 – $39.70 | 6 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $651.85 | $2,834.11 | $3.03 – $82.84 | 6 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $318.70 | $1,385.64 | $17.35 – $22.30 | 2 |
| ER Visit (level 1, minor) CPT 99281 | $66.93 | $291.00 | $291.00 – $291.00 | 2 |
| ER Visit (level 2) CPT 99282 | $92.46 | $402.00 | $402.00 – $402.00 | 2 |
| ER Visit (level 3) CPT 99283 | $201.02 | $874.00 | $540.00 – $874.00 | 2 |
| ER Visit (level 4) CPT 99284 | $294.63 | $1,281.00 | $1,281.00 – $1,281.00 | 2 |
| ER Visit (level 5, high severity) CPT 99285 | $447.58 | $1,946.00 | $1,587.00 – $1,946.00 | 2 |
| Established Patient Office Visit (level 1) CPT 99211 | $18.63 | $81.00 | $16.29 – $31.67 | 2 |
| Established Patient Office Visit (level 2) CPT 99212 | $21.85 | $95.00 | $30.65 – $37.15 | 2 |
| Established Patient Office Visit (level 3) CPT 99213 | $35.42 | $154.00 | $43.80 – $60.21 | 2 |
| Established Patient Office Visit (level 4) CPT 99214 | $40.71 | $177.00 | $66.94 – $69.21 | 2 |
| Established Patient Office Visit (level 5) CPT 99215 | $45.31 | $197.00 | $77.03 – $103.22 | 2 |
| Estradiol total CPT 82670 | $47.84 | $208.00 | $19.88 – $61.35 | 6 |
| Estrogens total-sendout CPT 82672 | $37.26 | $162.00 | $19.88 – $47.64 | 6 |
| Ethylene glycol -sendout CPT 82693 | $24.61 | $107.00 | $14.90 – $33.20 | 6 |
| Euglobulin lysis CPT 85360 | $14.49 | $63.00 | $8.41 – $18.77 | 6 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $110.63 | $481.00 | $82.11 – $216.53 | 6 |
| Event monitor CPT 93270 | $242.65 | $1,055.00 | $33.72 – $76.86 | 6 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $173.19 | $753.00 | $71.20 – $815.81 | 5 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $37.72 | $164.00 | $64.12 – $815.81 | 5 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $180.32 | $784.00 | $784.00 – $815.81 | 5 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $218.04 | $948.00 | $784.43 – $815.81 | 5 |
| Exchange blood transfusion newborn 36450 CPT 36450 | $117.07 | $509.00 | $179.48 – $821.43 | 5 |
| Exc hidradenitis peri/umb int 11470 CPT 11470 | $507.38 | $2,206.00 | $250.67 – $3,400.73 | 5 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $288.42 | $1,254.00 | $123.67 – $2,344.82 | 5 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $198.26 | $862.00 | $784.43 – $815.81 | 5 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $264.04 | $1,148.00 | $1,148.00 – $3,400.73 | 5 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $133.17 | $579.00 | $131.36 – $815.81 | 5 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $662.17 | $2,879.00 | $101.78 – $2,781.73 | 5 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $601.68 | $2,616.00 | $2,616.00 – $3,400.73 | 5 |
| Exercise tst brncspsm w/ecg CPT 94617 | $59.11 | $257.00 | $94.54 – $109.72 | 5 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $218.27 | $949.00 | $278.91 – $740.55 | 5 |
| External chromosome analysis 20-25 cells CPT 88264 | $214.13 | $931.00 | $144.61 – $319.03 | 6 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $90.16 | $392.00 | $10.74 – $162.56 | 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.