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 |
|---|---|---|---|---|
| Ghs insertion of needle - bone CPT 36680 | $61.87 | $269.00 | $105.48 – $468.74 | 5 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $305.21 | $1,327.00 | $211.63 – $740.55 | 5 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $316.48 | $1,376.00 | $263.66 – $740.55 | 5 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | $134.09 | $583.00 | $314.56 – $740.55 | 5 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | $251.62 | $1,094.00 | $132.51 – $158.54 | 5 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $1,484.42 | $6,454.00 | $362.70 – $536.17 | 5 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $250.70 | $1,090.00 | $106.86 – $350.29 | 5 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $97.98 | $426.00 | $116.37 – $740.55 | 5 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $109.94 | $478.00 | $143.23 – $740.55 | 5 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | $125.58 | $546.00 | $162.30 – $740.55 | 5 |
| Ghs layer closure 2.6 - 5.0 cm - 12052 CPT 12052 | $171.58 | $746.00 | $171.16 – $740.55 | 5 |
| Ghs layer closure 2.6 - 7.5 cm - 12042 CPT 12042 | $148.12 | $644.00 | $173.66 – $740.55 | 5 |
| Ghs layer closure 5.1 - 7.5 cm - 12053 CPT 12053 | $243.11 | $1,057.00 | $193.92 – $740.55 | 5 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $290.95 | $1,265.00 | $177.75 – $740.55 | 5 |
| Ghs layer closure 7.6 - 12.5 cm - 12044 CPT 12044 | $246.79 | $1,073.00 | $191.54 – $740.55 | 5 |
| Ghs layer closure 7.6 - 12.5 cm - 12054 CPT 12054 | $267.49 | $1,163.00 | $234.84 – $740.55 | 5 |
| Ghs layered repair 12.6 - 20.0 cm -12045 CPT 12045 | $303.60 | $1,320.00 | $229.02 – $740.55 | 5 |
| Ghs layered repair 12.6 - 20.0 cm -12055 CPT 12055 | $294.17 | $1,279.00 | $298.29 – $740.55 | 5 |
| Ghs moderate sedation < 5 yr, 30 min CPT 99151 | $119.37 | $519.00 | $39.66 – $41.25 | 5 |
| Ghs moderate sedation < 5 yr, 30 min, other CPT 99155 | $90.16 | $392.00 | $39.66 – $41.25 | 5 |
| Ghs moderate sedation, > 5 yr, 30 min, other CPT 99156 | $73.83 | $321.00 | $39.66 – $41.25 | 5 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $38.41 | $167.00 | $39.66 – $41.25 | 5 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $55.89 | $243.00 | $39.66 – $41.25 | 5 |
| Ghs myocardial strain img spckl track CPT 93356 | $504.85 | $2,195.00 | $853.36 – $887.49 | 5 |
| Ghs nailbed repair/nail removal CPT 11760 | $62.56 | $272.00 | $109.17 – $125.57 | 5 |
| Ghs o2 saturation CPT 82810 | $14.95 | $65.00 | $8.17 – $21.65 | 6 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | $19.09 | $83.00 | $22.33 – $97.66 | 6 |
| Ghs opcc repair cvp w subq port CPT 36576 | $5,787.95 | $25,165.00 | $1,342.17 – $1,395.86 | 5 |
| Ghs ot prosthetic training/15 min CPT 97761 | $31.51 | $137.00 | $39.92 – $66.86 | 5 |
| Ghs pacing - transcutaneous CPT 92953 | $504.16 | $2,192.00 | $24.23 – $1,227.90 | 6 |
| Ghs peritonsillar abscess i andd CPT 42700 | $207.92 | $904.00 | $135.79 – $350.29 | 5 |
| Ghs picc line insert < 5 CPT 36568 | $480.93 | $2,091.00 | $2,091.00 – $2,226.03 | 5 |
| Ghs plngl fx pm cl CPT 26725 | $85.56 | $372.00 | $187.23 – $919.89 | 5 |
| Ghs ppd (tb intradermal) CPT 86580 | $24.18 | $105.14 | $5.13 – $21.40 | 6 |
| Ghs pr without cont pulse ox CPT 94625 | $33.58 | $146.00 | $51.17 – $64.91 | 5 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $20.93 | $91.00 | $12.25 – $26.71 | 6 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $122.36 | $532.00 | $46.00 – $52.97 | 5 |
| Ghs quinidine CPT 80194 | $25.07 | $109.00 | $14.60 – $32.48 | 6 |
| Ghs removal intranasal foreign body CPT 30300 | $58.42 | $254.00 | $51.71 – $350.29 | 5 |
| Ghs sedimentation rate CPT 85651 | $5.98 | $26.00 | $4.27 – $9.38 | 6 |
| Ghs sensitivity (per antimicro) CPT 87184 | $11.73 | $51.00 | $7.48 – $16.60 | 6 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $290.95 | $1,265.00 | $175.62 – $359.25 | 5 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $243.11 | $1,057.00 | $243.19 – $359.25 | 5 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $177.79 | $773.00 | $223.91 – $359.25 | 5 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $278.76 | $1,212.00 | $319.00 – $359.25 | 5 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $133.63 | $581.00 | $150.40 – $359.25 | 5 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $121.90 | $530.00 | $138.76 – $359.25 | 5 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $173.42 | $754.00 | $194.40 – $359.25 | 5 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $303.60 | $1,320.00 | $245.14 – $359.25 | 5 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $134.09 | $583.00 | $345.43 – $359.25 | 5 |
| Ghs strapping shoulder - 29240 CPT 29240 | $50.83 | $221.00 | $31.07 – $140.28 | 5 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $241.50 | $1,050.00 | $156.00 – $740.55 | 5 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $218.27 | $949.00 | $105.14 – $740.55 | 5 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $237.82 | $1,034.00 | $319.54 – $4,220.67 | 5 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $72.68 | $316.00 | $165.11 – $919.89 | 5 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $352.59 | $1,533.00 | $244.30 – $919.89 | 5 |
| Ghs vaginal delivery only CPT 59409 | $455.86 | $1,982.00 | $800.16 – $4,532.58 | 5 |
| Gi inhouse confirmation CPT 87045 | $16.10 | $70.00 | $9.44 – $20.93 | 6 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $379.48 | $1,649.93 | $36.59 – $321.11 | 6 |
| Glucagon plasma - sendout CPT 82943 | $24.61 | $107.00 | $14.29 – $31.76 | 6 |
| Glucose 1 hr post dose CPT 82950 | $8.28 | $36.00 | $4.62 – $10.83 | 6 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | $6.90 | $30.00 | $6.05 – $12.99 | 6 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $4.14 | $18.00 | $2.99 – $8.50 | 6 |
| Glucose blood quantitative CPT 82947 | $6.67 | $29.00 | $3.93 – $8.66 | 6 |
| Glucose body fluid CPT 82945 | $6.67 | $29.00 | $3.93 – $8.66 | 6 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $17.25 | $75.00 | $12.87 – $28.15 | 6 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $6.67 | $29.00 | $3.92 – $8.66 | 6 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $31.97 | $139.00 | $18.58 – $41.14 | 6 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $31.74 | $138.00 | $18.52 – $41.14 | 6 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $73.83 | $321.00 | $32.29 – $53.20 | 3 |
| Graft axiofill 1000mg HCPCS J3590 | $145.14 | $631.06 | $246.74 – $246.74 | 1 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $9,519.85 | $41,390.66 | $1.00 – $1.00 | 1 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $40,207.12 | $174,813.58 | $28.41 – $54.75 | 3 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $310.27 | $1,349.00 | $108.70 – $116.00 | 2 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $1,491.55 | $6,485.00 | $1.00 – $1.00 | 2 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $28,666.90 | $124,638.68 | $378.18 – $378.18 | 1 |
| Granulocyte pheresis ea unit HCPCS P9050 | $106.26 | $462.00 | $283.00 – $577.65 | 5 |
| Great toe with reduction 28495 CPT 28495 | $78.20 | $340.00 | $83.52 – $919.89 | 5 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $23,495.50 | $102,154.35 | $14.87 – $38.03 | 2 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $188.42 | $819.21 | $52.71 – $52.71 | 1 |
| Gw stiffened micro access kit HCPCS C1894 | $5,095.07 | $22,152.46 | $21.38 – $29.74 | 2 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $105.29 | $457.79 | $7.74 – $28.29 | 2 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $77.37 | $336.41 | $1.41 – $6.15 | 2 |
| Hand X-ray CPT 73130 | $78.66 | $342.00 | $29.59 – $105.12 | 6 |
| Haptoglobin quantitative CPT 83010 | $21.39 | $93.00 | $12.58 – $27.43 | 6 |
| Hba1/hba2 full gene sequence CPT 81259 | $755.55 | $3,285.00 | $540.00 – $1,322.30 | 6 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | $108.33 | $471.00 | $182.16 – $446.06 | 6 |
| Hba1/hba2 gene fam vrnt CPT 81258 | $472.65 | $2,055.00 | $337.73 – $827.16 | 6 |
| Hbb full gene sequence CPT 81364 | $275.77 | $1,199.00 | $240.04 – $715.28 | 6 |
| Hbot, full body chamber, 30m HCPCS G0277 | $120.29 | $523.00 | $98.32 – $740.55 | 5 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $245.87 | $1,069.00 | $84.50 – $577.86 | 6 |
| Hcg qualitative CPT 84703 | $13.11 | $57.00 | $7.52 – $16.60 | 6 |
| Hcg quantitative CPT 84702 | $25.76 | $112.00 | $15.05 – $33.20 | 6 |
| Hc nm kidney imaging with flow CPT 78701 | $411.01 | $1,787.00 | $191.07 – $697.93 | 6 |
| Head CT scan (with and without contrast) CPT 70470 | $576.61 | $2,507.00 | $300.68 – $606.37 | 6 |
| Head CT scan (with contrast) CPT 70460 | $549.24 | $2,388.00 | $270.44 – $606.37 | 6 |
| Head CT scan (without contrast) CPT 70450 | $521.87 | $2,269.00 | $172.70 – $606.37 | 6 |
| Hematocrit CPT 85014 | $4.14 | $18.00 | $2.31 – $9.31 | 6 |
| Hemoglobin CPT 85018 | $4.14 | $18.00 | $2.31 – $9.31 | 6 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $11.73 | $51.00 | $8.17 – $18.04 | 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.