STONESPRINGS HOSPITAL CENTER
24440 Stone Springs Boulevard, Dulles, VA · HCA Virginia · · NPI 1972904738
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 |
|---|---|---|---|---|
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $577.30 | $577.30 | $11.05 – $81.65 | 15 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $862.00 | $862.00 | $12.94 – $95.57 | 15 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $10.30 – $62.48 | 15 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $1,359.01 – $4,792.07 | 5 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $23.05 – $114.32 | 15 |
| Cyto/molecular report CPT 88291 | not published | not published | $24.46 – $164.68 | 5 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $19.48 – $121.19 | 15 |
| Cytopath c/v automated CPT 88147 | not published | not published | $38.82 – $192.44 | 15 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $21.23 – $105.25 | 15 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $13.96 – $86.19 | 15 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $11.25 – $55.76 | 15 |
| Cytopath c/v manual CPT 88150 | not published | not published | $13.96 – $67.59 | 15 |
| Cytopath c/v redo CPT 88153 | not published | not published | $18.45 – $91.48 | 15 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $17.69 – $114.94 | 15 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $24.67 – $198.17 | 4 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $1,219.68 | $1,219.68 | $49.76 – $242.08 | 4 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $73.44 | $73.44 | $20.43 – $150.26 | 15 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | not published | not published | $15.55 – $114.94 | 15 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $376.01 | $376.01 | $33.84 – $175.74 | 4 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | not published | not published | $33.84 – $183.24 | 4 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $609.77 | $609.77 | $7.33 – $35.66 | 3 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $609.84 | $609.84 | $81.00 – $725.66 | 4 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $609.84 | $609.84 | $49.76 – $373.94 | 4 |
| Cytopath smear other source CPT 88160 | $322.50 | $322.50 | $24.67 – $205.68 | 4 |
| Cytopath smear other source CPT 88162 | not published | not published | $49.76 – $339.02 | 4 |
| Cytopath smear oth prep screen & interp CPT 88161 | not published | not published | $24.67 – $213.18 | 4 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $13.96 – $67.59 | 15 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $13.96 – $67.59 | 15 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $32.41 – $160.69 | 15 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $13.96 – $67.59 | 15 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $60.39 – $299.38 | 15 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $22.79 – $168.37 | 15 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $291.26 – $1,916.24 | 4 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | not published | not published | $3.38 – $10.92 | 5 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $216.60 – $816.17 | 5 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | not published | not published | $11.68 – $41.31 | 5 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $12.03 – $39.49 | 5 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $439.73 | $439.73 | $0.02 – $0.08 | 5 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.04 – $0.16 | 5 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $39.74 – $145.91 | 5 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | not published | not published | $2.19 – $8.00 | 5 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $2.19 – $8.00 | 5 |
| Dark field exam spec collj CPT 87164 | not published | not published | $8.25 – $60.94 | 15 |
| Dark field exam without collj CPT 87166 | not published | not published | $8.68 – $64.07 | 15 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $186.77 – $690.30 | 5 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $638.04 | $638.04 | $19.80 – $69.77 | 5 |
| Daunorubicin citrate inj HCPCS J9151 | not published | not published | $52.47 – $52.47 | 1 |
| Dch glucoscan CPT 82948 | not published | not published | $3.87 – $19.21 | 15 |
| Dch pulmonary stress test CPT 94621 | not published | not published | $298.48 – $298.48 | 1 |
| Dch validity tests CPT 81002 | not published | not published | $2.67 – $14.49 | 15 |
| Deamidated gliadin antibody iga CPT 86258 | not published | not published | $9.25 – $46.81 | 15 |
| Debridement (>20 cm) charge pt CPT 97598 | not published | not published | $49.76 – $143.62 | 11 |
| Decalcification CPT 88311 | $327.37 | $327.37 | $8.72 – $43.93 | 4 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | not published | not published | $1.33 – $2.47 | 5 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $251.36 | $251.36 | $6.16 – $22.45 | 5 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | not published | not published | $3.27 – $11.79 | 5 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | not published | not published | $62.98 – $62.98 | 1 |
| Dengue vacc quad 3 dose subq CPT 90587 | not published | not published | $52.47 – $209.88 | 4 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | not published | not published | $20.86 – $78.07 | 5 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | not published | not published | $2.77 – $3.95 | 12 |
| Depo-estradiol cypionate inj HCPCS J1000 | not published | not published | $31.74 – $137.32 | 5 |
| Derma-gide, 1 sq cm HCPCS Q4203 | not published | not published | $225.13 – $1,356.38 | 4 |
| Dermagraft HCPCS Q4106 | not published | not published | $40.90 – $40.90 | 1 |
| Dermapure 1 square cm HCPCS Q4152 | not published | not published | $40.96 – $336.92 | 4 |
| Dermavest, plurivest sq cm HCPCS Q4153 | not published | not published | $96.06 – $336.92 | 4 |
| Derm-maxx, per sq cm HCPCS Q4238 | not published | not published | $336.92 – $2,685.21 | 4 |
| Description not available HCPCS S0013 | not published | not published | $13.83 – $13.83 | 1 |
| Design mlc device for imrt CPT 77338 | not published | not published | $872.71 – $1,421.88 | 2 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $523.47 | $523.47 | $3.37 – $9.04 | 5 |
| Desoxycorticosterone CPT 82633 | not published | not published | $23.79 – $175.72 | 15 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $23.05 – $114.32 | 15 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $33.53 – $227.48 | 15 |
| Determination venous press CPT 93770 | not published | not published | $33.44 – $33.44 | 1 |
| Developmental screen/score/document 96110 CPT 96110 | not published | not published | $51.87 – $51.87 | 1 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,127.43 – $4,046.36 | 2 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $21.79 – $29.06 | 2 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $36.00 – $182.03 | 4 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $83.01 – $261.45 | 5 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.06 – $7.18 | 2 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.03 – $0.06 | 5 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.07 – $0.29 | 5 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $153.93 – $542.03 | 5 |
| Dexamethasone panel CPT 80420 | not published | not published | $124.30 – $616.20 | 15 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $2.33 – $2.33 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $49.95 – $153.73 | 5 |
| Dextran 40 infusion HCPCS J7100 | not published | not published | $39.86 – $1,009.62 | 2 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $13.21 – $13.21 | 1 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.65 – $0.65 | 1 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $0.94 – $3.47 | 5 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $319.58 | $319.58 | $7.41 – $16.03 | 2 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $1.36 – $4.64 | 5 |
| Dextrose 5 % IV bolus HCPCS J7070 | $319.58 | $319.58 | $2.73 – $7.79 | 5 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $351.68 | $351.68 | $17.07 – $126.14 | 15 |
| Diabetes (HbA1c) Test CPT 83036 | $577.08 | $577.08 | $7.46 – $55.05 | 15 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $203.85 – $290.83 | 12 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $34.34 – $49.00 | 12 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $34.34 – $49.00 | 12 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $34.34 – $49.00 | 12 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $11.27 – $17.55 | 12 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $67.97 – $96.97 | 12 |
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.