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 |
|---|---|---|---|---|
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $34.34 – $49.00 | 12 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $90.05 – $643.65 | 5 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $73.89 – $502.13 | 5 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $1,292.85 | $1,292.85 | $79.86 – $643.65 | 14 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $62.67 – $502.13 | 14 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $76.53 – $507.14 | 3 |
| Dialysis one evaluation CPT 90945 | not published | not published | $268.88 – $268.88 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $5.23 – $35.02 | 13 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | not published | not published | $0.06 – $0.19 | 5 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $213.55 | $213.55 | $4.34 – $17.73 | 5 |
| Dicyclomine injection HCPCS J0500 | $541.64 | $541.64 | $9.64 – $30.02 | 5 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.22 – $0.74 | 2 |
| Diffusing capacity CPT 94729 | not published | not published | $525.83 – $525.83 | 1 |
| Digital analysis of eeg CPT 95957 | not published | not published | $722.50 – $722.50 | 1 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $3.66 – $25.36 | 5 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $4,885.90 | $4,885.90 | $3,726.43 – $13,692.52 | 5 |
| Digoxin total therapeutic drug level CPT 80162 | $402.95 | $402.95 | $10.20 – $75.31 | 15 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $1,017.28 | $1,017.28 | $64.31 – $151.26 | 5 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.05 – $0.08 | 2 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $49.64 – $49.64 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $2.44 – $12.04 | 5 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $536.04 – $1,985.46 | 5 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.02 – $3.76 | 2 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $156.07 | $156.07 | $0.49 – $1.88 | 5 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $48.68 – $67.36 | 2 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $2.88 – $22.29 | 5 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $33.76 – $33.76 | 1 |
| Disability dlco CPT 94727 | not published | not published | $166.42 – $166.42 | 1 |
| Disaccharidases CPT 82657 | not published | not published | $17.02 – $102.43 | 15 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $221.16 – $3,947.38 | 4 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $79.41 – $113.29 | 12 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $188.50 – $268.93 | 12 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $59.31 – $79.08 | 2 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $279.00 – $1,062.07 | 14 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $274.83 – $1,046.19 | 13 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $137.00 – $521.51 | 13 |
| Dna antibody native/double stranded CPT 86225 | $551.86 | $551.86 | $10.55 – $77.95 | 15 |
| Dna gardnerella CPT 87510 | not published | not published | $15.40 – $113.76 | 15 |
| Dna probe chlamydia CPT 87490 | not published | not published | $17.47 – $113.76 | 15 |
| Dna probe gc CPT 87590 | not published | not published | $20.64 – $113.76 | 15 |
| Dna trichomonas CPT 87660 | not published | not published | $15.40 – $113.76 | 15 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | not published | not published | $6.11 – $21.25 | 5 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | not published | not published | $0.46 – $1.72 | 5 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $38.71 – $131.86 | 5 |
| Dolasetron mesylate HCPCS J1260 | not published | not published | $5.61 – $9.73 | 2 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $55.98 – $151.37 | 2 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | not published | not published | $0.53 – $2.12 | 5 |
| Doppler echo complete CPT 93320 | $1,804.33 | $1,804.33 | $372.11 – $372.11 | 1 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $1,142.99 – $1,142.99 | 1 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,091.04 | $1,091.04 | $625.93 – $750.86 | 2 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $1,028.17 | $1,028.17 | $405.79 – $489.51 | 2 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $0.80 – $0.80 | 1 |
| Dornase alfa non-comp unit HCPCS J7639 | $557.95 | $557.95 | $40.19 – $146.17 | 5 |
| Dornhoffer fixed part w/window HCPCS L8614 | not published | not published | $17,904.53 – $25,543.79 | 12 |
| Dorsi & plantar flex ass/res HCPCS L2220 | not published | not published | $70.57 – $100.69 | 12 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $180.10 – $655.72 | 5 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | not published | not published | $2.36 – $7.37 | 5 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $112.81 – $275.63 | 5 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $214.78 | $214.78 | $0.09 – $0.27 | 5 |
| Dpyd gene common variants CPT 81232 | not published | not published | $174.81 – $665.45 | 13 |
| Drainable plastic pch w fcpl HCPCS A4375 | not published | not published | $18.35 – $26.18 | 12 |
| Drain chst dry seal exp thorastat HCPCS A7041 | not published | not published | $79.30 – $113.13 | 12 |
| Drain ostomy pouch w/flange HCPCS A5063 | not published | not published | $2.90 – $4.13 | 12 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | not published | not published | $37.86 – $336.92 | 4 |
| Driver pneumatic vad, rep HCPCS Q0480 | not published | not published | $81,182.25 – $115,820.01 | 12 |
| Dronabinol 2.5mg oral HCPCS Q0167 | not published | not published | $1.11 – $3.58 | 5 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $126.41 | $126.41 | $6.43 – $19.03 | 5 |
| Drop lock knee HCPCS L2182 | not published | not published | $85.66 – $122.20 | 12 |
| Drop lock retainer each HCPCS L2785 | not published | not published | $27.43 – $39.13 | 12 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | not published | not published | $9.40 – $336.92 | 4 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | not published | not published | $9.01 – $336.92 | 4 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | not published | not published | $3.86 – $336.92 | 4 |
| Drsg surg adh 11x11 3/4 occl drap wnd 28x30 HCPCS A6259 | not published | not published | $11.69 – $16.68 | 12 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | not published | not published | $137.66 – $336.92 | 2 |
| Drsg wnd hyalomatrix 10x10cm -cost per sq cm HCPCS Q4117 | not published | not published | $336.92 – $336.92 | 1 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | not published | not published | $37.34 – $336.92 | 4 |
| Drsg wound/burn 18x10cm suprathel resorb cost per sq cm HCPCS A2012 | not published | not published | $336.92 – $336.92 | 1 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | not published | not published | $187.19 – $336.92 | 2 |
| Drug assay caffeine CPT 80155 | not published | not published | $29.62 – $146.82 | 15 |
| Drug assay posaconazole CPT 80187 | not published | not published | $20.82 – $110.07 | 15 |
| Drug assay rufinamide CPT 80210 | not published | not published | $20.82 – $110.07 | 15 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $29.62 – $156.59 | 15 |
| Drug assay voriconazole CPT 80285 | not published | not published | $20.82 – $110.07 | 15 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $14.31 – $75.68 | 15 |
| Drug of abuse screen urine CPT 80305 | not published | not published | $9.68 – $82.50 | 15 |
| Drug screen quant tiagabine CPT 80199 | not published | not published | $20.82 – $103.19 | 15 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $152.60 – $910.94 | 14 |
| Drug test def 1-7 classes HCPCS G0480 | $1,626.36 | $1,626.36 | $87.86 – $438.60 | 15 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $189.60 – $1,180.85 | 14 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $120.24 – $674.77 | 14 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $62.14 – $291.63 | 14 |
| Drug test prsmv instrmnt CPT 80306 | not published | not published | $13.16 – $82.50 | 15 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $1,626.36 | $1,626.36 | $47.71 – $236.53 | 15 |
| Drvvt confirm - quest CPT 85597 | not published | not published | $13.81 – $101.99 | 15 |
| Ductogram sgl duct CPT 77053 | not published | not published | $64.23 – $699.84 | 4 |
| Duodenal motility study CPT 91022 | not published | not published | $765.38 – $765.38 | 1 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $827.29 – $1,210.56 | 2 |
| Duplex scan unilateral study 93986 CPT 93986 | not published | not published | $397.88 – $704.58 | 2 |
| Dup scan/hemodialysis access 93990 CPT 93990 | not published | not published | $712.25 – $716.14 | 2 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | not published | not published | $785.14 – $886.40 | 2 |
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.