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 |
|---|---|---|---|---|
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | not published | not published | $0.21 – $1.40 | 2 |
| Admin ecg contrast agent CPT 93352 | not published | not published | $21.28 – $161.74 | 3 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | not published | not published | $138.91 – $138.91 | 1 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | not published | not published | $240.41 – $240.41 | 1 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | not published | not published | $776.38 – $776.38 | 1 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | not published | not published | $519.15 – $519.15 | 1 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | not published | not published | $138.91 – $138.91 | 1 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | not published | not published | $138.91 – $138.91 | 1 |
| Administration immunization 1 vaccine CPT 90471 | not published | not published | $118.85 – $118.85 | 1 |
| Administration immunization each additional vaccine CPT 90472 | not published | not published | $78.42 – $78.42 | 1 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $60.63 – $60.63 | 1 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $14.04 – $18.72 | 2 |
| Administration vaccine influenza virus HCPCS G0008 | not published | not published | $21.00 – $21.00 | 1 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $11.98 – $15.98 | 2 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $30.83 – $111.80 | 5 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $131.04 – $2,938.37 | 4 |
| Adrenalin epinephrine inject HCPCS J0171 | not published | not published | $0.55 – $0.73 | 3 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $80.96 – $86.63 | 10 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $318.12 – $318.12 | 1 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $426.53 – $426.53 | 1 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $426.53 – $426.53 | 1 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,924.37 – $7,800.06 | 2 |
| Afamitresgene autoleucel HCPCS Q2057 | not published | not published | $1,199,550.00 – $2,042,143.00 | 2 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $15.40 – $113.76 | 15 |
| #afb mycobacteria suscep. #1 CPT 87190 | $93.54 | $93.54 | $5.61 – $32.07 | 15 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $88.58 – $663.36 | 15 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $137.00 – $521.51 | 13 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $274.83 – $1,046.19 | 13 |
| Aflibercept injection HCPCS J0178 | not published | not published | $596.89 – $2,024.34 | 5 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | not published | not published | $10.82 – $68.21 | 2 |
| Afo molded ankle gauntlet HCPCS L1904 | not published | not published | $483.14 – $689.28 | 12 |
| Afo molded plas rig ant tib HCPCS L1945 | not published | not published | $1,019.02 – $1,453.80 | 12 |
| Afo molded to patient plasti HCPCS L1940 | not published | not published | $426.22 – $608.08 | 12 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | not published | not published | $802.79 – $1,145.32 | 12 |
| Afo sing bar clasp attach sh HCPCS L1910 | not published | not published | $235.37 – $335.80 | 12 |
| Afo sing solid stirrup calf HCPCS L1980 | not published | not published | $316.30 – $451.25 | 12 |
| Afo sing upright with adjust s HCPCS L1920 | not published | not published | $301.30 – $429.85 | 12 |
| Afo spiral molded to pt plas HCPCS L1950 | not published | not published | $675.65 – $963.93 | 12 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | not published | not published | $232.51 – $331.71 | 12 |
| Afo supramalleolar custom HCPCS L1907 | not published | not published | $506.21 – $722.20 | 12 |
| Afo tib fx cast molded to pt HCPCS L2108 | not published | not published | $1,020.30 – $1,455.63 | 12 |
| Afo tib fx cast plaster mold HCPCS L2106 | not published | not published | $585.98 – $836.00 | 12 |
| Afo tib fx semi-rigid l2114 HCPCS L2114 | not published | not published | $588.62 – $839.76 | 12 |
| Afo tibial fracture rigid HCPCS L2116 | not published | not published | $677.26 – $966.22 | 12 |
| Afo tibial fracture soft HCPCS L2112 | not published | not published | $469.29 – $669.52 | 12 |
| Afo, walk boot type, cus fab HCPCS L4631 | not published | not published | $1,434.48 – $2,046.52 | 12 |
| Afo w/ankle joint, prefab HCPCS L1971 | not published | not published | $421.67 – $601.59 | 12 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $167.13 – $610.35 | 5 |
| Air conduction bilat CPT 92552 | not published | not published | $76.50 – $76.50 | 1 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $159.18 – $159.18 | 1 |
| Ak 4 bar ling w/hydraul swig HCPCS L5613 | not published | not published | $2,250.20 – $3,210.28 | 12 |
| Ak 4 bar link w/fric swing HCPCS L5611 | not published | not published | $1,479.35 – $2,110.54 | 12 |
| Ak/bk self-aligning unit ea HCPCS L5617 | not published | not published | $504.31 – $719.49 | 12 |
| Ak flex inner socket ext fra HCPCS L5651 | not published | not published | $1,102.66 – $1,573.14 | 12 |
| Ak/knee disartic acrylic soc HCPCS L5631 | not published | not published | $492.77 – $703.02 | 12 |
| Ak/knee disartic pelvic band HCPCS L5697 | not published | not published | $77.57 – $110.67 | 12 |
| Ak/knee disartic pelvic join HCPCS L5696 | not published | not published | $190.97 – $272.44 | 12 |
| Ak/knee disartic silesian ba HCPCS L5698 | not published | not published | $96.48 – $137.64 | 12 |
| Ak open end sach HCPCS L5321 | not published | not published | $3,017.80 – $4,305.39 | 12 |
| Ak pelvic control belt light HCPCS L5692 | not published | not published | $126.05 – $179.83 | 12 |
| Ak pelvic control belt pad/l HCPCS L5694 | not published | not published | $166.57 – $237.65 | 12 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | not published | not published | $174.73 – $249.29 | 12 |
| Ak univ multiplex sys frict HCPCS L5616 | not published | not published | $1,247.04 – $1,779.11 | 12 |
| Albumin body fluid quantitative each specimen CPT 82042 | $93.54 | $93.54 | $5.98 – $29.64 | 15 |
| Albumin (human), 25%, 50ml HCPCS P9047 | not published | not published | $39.81 – $140.66 | 5 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $15.92 – $56.26 | 5 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $39.81 – $140.66 | 5 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $7.96 – $30.44 | 5 |
| Albumin ischemia modified CPT 82045 | not published | not published | $26.06 – $192.57 | 15 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $775.96 | $775.96 | $4.44 – $32.85 | 15 |
| Albumin serum plasma or whole blood CPT 82040 | $464.31 | $464.31 | $3.80 – $28.10 | 15 |
| Albuterol comp con HCPCS J7610 | not published | not published | $1.12 – $1.12 | 1 |
| Albuterol comp unit HCPCS J7609 | not published | not published | $0.46 – $0.46 | 1 |
| Albuterol ipratrop non-comp HCPCS J7620 | $22.45 | $22.45 | $0.14 – $0.53 | 5 |
| Albuterol non-comp con HCPCS J7611 | $9.18 | $9.18 | $0.14 – $0.69 | 5 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.06 – $0.19 | 5 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $876.60 | $876.60 | $17.27 – $70.12 | 14 |
| Alcohols biomarkers 3/more CPT 80322 | not published | not published | $61.31 – $61.31 | 1 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $5,624.89 – $8,848.01 | 2 |
| Aldosterone suppression eval CPT 80408 | not published | not published | $96.37 – $711.88 | 15 |
| Alefacept HCPCS J0215 | not published | not published | $37.89 – $37.89 | 1 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $1,831.12 – $6,484.82 | 5 |
| Alginate dressing <=16 sq in HCPCS A6196 | not published | not published | $7.87 – $11.22 | 12 |
| Alginate drsg >16 <=48 sq in HCPCS A6197 | not published | not published | $17.58 – $25.08 | 12 |
| Alginate drsg wound filler HCPCS A6199 | not published | not published | $5.64 – $8.05 | 12 |
| Alglucerase injection HCPCS J0205 | not published | not published | $38.25 – $38.25 | 1 |
| Alglucosidase alfa injection HCPCS J0220 | not published | not published | $188.10 – $188.10 | 1 |
| Alkaline phosphatase CPT 84075 | $603.09 | $603.09 | $3.97 – $29.35 | 15 |
| Allergen alpha lactalbumin ige CPT 86008 | not published | not published | $13.77 – $68.22 | 14 |
| Allergen egg white ige CPT 86003 | $202.78 | $202.78 | $4.00 – $29.64 | 15 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $6.12 – $30.35 | 15 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $90.24 – $90.24 | 1 |
| Allergy Skin Testing CPT 95004 | not published | not published | $17.50 – $17.50 | 1 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $59.36 – $59.36 | 1 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $62.07 – $336.92 | 4 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $76.64 – $336.92 | 4 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | not published | not published | $336.92 – $336.92 | 1 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $18.35 – $336.92 | 4 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | not published | not published | $118.75 – $336.92 | 4 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $336.92 – $336.92 | 1 |
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.