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 |
|---|---|---|---|---|
| Full sole/heel wedge btween HCPCS L3420 | not published | not published | $49.22 – $70.21 | 12 |
| Functional brain mapping CPT 96020 | not published | not published | $424.62 – $424.62 | 1 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $313.25 – $313.25 | 1 |
| Furnsh initial orthosis only HCPCS L1200 | not published | not published | $1,350.35 – $1,926.50 | 12 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | not published | not published | $0.01 – $0.05 | 5 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $274.83 – $1,046.19 | 13 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $137.00 – $521.51 | 13 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $274.83 – $1,046.19 | 13 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $185.20 – $704.99 | 13 |
| G6pc gene CPT 81250 | not published | not published | $58.49 – $444.49 | 14 |
| G6pd full gene sequence CPT 81249 | not published | not published | $600.00 – $2,284.00 | 13 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $665.45 | 13 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $1,428.43 | 13 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $346.73 | $346.73 | $60.18 – $125.33 | 2 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | not published | not published | $51.57 – $131.52 | 2 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | not published | not published | $0.20 – $0.74 | 5 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $1.12 – $3.87 | 5 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.09 – $0.27 | 5 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | not published | not published | $11.03 – $39.09 | 5 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $16.18 – $119.49 | 15 |
| Galactokinase - sendout CPT 82759 | not published | not published | $16.49 – $121.84 | 15 |
| Galactose transferase test CPT 82776 | not published | not published | $9.02 – $47.54 | 15 |
| Galectin-3 CPT 82777 | not published | not published | $33.97 – $168.43 | 15 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $7.03 – $9.57 | 2 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $706.92 – $963.28 | 2 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $722.01 – $1,457.84 | 2 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $959.01 – $1,268.08 | 2 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $764.84 – $960.63 | 2 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $1.89 – $1.89 | 1 |
| Galsulfase injection HCPCS J1458 | not published | not published | $363.66 – $1,361.73 | 5 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $260.06 – $488.85 | 5 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $36.67 – $132.29 | 5 |
| Gammaglobulin iga CPT 82784 | not published | not published | $7.14 – $52.74 | 15 |
| Gammaglobulin ige CPT 82785 | $603.09 | $603.09 | $12.64 – $93.42 | 15 |
| Gamma glutamyltransferase CPT 82977 | $237.95 | $237.95 | $5.53 – $40.84 | 15 |
| Gammagraft HCPCS Q4111 | not published | not published | $5.70 – $336.92 | 4 |
| Gammaplex injection HCPCS J1557 | not published | not published | $43.11 – $169.41 | 5 |
| Gamunex-c/gammaked HCPCS J1561 | not published | not published | $36.26 – $130.06 | 5 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $969.11 | $969.11 | $24.07 – $88.83 | 5 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $15,433.60 – $15,433.60 | 1 |
| Gardner vag dna amp probe CPT 87511 | not published | not published | $26.95 – $199.10 | 15 |
| Gardner vag dna quant CPT 87512 | not published | not published | $32.06 – $160.98 | 15 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $5.15 – $37.15 | 15 |
| Gastric emptying imag study CPT 78265 | not published | not published | $172.14 – $1,806.24 | 4 |
| Gastric emptying imag study CPT 78266 | not published | not published | $182.66 – $2,070.50 | 4 |
| Gastric motility studies CPT 91020 | not published | not published | $953.99 – $953.99 | 1 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $102.84 – $905.10 | 4 |
| Gastrin test CPT 82938 | not published | not published | $13.58 – $100.36 | 15 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $120.67 – $1,118.04 | 4 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $1,003.44 – $1,003.44 | 1 |
| Gastro/jejuno tube, std HCPCS B4087 | not published | not published | $24.32 – $32.43 | 2 |
| Gated heart multiple CPT 78473 | not published | not published | $261.51 – $1,830.84 | 4 |
| Gauze >16<=48 no w/sal without b HCPCS A6223 | not published | not published | $2.59 – $3.70 | 12 |
| Gauze >16 <=48 sq in w/bordr HCPCS A6220 | not published | not published | $2.77 – $3.95 | 12 |
| Gauze <=16 in no w/sal without b HCPCS A6222 | not published | not published | $2.28 – $3.25 | 12 |
| Gauze <= 16 sq in w/border HCPCS A6219 | not published | not published | $1.02 – $1.46 | 12 |
| Gauze > 48 in no w/sal without b HCPCS A6224 | not published | not published | $3.85 – $5.49 | 12 |
| Gba gene CPT 81251 | not published | not published | $47.25 – $846.55 | 14 |
| Gc stocking full lngth 18-30 HCPCS A6536 | not published | not published | $55.46 – $79.13 | 12 |
| Gc stocking full lngth 30-40 HCPCS A6537 | not published | not published | $65.75 – $93.81 | 12 |
| Gc stocking full lngth 40+ HCPCS A6538 | not published | not published | $76.99 – $109.84 | 12 |
| Gc stocking thighlngth 18-30 HCPCS A6533 | not published | not published | $41.14 – $58.70 | 12 |
| Gc stocking thighlngth 30-40 HCPCS A6534 | not published | not published | $46.99 – $67.04 | 12 |
| Gc stocking thighlngth 40+ HCPCS A6535 | not published | not published | $54.10 – $77.18 | 12 |
| Gc stocking waistlngth 18-30 HCPCS A6539 | not published | not published | $73.39 – $104.71 | 12 |
| Gc stocking waistlngth 30-40 HCPCS A6540 | not published | not published | $87.51 – $124.85 | 12 |
| Gc stocking waistlngth 40+ HCPCS A6541 | not published | not published | $103.66 – $147.88 | 12 |
| Gefitinib oral HCPCS J8565 | not published | not published | $130.14 – $771.15 | 2 |
| Gel cap app device for trach HCPCS L8515 | not published | not published | $56.88 – $81.15 | 12 |
| Gel cap for trach voice pros HCPCS L8512 | not published | not published | $1.94 – $2.77 | 12 |
| Gel-one HCPCS J7326 | not published | not published | $403.86 – $1,399.33 | 5 |
| Gel-syn injection 0.1 mg HCPCS J7328 | not published | not published | $0.44 – $1.78 | 5 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $847.51 | $847.51 | $2.23 – $9.51 | 5 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | not published | not published | $174.84 – $636.45 | 5 |
| General health panel CPT 80050 | not published | not published | $45.36 – $220.68 | 5 |
| Genetic tstg severe inh cond CPT 81443 | not published | not published | $2,448.56 – $9,320.82 | 13 |
| Genome re-evaluation CPT 81427 | not published | not published | $1,794.96 – $8,898.63 | 14 |
| Genome sequence analysis CPT 81425 | not published | not published | $3,863.20 – $19,152.07 | 14 |
| Genome sequence analysis CPT 81426 | not published | not published | $2,080.84 – $10,315.88 | 14 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | not published | not published | $1.85 – $5.75 | 5 |
| Gentamicin peak therapeutic drug level CPT 80170 | not published | not published | $12.58 – $92.97 | 15 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $4.73 – $12.61 | 5 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $1,994.57 – $1,994.57 | 1 |
| Ghs acetylcholinesterase, rbc CPT 82482 | not published | not published | $7.53 – $43.60 | 15 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | not published | not published | $13.14 – $91.15 | 15 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | not published | not published | $102.26 – $821.70 | 14 |
| Ghs analysis neurostim without reprogramming CPT 95970 | not published | not published | $84.56 – $84.56 | 1 |
| Ghs antibodies (torch) igm CPT 86694 | not published | not published | $11.05 – $81.65 | 15 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $3.70 – $25.54 | 15 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $818.27 – $818.27 | 1 |
| Ghs chemo IV push, ea addtl CPT 96411 | not published | not published | $265.15 – $265.15 | 1 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $917.76 | $917.76 | $26.95 – $199.10 | 15 |
| Ghs community re-entry 15 minutes CPT 97537 | $227.02 | $227.02 | $32.54 – $49.44 | 11 |
| Ghs diphtheria toxoid ab igg CPT 86648 | not published | not published | $11.68 – $86.27 | 15 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | not published | not published | $3,012.60 – $3,012.60 | 1 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $109.23 – $109.23 | 1 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $366.47 – $366.47 | 1 |
| Ghs elect vertical elct CPT 92547 | not published | not published | $20.48 – $20.48 | 1 |
| Ghs eye exam CPT 92002 | not published | not published | $429.27 – $429.27 | 1 |
| Ghs fat & muscle CPT 89160 | not published | not published | $3.73 – $20.91 | 15 |
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.