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 |
|---|---|---|---|---|
| Leukocyte phagocytosis CPT 86344 | not published | not published | $7.98 – $45.31 | 15 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $3,842.28 | $3,842.28 | $129.22 – $452.57 | 5 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | not published | not published | $1,252.72 – $4,674.26 | 5 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $4,386.04 – $4,386.04 | 1 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $46.93 – $401.48 | 2 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $165.56 – $1,872.68 | 5 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $39.29 – $151.13 | 5 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $1.31 – $5.30 | 2 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.21 – $1.01 | 5 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.07 – $0.21 | 5 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | not published | not published | $0.04 – $0.11 | 5 |
| Levetiracetam therapeutic drug level CPT 80177 | $855.65 | $855.65 | $10.18 – $73.45 | 15 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | not published | not published | $0.77 – $5.72 | 5 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $290.76 – $1,028.52 | 2 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $798.20 | $798.20 | $5.45 – $15.85 | 5 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $10,513.40 – $10,513.40 | 1 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | not published | not published | $0.01 – $0.13 | 2 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $78.30 | $78.30 | $0.01 – $0.03 | 5 |
| Lidocaine therapeutic drug level CPT 80176 | not published | not published | $11.28 – $83.31 | 15 |
| Lift assist for elbow HCPCS L6635 | not published | not published | $183.29 – $261.50 | 12 |
| Lift heel adj small gl60404sm HCPCS L3332 | not published | not published | $66.34 – $94.64 | 12 |
| Lift heel adjustable med HCPCS L3334 | not published | not published | $34.34 – $48.98 | 12 |
| Lifts elevation metal extens HCPCS L3330 | not published | not published | $509.14 – $726.38 | 12 |
| Liletta, 52 mg HCPCS J7297 | $3,080.46 | $3,080.46 | $864.84 – $3,111.05 | 2 |
| Limb exercise test CPT 95875 | not published | not published | $404.59 – $404.59 | 1 |
| Limited ankle motion ea jnt HCPCS L2200 | not published | not published | $40.97 – $58.45 | 12 |
| Limited autopsy CPT 88036 | not published | not published | $12.08 – $512.67 | 3 |
| Limited autopsy CPT 88037 | not published | not published | $10.72 – $454.93 | 3 |
| Limited motion knee joint HCPCS L2184 | not published | not published | $117.10 – $167.06 | 12 |
| Limited visual field xm CPT 92081 | not published | not published | $206.08 – $206.08 | 1 |
| Lincomycin injection HCPCS J2010 | not published | not published | $4.68 – $14.31 | 5 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $1,141.86 | $1,141.86 | $2.60 – $7.26 | 5 |
| Lipase CPT 83690 | $612.47 | $612.47 | $5.29 – $39.06 | 15 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $26.00 – $129.76 | 15 |
| Lipoprotein blood quant CPT 83704 | not published | not published | $26.25 – $181.44 | 15 |
| Lipoprotein direct measurement hdl CPT 83718 | not published | not published | $6.29 – $46.45 | 15 |
| Lipoprotein direct measurement ldl CPT 83721 | not published | not published | $8.06 – $54.12 | 15 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $26.25 – $142.34 | 15 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $387,331.50 – $1,489,833.29 | 4 |
| Listeria monocytogenes CPT 86723 | not published | not published | $10.13 – $74.83 | 15 |
| Lith ion batt cid, ear level HCPCS L8624 | not published | not published | $145.37 – $207.39 | 12 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | not published | not published | $58.31 – $83.19 | 12 |
| Lithium ion battery charger HCPCS L7368 | not published | not published | $454.92 – $649.02 | 12 |
| Lithium therapeutic drug level CPT 80178 | $642.39 | $642.39 | $5.08 – $37.51 | 15 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $2,806.92 | $2,806.92 | $135.28 – $670.68 | 14 |
| Liver elastography 91200 CPT 91200 | not published | not published | $313.99 – $313.99 | 1 |
| Liver Function Test CPT 80076 | $810.01 | $810.01 | $6.27 – $46.37 | 15 |
| Liver imaging CPT 78201 | not published | not published | $75.81 – $1,101.15 | 4 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $88.46 – $1,101.15 | 4 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $87.24 – $917.06 | 4 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $101.51 – $848.52 | 4 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $245.06 – $245.06 | 1 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $2,559.02 – $3,650.87 | 12 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $0.70 – $2.80 | 5 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $112.77 – $112.77 | 1 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $159.00 – $586.23 | 5 |
| Long tongue stirrup HCPCS L2265 | not published | not published | $101.50 – $144.80 | 12 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | not published | not published | $1.18 – $3.74 | 5 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | not published | not published | $45.41 – $64.79 | 12 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | not published | not published | $70.11 – $100.02 | 12 |
| Loudness balance test CPT 92562 | not published | not published | $71.60 – $71.60 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $7,023.34 | $7,023.34 | $224.75 – $1,893.58 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $6,772.97 | $6,772.97 | $215.67 – $1,556.04 | 3 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $6,014.58 | $6,014.58 | $178.39 – $1,331.37 | 3 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $11,569.87 | $11,569.87 | $405.75 – $5,062.54 | 3 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | not published | not published | $316.24 – $2,845.02 | 3 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $7,497.38 | $7,497.38 | $263.44 – $2,594.65 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $1,036.74 | $1,036.74 | $41.29 – $245.18 | 4 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $402.73 – $430.92 | 10 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $13.92 – $42.14 | 2 |
| Lso corset front HCPCS L0972 | not published | not published | $104.09 – $148.51 | 12 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $48.88 – $69.73 | 12 |
| Lso full corset HCPCS L0976 | not published | not published | $137.81 – $196.61 | 12 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $145.69 – $207.86 | 12 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,186.51 – $1,692.76 | 12 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $692.06 – $987.34 | 12 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $94.36 – $134.62 | 12 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $824.95 – $1,176.93 | 12 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,221.23 – $1,742.29 | 12 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $257.98 – $368.05 | 12 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $167.08 – $238.36 | 12 |
| Lso s/c shell/panel custom HCPCS L0640 | not published | not published | $941.39 – $1,343.05 | 12 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $966.45 – $1,378.80 | 12 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $16.88 – $124.68 | 15 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $1.70 – $2.43 | 12 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $54.82 – $78.22 | 12 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $74.65 – $106.50 | 12 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $156.02 – $3,947.38 | 4 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $71.76 – $102.38 | 12 |
| Lumbar sling HCPCS L1090 | not published | not published | $101.97 – $145.48 | 12 |
| Lumizyme injection HCPCS J0221 | not published | not published | $151.18 – $549.58 | 5 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $90.77 – $90.77 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | not published | not published | $136.60 – $136.60 | 1 |
| Lung perfusion imaging CPT 78580 | $2,758.14 | $2,758.14 | $129.71 – $1,049.41 | 4 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $153.78 – $558.57 | 5 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $30.93 – $113.34 | 5 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $277.57 – $850.04 | 2 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $226.03 – $687.20 | 2 |
| Lvad shower bag heartmate HCPCS Q0501 | not published | not published | $460.31 – $656.71 | 12 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $254.54 – $363.15 | 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.