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 |
|---|---|---|---|---|
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | not published | not published | $123.69 – $460.23 | 5 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $94.77 | $94.77 | $4.22 – $23.03 | 2 |
| Papaverin hcl injection HCPCS J2440 | not published | not published | $34.81 – $121.74 | 2 |
| Parathormone (pth) intact CPT 83970 | $952.56 | $952.56 | $31.70 – $234.14 | 15 |
| Parathyrd planar w/spect&ct CPT 78072 | not published | not published | $272.41 – $1,869.55 | 4 |
| Parathyroid planar imaging CPT 78070 | not published | not published | $140.05 – $1,334.80 | 4 |
| Parathyroid planar img w/tomo spect CPT 78071 | $2,806.06 | $2,806.06 | $208.06 – $1,524.70 | 4 |
| Parenteral 50% dextrose solu HCPCS B4164 | not published | not published | $18.50 – $24.66 | 2 |
| Paricalcitol HCPCS J2501 | not published | not published | $0.61 – $2.57 | 5 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | not published | not published | $1.91 – $21.01 | 4 |
| Passy muir valve metal trach HCPCS L8501 | $2,356.00 | $2,356.00 | $110.91 – $158.23 | 12 |
| Paste skin barrier .5oz adapt HCPCS A4406 | not published | not published | $6.12 – $8.73 | 12 |
| Path clin consltj high 41-60 CPT 80505 | not published | not published | $152.32 – $741.04 | 3 |
| Path clin consltj mod 21-40 CPT 80504 | not published | not published | $152.32 – $741.04 | 3 |
| Path clin consltj prolng svc CPT 80506 | not published | not published | $43.26 – $210.46 | 3 |
| Path clin consltj sf 5-20 CPT 80503 | not published | not published | $50.75 – $246.90 | 3 |
| Patient recorded spirometry CPT 94014 | not published | not published | $196.88 – $196.88 | 1 |
| Patient recorded spirometry CPT 94015 | not published | not published | $101.14 – $101.14 | 1 |
| Patten bottom HCPCS L2370 | not published | not published | $288.94 – $412.23 | 12 |
| Pca3/klk3 antigen CPT 81313 | not published | not published | $195.84 – $1,056.66 | 15 |
| Pcv21 vaccine im CPT 90684 | not published | not published | $245.92 – $912.26 | 5 |
| Pdgfra gene CPT 81314 | not published | not published | $329.51 – $1,337.81 | 14 |
| Pd hl 3.5in 4d med rbr mld 6432 HCPCS L3350 | not published | not published | $20.61 – $29.40 | 12 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $152.33 – $152.33 | 1 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $152.33 – $152.33 | 1 |
| Pediatric electric hand HCPCS L7008 | not published | not published | $5,626.08 – $8,026.54 | 12 |
| Pediatric electric hook HCPCS L7045 | not published | not published | $1,484.09 – $2,117.31 | 12 |
| Ped term dev, hand, vol clos HCPCS L6714 | not published | not published | $1,192.76 – $1,701.67 | 12 |
| Ped term dev, hand, vol open HCPCS L6713 | not published | not published | $1,408.26 – $2,009.12 | 12 |
| Ped term dev, hook, vol clos HCPCS L6712 | not published | not published | $1,115.77 – $1,591.83 | 12 |
| Ped term dev, hook, vol open HCPCS L6711 | not published | not published | $606.00 – $864.56 | 12 |
| Pegademase bovine, 25 iu HCPCS J2504 | not published | not published | $334.84 – $334.84 | 1 |
| Pegaptanib sodium injection HCPCS J2503 | not published | not published | $714.81 – $714.81 | 1 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $20,302.88 – $75,323.76 | 5 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | not published | not published | $14.98 – $325.53 | 5 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $100.69 – $352.58 | 5 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | not published | not published | $122.70 – $429.27 | 5 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $188.44 – $390.19 | 5 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $84.68 – $262.01 | 5 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $123.11 – $337.16 | 5 |
| Peginesatide injection HCPCS J0890 | not published | not published | $7.46 – $7.46 | 1 |
| Peg interferon alfa-2a/180 HCPCS S0145 | not published | not published | $1,033.48 – $1,033.48 | 1 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $2,673.99 – $9,987.35 | 5 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $170.20 – $598.77 | 5 |
| Pelv band/spread bar thigh c HCPCS L1640 | not published | not published | $444.55 – $634.22 | 12 |
| Pelvic band & belt thigh fla HCPCS L2192 | not published | not published | $352.91 – $503.49 | 12 |
| Pelvic control band & belt b HCPCS L2640 | not published | not published | $289.63 – $413.20 | 12 |
| Pelvic control band & belt u HCPCS L2630 | not published | not published | $213.41 – $304.47 | 12 |
| Pelvic control hip heavy dut HCPCS L2620 | not published | not published | $260.87 – $372.17 | 12 |
| Pelvic control pelvic sling HCPCS L2580 | not published | not published | $399.99 – $570.65 | 12 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $6,267.89 | $6,267.89 | $215.67 – $1,813.75 | 3 |
| Pelvic CT scan (with contrast) CPT 72193 | $5,155.57 | $5,155.57 | $205.30 – $1,501.59 | 3 |
| Pelvic CT scan (without contrast) CPT 72192 | $4,185.82 | $4,185.82 | $191.29 – $1,317.16 | 3 |
| Pelvic & hip control thigh c HCPCS L1680 | not published | not published | $1,050.08 – $1,498.12 | 12 |
| Pelvic MRI (with and without contrast) CPT 72197 | $11,123.29 | $11,123.29 | $390.12 – $4,986.36 | 3 |
| Pelvic MRI (with contrast) CPT 72196 | not published | not published | $305.83 – $2,807.85 | 3 |
| Pelvic MRI (without contrast) CPT 72195 | $6,198.54 | $6,198.54 | $257.19 – $2,346.24 | 3 |
| Pelvic Ultrasound (complete) CPT 76856 | $1,275.19 | $1,275.19 | $124.64 – $430.50 | 4 |
| Pelvic Ultrasound (limited) CPT 76857 | $1,295.40 | $1,295.40 | $91.22 – $390.49 | 4 |
| Pelv & thor control gluteal HCPCS L2650 | not published | not published | $123.31 – $175.93 | 12 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $44.51 – $158.28 | 5 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $19,969.18 | $19,969.18 | $2.83 – $9.51 | 5 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $13.03 – $51.73 | 5 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | not published | not published | $20.23 – $84.72 | 5 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | not published | not published | $0.58 – $2.07 | 5 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $26.55 – $42.65 | 2 |
| Penile vascular study CPT 93980 | not published | not published | $335.24 – $691.93 | 2 |
| Penile vascular study CPT 93981 | not published | not published | $287.30 – $569.63 | 2 |
| Penis study CPT 54240 | not published | not published | $372.22 – $372.22 | 1 |
| Pentamidine 300 mg solution for injection HCPCS J2516 | not published | not published | $0.64 – $0.64 | 1 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $59.63 – $435.71 | 5 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $11.58 – $11.58 | 1 |
| Pentazocine injection HCPCS J3070 | not published | not published | $72.58 – $98.63 | 2 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $49.03 – $96.09 | 2 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $2,005.07 – $6,723.32 | 5 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $1,295.34 | $1,295.34 | $31.41 – $106.56 | 5 |
| Peritoneogram rs&i CPT 74190 | not published | not published | $83.27 – $1,086.50 | 4 |
| Perit-vens shunt pat tst CPT 78291 | not published | not published | $156.66 – $1,154.49 | 4 |
| Peroneal straps pair pre ots HCPCS L0980 | not published | not published | $19.85 – $28.32 | 12 |
| Perp bk ptb thermopls direct HCPCS L5520 | not published | not published | $1,320.40 – $1,883.77 | 12 |
| Perphenazine 4mg oral HCPCS Q0175 | not published | not published | $0.44 – $1.78 | 2 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $5.81 – $5.81 | 1 |
| Pertussis ag if CPT 87265 | not published | not published | $9.20 – $62.48 | 15 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | not published | not published | $12.17 – $45.08 | 5 |
| Pertuzu, trastuzu, 10 mg HCPCS J9316 | not published | not published | $47.24 – $161.54 | 5 |
| Pessary 3.5 in 7 vag sil rng fold HCPCS A4562 | not published | not published | $53.11 – $75.77 | 12 |
| Pessary reusable rub anytype HCPCS A4561 | not published | not published | $21.32 – $30.42 | 12 |
| Pet CT skull-mid thgh initial CPT 78815 | not published | not published | $421.27 – $4,037.57 | 3 |
| Pet CT whole body initial CPT 78816 | not published | not published | $427.59 – $4,171.08 | 3 |
| Pet fdg brain metoblic eval sb CPT 78608 | not published | not published | $256.93 – $3,930.39 | 3 |
| Pet image full body CPT 78813 | not published | not published | $340.42 – $4,409.13 | 3 |
| Pet image ltd area CPT 78811 | not published | not published | $264.72 – $2,938.37 | 3 |
| Pet image skull-thigh CPT 78812 | not published | not published | $332.82 – $3,901.90 | 3 |
| Pet image w/ct lmtd CPT 78814 | not published | not published | $378.73 – $4,542.30 | 3 |
| Pet not otherwise specified HCPCS G0235 | not published | not published | $848.52 – $848.52 | 1 |
| Pet scan brain perf study CPT 78609 | not published | not published | $308.74 – $1,503.22 | 3 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | not published | not published | $13.89 – $27.49 | 12 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | not published | not published | $19.46 – $37.87 | 12 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | not published | not published | $7.15 – $15.01 | 12 |
| Ph body fluid CPT 83986 | $84.92 | $84.92 | $2.75 – $16.85 | 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.