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 |
|---|---|---|---|---|
| PSA (Prostate) Test CPT 84153 | $749.40 | $749.40 | $14.12 – $104.34 | 15 |
| Psych/neuropsych test admin automated result 96146 CPT 96146 | not published | not published | $91.27 – $91.27 | 1 |
| Psychotherapy patient individual therapy 30 minutes CPT 90832 | not published | not published | $594.98 – $594.98 | 1 |
| Psychotherapy patient individual therapy 45 minutes CPT 90834 | not published | not published | $594.98 – $594.98 | 1 |
| Psychotherapy patient individual therapy 60 minutes CPT 90837 | not published | not published | $594.98 – $594.98 | 1 |
| Psych test eval svc phys/qhp 1st hr CPT 96130 | not published | not published | $91.27 – $91.27 | 1 |
| Psych test eval svc phys/qhp ea addl hr CPT 96131 | not published | not published | $91.27 – $91.27 | 1 |
| Psycl/nrpsyc tech 1st CPT 96138 | not published | not published | $91.27 – $91.27 | 1 |
| Psy/npsy phys/qhp 2> tst 1st 30 min CPT 96136 | not published | not published | $91.27 – $91.27 | 1 |
| Psy/npsy phys/qhp 2> tst ea l 30 min CPT 96137 | not published | not published | $91.27 – $91.27 | 1 |
| Psy/npsy tst admin tech 2> ea l 30 min CPT 96139 | not published | not published | $91.27 – $91.27 | 1 |
| Psytx complex interactive CPT 90785 | not published | not published | $594.98 – $594.98 | 1 |
| Psytx pt w/e&m 16-37 min CPT 90833 | not published | not published | $594.98 – $594.98 | 1 |
| Psytx pt w/e&m 38-52 min CPT 90836 | not published | not published | $594.98 – $594.98 | 1 |
| Psytx pt w/e&m 53+ min CPT 90838 | not published | not published | $594.98 – $594.98 | 1 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | not published | not published | $10.55 – $37.08 | 13 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | not published | not published | $13.90 – $42.23 | 13 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | not published | not published | $10.30 – $35.02 | 13 |
| Pt application of modality traction mechanical CPT 97012 | not published | not published | $10.55 – $41.20 | 13 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $290.53 – $1,142.00 | 14 |
| Pten gene full sequence CPT 81321 | not published | not published | $600.00 – $2,284.00 | 14 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.60 – $237.10 | 14 |
| Pt evaluation high complexity patient/family CPT 97163 | $881.96 | $881.96 | $72.78 – $123.60 | 13 |
| Pt evaluation low complexity patient/family CPT 97161 | $881.96 | $881.96 | $72.78 – $123.60 | 13 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $881.96 | $881.96 | $72.78 – $123.60 | 13 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $14.71 – $95.74 | 3 |
| Pt prgrm for implt neurostim HCPCS L8681 | not published | not published | $990.54 – $1,413.17 | 12 |
| Pt re-evaluation patient/family CPT 97164 | $526.38 | $526.38 | $50.20 – $67.98 | 13 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $227.02 | $227.02 | $30.48 – $40.64 | 12 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | not published | not published | $9.09 – $38.11 | 13 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $219.67 | $219.67 | $21.39 – $45.32 | 13 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | not published | not published | $22.06 – $41.20 | 13 |
| Pt wheelchair management each 15 minutes CPT 97542 | not published | not published | $22.83 – $41.20 | 13 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,409.60 – $20,936.63 | 13 |
| Pulmonary vent imaging CPT 78579 | not published | not published | $85.88 – $1,024.40 | 4 |
| Pulse ox continuous overnight monitoring CPT 94762 | not published | not published | $88.86 – $88.86 | 1 |
| Pulse ox multiple CPT 94761 | $139.08 | $139.08 | $18.85 – $18.85 | 1 |
| Pulse ox single CPT 94760 | $85.08 | $85.08 | $8.98 – $8.98 | 1 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $75.13 – $336.92 | 4 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $55.16 – $336.92 | 4 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $618.51 – $882.41 | 12 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $14,651.78 – $20,903.20 | 12 |
| Pyridoxine hcl 100 mg HCPCS J3415 | $77.86 | $77.86 | $9.43 – $41.23 | 5 |
| Pyruvate CPT 84210 | not published | not published | $11.12 – $61.59 | 15 |
| Pyruvate kinase CPT 84220 | not published | not published | $7.25 – $53.51 | 15 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $311.04 – $443.75 | 12 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $26.53 – $26.53 | 1 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | not published | not published | $145.12 – $1,567.18 | 4 |
| Quant diff pulm perf w/imaging CPT 78597 | not published | not published | $127.29 – $1,567.18 | 4 |
| Quest t3 uptake CPT 84479 | $251.00 | $251.00 | $4.96 – $36.70 | 15 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $503.56 – $718.42 | 12 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $312.46 – $432.55 | 2 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | $3,792.98 | $3,792.98 | $461.26 – $933.97 | 2 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $180.86 – $636.34 | 5 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | not published | not published | $217.43 – $741.87 | 5 |
| Rabies vaccine id CPT 90676 | not published | not published | $627.68 – $627.68 | 1 |
| Radiation handling CPT 77790 | not published | not published | $317.38 – $317.38 | 1 |
| Radiation physics consult CPT 77336 | not published | not published | $545.43 – $545.43 | 1 |
| Radiation therapy dose plan CPT 77300 | not published | not published | $126.80 – $378.85 | 2 |
| Radiation therapy management CPT 77431 | not published | not published | $66.47 – $412.53 | 4 |
| Radiation treatment aid(s) CPT 77332 | not published | not published | $68.24 – $361.34 | 2 |
| Radiation treatment aid(s) CPT 77333 | not published | not published | $151.51 – $528.15 | 2 |
| Radiation treatment aid(s) CPT 77334 | not published | not published | $232.97 – $861.93 | 2 |
| Radiation treatment delivery CPT 77401 | not published | not published | $325.98 – $325.98 | 1 |
| Radiation treatment delivery CPT 77402 | not published | not published | $325.98 – $325.98 | 1 |
| Radiation treatment delivery CPT 77412 | not published | not published | $427.12 – $427.12 | 1 |
| Radiation tx management x5 CPT 77427 | not published | not published | $117.86 – $755.45 | 4 |
| Radiesse injection HCPCS Q2026 | not published | not published | $925.35 – $925.35 | 1 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $4,749.78 – $6,776.35 | 12 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $729.13 – $1,040.22 | 12 |
| Radiology port images(s) CPT 77417 | not published | not published | $109.09 – $109.09 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | not published | not published | $1,624.79 – $6,833.09 | 2 |
| Radium ra223 dichl ther/uci HCPCS A9606 | not published | not published | $123.07 – $455.59 | 5 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | not published | not published | $137.36 – $2,938.37 | 4 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | not published | not published | $173.35 – $3,103.55 | 4 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $311.01 – $3,260.85 | 4 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $4,281.37 | $4,281.37 | $188.99 – $2,938.37 | 4 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $117.18 – $1,160.68 | 4 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $82.36 – $488.18 | 2 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $55.03 – $200.29 | 5 |
| Range of motion measurements CPT 95852 | not published | not published | $14.79 – $23.40 | 13 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $67.81 – $173.42 | 5 |
| Rapid Strep Test CPT 87880 | not published | not published | $12.69 – $62.90 | 15 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | $4,684.22 | $4,684.22 | $277.84 – $1,015.93 | 5 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $165.24 – $595.72 | 5 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $349.82 – $1,417.96 | 2 |
| Rbc count only automated CPT 85041 | not published | not published | $2.32 – $16.32 | 15 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $6.60 – $48.80 | 15 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $5.74 – $36.42 | 15 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $3.46 – $1,314.62 | 4 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $22,675.48 – $22,675.48 | 1 |
| Reconstruct elbow joint CPT 24361 | not published | not published | $22,675.48 – $22,675.48 | 1 |
| Reconstruct elbow joint CPT 24362 | not published | not published | $16,603.53 – $16,603.53 | 1 |
| Reconstruct elbow med ligmnt CPT 24346 | not published | not published | $16,603.53 – $16,603.53 | 1 |
| Reconstruct head of radius CPT 24365 | not published | not published | $16,603.53 – $16,603.53 | 1 |
| Reconstruct head of radius CPT 24366 | not published | not published | $16,603.53 – $16,603.53 | 1 |
| Reconstruction knee CPT 27428 | not published | not published | $16,603.53 – $16,603.53 | 1 |
| Reconstruction knee CPT 27429 | not published | not published | $16,603.53 – $16,603.53 | 1 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | $16,603.53 – $16,603.53 | 1 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $22,675.48 – $22,675.48 | 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.