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 |
|---|---|---|---|---|
| R hrt cath chd nml nt cnj CPT 93593 | not published | not published | $10,513.40 – $10,513.40 | 1 |
| Rhythm ecg with report CPT 93040 | not published | not published | $57.58 – $57.58 | 1 |
| Rib gusset (elastic) each HCPCS L1280 | not published | not published | $89.06 – $127.06 | 12 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $2,116.30 – $7,250.40 | 2 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $2,005.30 | $2,005.30 | $0.11 – $0.40 | 5 |
| Right ventric recording CPT 93603 | not published | not published | $740.00 – $740.00 | 1 |
| Rilonacept injection HCPCS J2793 | not published | not published | $25.15 – $89.99 | 2 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | not published | not published | $5.45 – $7.77 | 12 |
| Ring flange plas/leather mol HCPCS L1110 | not published | not published | $220.12 – $314.03 | 12 |
| Ring flange plastic/leather HCPCS L1100 | not published | not published | $162.85 – $232.33 | 12 |
| Ring fx reform 11-13x17mm HCPCS L8610 | not published | not published | $540.19 – $770.67 | 12 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | not published | not published | $5.45 – $7.77 | 12 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | not published | not published | $11.14 – $39.56 | 5 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | not published | not published | $7.88 – $29.63 | 5 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | not published | not published | $57.32 – $198.14 | 5 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $28.15 – $97.71 | 5 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | not published | not published | $26.07 – $79.90 | 5 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $24.82 – $55.39 | 5 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | not published | not published | $18.71 – $41.25 | 5 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | not published | not published | $10,513.40 – $10,513.40 | 1 |
| R&l hrt cath chd nml nt cnj CPT 93596 | not published | not published | $10,513.40 – $10,513.40 | 1 |
| Robot lin-radsurg com, first HCPCS G0339 | not published | not published | $11,717.27 – $11,717.27 | 1 |
| Robt lin-radsurg fractx 2-5 HCPCS G0340 | not published | not published | $8,359.50 – $8,359.50 | 1 |
| Rocker bottom, contact afo HCPCS L2232 | not published | not published | $89.53 – $127.74 | 12 |
| Rolapitant, oral, 1mg HCPCS J8670 | not published | not published | $1.34 – $5.30 | 5 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | not published | not published | $23.66 – $81.91 | 5 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | not published | not published | $7.89 – $29.28 | 5 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | not published | not published | $8.62 – $32.09 | 5 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | not published | not published | $0.04 – $0.13 | 5 |
| Rotation wrst with cable lock HCPCS L6625 | not published | not published | $492.76 – $703.00 | 12 |
| Rotavirus antibody CPT 86759 | not published | not published | $14.00 – $74.83 | 15 |
| Round caliper and plate atta HCPCS L2240 | not published | not published | $81.86 – $116.78 | 12 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | not published | not published | $17.13 – $61.96 | 5 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | not published | not published | $127.06 – $1,239.33 | 4 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | not published | not published | $250.60 – $2,938.37 | 4 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | not published | not published | $361.16 – $4,180.72 | 4 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $561.65 – $1,388.45 | 3 |
| Rsv assay w/optic CPT 87807 | not published | not published | $10.06 – $62.48 | 15 |
| Rsv vacc mrna lipid nano im CPT 90683 | not published | not published | $295.57 – $922.20 | 2 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $22.52 – $24.10 | 10 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $52.37 – $56.04 | 10 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $53.05 – $56.76 | 10 |
| Rtm tx mgmt 1st 20 min CPT 98980 | not published | not published | $55.34 – $59.21 | 10 |
| Rtm tx mgmt ea addl 20 min CPT 98981 | not published | not published | $42.49 – $45.46 | 10 |
| Rubella antibody igg CPT 86762 | not published | not published | $11.05 – $81.65 | 15 |
| Rubeola ag if CPT 87283 | not published | not published | $46.69 – $231.45 | 15 |
| Rubeola antibody igg CPT 86765 | not published | not published | $9.89 – $55.54 | 15 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $329.51 – $1,254.33 | 13 |
| Russell viper venom diluted CPT 85613 | $757.25 | $757.25 | $7.36 – $54.28 | 15 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $704.18 – $3,491.00 | 14 |
| Sach foot, replacement HCPCS L5971 | not published | not published | $201.57 – $287.57 | 12 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | not published | not published | $26.85 – $98.00 | 5 |
| Safety plan interven HCPCS G0560 | not published | not published | $26.03 – $34.71 | 2 |
| Salivary gland function exam CPT 78232 | not published | not published | $70.59 – $848.52 | 4 |
| Salivary gland imaging CPT 78230 | not published | not published | $80.77 – $848.52 | 4 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $78.35 – $848.52 | 4 |
| Salmonella antibody CPT 86768 | not published | not published | $10.13 – $74.83 | 15 |
| Saquinavir, 200 mg HCPCS S0140 | not published | not published | $1.13 – $1.13 | 1 |
| Sargramostim injection HCPCS J2820 | not published | not published | $44.91 – $163.64 | 5 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $42.22 – $171.05 | 14 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $121.16 – $508.59 | 5 |
| Sarscov coronavirus ag ia CPT 87426 | $37.42 | $37.42 | $35.33 – $183.63 | 15 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $53.97 – $298.37 | 15 |
| Sbrt management CPT 77435 | not published | not published | $2,473.69 – $2,783.77 | 2 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $2,296.80 | $2,296.80 | $1,208.64 – $1,563.81 | 2 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | not published | not published | $697.35 – $919.31 | 2 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $2,504.64 | $2,504.64 | $821.59 – $878.27 | 2 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $1,247.00 | $1,247.00 | $543.89 – $617.42 | 2 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $1,277.22 | $1,277.22 | $582.25 – $657.67 | 2 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $1,808.99 | $1,808.99 | $565.00 – $684.33 | 2 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,999.31 | $1,999.31 | $1,168.35 – $1,232.31 | 2 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $2,177.60 | $2,177.60 | $696.91 – $746.88 | 2 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $2,304.69 | $2,304.69 | $578.43 – $642.94 | 2 |
| Scap thorac prosth tiss shap HCPCS L6570 | not published | not published | $4,248.24 – $6,060.82 | 12 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $13.96 – $67.59 | 15 |
| Scr c/v cyto,autosys and md HCPCS G0141 | not published | not published | $21.98 – $106.93 | 2 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $24.53 – $121.58 | 15 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $33.77 – $167.37 | 15 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | not published | not published | $20.34 – $150.26 | 15 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $20.77 – $114.94 | 15 |
| Screen cerv/vag thin layer HCPCS G0123 | not published | not published | $15.55 – $114.94 | 15 |
| Screen c/v thin layer by md HCPCS G0124 | not published | not published | $21.98 – $106.93 | 2 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | not published | not published | $13.86 – $90.21 | 15 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $21.71 – $107.64 | 14 |
| Screening hepatitis c antibody high risk HCPCS G0472 | not published | not published | $35.59 – $176.44 | 15 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | not published | not published | $18.49 – $91.65 | 14 |
| Screening Mammogram CPT 77067 | not published | not published | $66.07 – $530.90 | 14 |
| Screening pap smear by phys HCPCS P3001 | not published | not published | $21.98 – $106.93 | 2 |
| Screening prostate cancer PSA HCPCS G0103 | $749.36 | $749.36 | $14.83 – $104.34 | 15 |
| Screen pap by tech w md supv HCPCS P3000 | not published | not published | $13.96 – $67.59 | 15 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | not published | not published | $1.98 – $10.69 | 3 |
| Sedimentation rate erythrocyte automated CPT 85652 | $353.01 | $353.01 | $2.07 – $15.31 | 15 |
| Seg acet and eth estr yearly HCPCS J7294 | not published | not published | $2,246.75 – $7,697.35 | 2 |
| Select picture audiometry CPT 92583 | not published | not published | $154.60 – $154.60 | 1 |
| Self-adher band w>=3" <5"/yd HCPCS A6454 | not published | not published | $0.84 – $1.20 | 12 |
| Semen analysis HCPCS G0027 | not published | not published | $4.99 – $36.91 | 15 |
| Semen analysis presence/motility CPT 89321 | not published | not published | $9.25 – $68.37 | 15 |
| Semen analysis w/count CPT 89310 | not published | not published | $6.61 – $48.84 | 15 |
| Sensorimotor examination CPT 92060 | not published | not published | $219.74 – $219.74 | 1 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $51.26 – $51.26 | 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.