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 |
|---|---|---|---|---|
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $192.00 – $730.89 | 13 |
| Serial tonometry CPT 92100 | not published | not published | $351.73 – $351.73 | 1 |
| Sermorelin acetate injection HCPCS Q0515 | not published | not published | $1.64 – $3.55 | 2 |
| Serpina1 gene CPT 81332 | not published | not published | $43.65 – $288.26 | 14 |
| Set radiation therapy field CPT 77280 | not published | not published | $143.75 – $785.20 | 2 |
| Set radiation therapy field CPT 77285 | not published | not published | $216.50 – $1,246.43 | 2 |
| Set radiation therapy field CPT 77290 | not published | not published | $317.07 – $1,528.44 | 2 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $28.54 | $28.54 | $0.01 – $0.27 | 2 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $61.55 | $61.55 | $0.05 – $0.82 | 2 |
| Sewhfo airplane without jnts cf HCPCS L3976 | not published | not published | $1,375.57 – $1,962.48 | 12 |
| Sewhfo airplane w/jnt(s) cf HCPCS L3978 | not published | not published | $1,624.10 – $2,317.04 | 12 |
| Sewhfo cap desgn w/jnt(s) cf HCPCS L3977 | not published | not published | $1,541.65 – $2,199.42 | 12 |
| Sewhfo cap design without jnt cf HCPCS L3975 | not published | not published | $1,375.57 – $1,962.48 | 12 |
| Sewho airplane without jnts cf HCPCS L3967 | not published | not published | $1,624.10 – $2,317.04 | 12 |
| Sewho airplane w/jnt(s) cf HCPCS L3973 | not published | not published | $1,624.10 – $2,317.04 | 12 |
| Sewho cap design without jnts cf HCPCS L3961 | not published | not published | $1,375.57 – $1,962.48 | 12 |
| Sewho cap design w/jnt(s) cf HCPCS L3971 | not published | not published | $1,541.65 – $2,199.42 | 12 |
| Sewho erbs palsey design abd HCPCS L3962 | not published | not published | $605.10 – $863.28 | 12 |
| Sex chromatin identification CPT 88130 | not published | not published | $13.81 – $85.34 | 15 |
| Sex chromatin identification CPT 88140 | not published | not published | $6.13 – $45.35 | 15 |
| Sf3b1 gene common variants CPT 81347 | not published | not published | $193.25 – $735.63 | 13 |
| Sheath above knee HCPCS L8410 | not published | not published | $21.30 – $30.39 | 12 |
| Sheath below knee HCPCS L8400 | not published | not published | $15.95 – $22.76 | 12 |
| Sheath upper limb HCPCS L8415 | not published | not published | $20.95 – $29.89 | 12 |
| Shigella antibody CPT 86771 | not published | not published | $18.79 – $93.17 | 15 |
| Shlder disart int lock elbow HCPCS L6300 | not published | not published | $3,420.82 – $4,880.37 | 12 |
| Shldr disar prosth tiss shap HCPCS L6550 | not published | not published | $3,501.27 – $4,995.15 | 12 |
| Shldr disartic myoelectronic HCPCS L6965 | not published | not published | $13,682.25 – $19,520.01 | 12 |
| Shoe clubfoot wedge HCPCS L3380 | not published | not published | $44.59 – $63.62 | 12 |
| Shoe dennis browne splint bo HCPCS L3640 | not published | not published | $38.89 – $55.49 | 12 |
| Shoe heel new leather standa HCPCS L3455 | not published | not published | $36.62 – $52.25 | 12 |
| Shoe heel new rubber standar HCPCS L3460 | not published | not published | $30.87 – $44.04 | 12 |
| Shoe heel pad & depress for HCPCS L3480 | not published | not published | $56.05 – $79.97 | 12 |
| Shoe heel sach cushion type HCPCS L3450 | not published | not published | $94.98 – $135.50 | 12 |
| Shoe heel thomas extend to b HCPCS L3470 | not published | not published | $56.05 – $79.97 | 12 |
| Shoe heel thomas with wedge HCPCS L3465 | not published | not published | $52.62 – $75.07 | 12 |
| Shoe lift elev heel/sole neo HCPCS L3310 | not published | not published | $73.22 – $104.46 | 12 |
| Shoe metatarsal bar between HCPCS L3410 | not published | not published | $83.51 – $119.14 | 12 |
| Shoe metatarsal bar wedge ro HCPCS L3400 | not published | not published | $36.62 – $52.25 | 12 |
| Shoe outflare wedge HCPCS L3390 | not published | not published | $44.59 – $63.62 | 12 |
| Shoe sole wedge between sole HCPCS L3370 | not published | not published | $44.59 – $63.62 | 12 |
| Shoe sole wedge outside sole HCPCS L3360 | not published | not published | $32.04 – $45.71 | 12 |
| Shoe wedge sach HCPCS L3340 | not published | not published | $76.70 – $109.42 | 12 |
| Sho heel count plast reinfor HCPCS L3430 | not published | not published | $144.16 – $205.68 | 12 |
| Sho insert w arch toe filler HCPCS L5000 | not published | not published | $511.75 – $730.09 | 12 |
| Sho lift taper to metatarsal HCPCS L3300 | not published | not published | $46.91 – $66.93 | 12 |
| Shoulder abduction joint pai HCPCS L6640 | not published | not published | $259.64 – $370.42 | 12 |
| Shoulder flexion-abduction j HCPCS L6645 | not published | not published | $298.37 – $425.67 | 12 |
| Shoulder harness HCPCS L5699 | not published | not published | $171.19 – $244.24 | 12 |
| Shoulder lock actuator HCPCS L6647 | not published | not published | $468.03 – $667.72 | 12 |
| Shoulder MRI (with and without contrast) CPT 73223 | not published | not published | $382.74 – $4,953.48 | 3 |
| Shoulder MRI (with contrast) CPT 73222 | not published | not published | $289.40 – $2,775.94 | 3 |
| Shoulder MRI (without contrast) CPT 73221 | not published | not published | $243.03 – $2,312.99 | 3 |
| Shoulder universal joint HCPCS L6650 | not published | not published | $310.79 – $443.40 | 12 |
| Shoulder X-ray CPT 73030 | not published | not published | $34.78 – $182.03 | 4 |
| Shrinker prosth above knee HCPCS L8460 | not published | not published | $61.19 – $87.30 | 12 |
| Shrinker prosth below knee HCPCS L8440 | not published | not published | $38.40 – $54.78 | 12 |
| Shrinker upper limb HCPCS L8465 | not published | not published | $54.17 – $77.29 | 12 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | not published | not published | $89.70 – $341.00 | 4 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $9.38 – $70.28 | 15 |
| Sialography s&i CPT 70390 | not published | not published | $66.81 – $563.52 | 4 |
| Sickling rbc CPT 85660 | $448.96 | $448.96 | $4.23 – $30.86 | 15 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $253.40 – $253.40 | 1 |
| Sildenafil citrate, 25 mg HCPCS S0090 | $122.72 | $122.72 | $0.25 – $0.25 | 1 |
| Silicon gel insert w/wo lock HCPCS L6692 | not published | not published | $513.47 – $732.55 | 12 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $5,959.90 | $5,959.90 | $107.44 – $291.84 | 5 |
| Single energy x-ray study HCPCS G0130 | not published | not published | $42.66 – $245.18 | 3 |
| Single pivot hinge pair HCPCS L6605 | not published | not published | $170.30 – $242.96 | 12 |
| Sinus CT scan (with and without contrast) CPT 70488 | not published | not published | $224.75 – $1,598.48 | 3 |
| Sinus CT scan (with contrast) CPT 70487 | $5,170.92 | $5,170.92 | $200.11 – $1,317.58 | 3 |
| Sinus CT scan (without contrast) CPT 70486 | $4,106.87 | $4,106.87 | $152.84 – $1,109.26 | 3 |
| Sinus/juglr venogram s&i CPT 75860 | not published | not published | $203.97 – $6,438.74 | 4 |
| Sio flex pelvisacral custom HCPCS L0622 | not published | not published | $260.30 – $371.35 | 12 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | not published | not published | $102.85 – $146.73 | 12 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $42,762.82 – $144,170.89 | 5 |
| Sirolimus, oral HCPCS J7520 | not published | not published | $0.85 – $2.57 | 5 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $88.22 – $230.84 | 5 |
| Six volt bat otto bock/eq ea HCPCS L7360 | not published | not published | $274.36 – $391.42 | 12 |
| Skeletal muscle relaxant 1/2 CPT 80369 | not published | not published | $100.00 – $100.00 | 1 |
| Skel musc relaxant 3 or more CPT 80370 | not published | not published | $100.00 – $100.00 | 1 |
| Skin barrier with flange HCPCS A4373 | not published | not published | $6.71 – $9.57 | 12 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $23.67 – $120.02 | 4 |
| Skyla, 13.5 mg HCPCS J7301 | not published | not published | $938.77 – $3,369.26 | 2 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $665.45 | 13 |
| Sleep study attended CPT 95807 | not published | not published | $2,222.41 – $2,222.41 | 1 |
| Sleep Study (Polysomnography) CPT 95810 | not published | not published | $3,412.76 – $3,412.76 | 1 |
| Sleep study unattended CPT 95806 | not published | not published | $822.82 – $822.82 | 1 |
| Sleeve fing rolyan med HCPCS L3933 | not published | not published | $174.67 – $249.19 | 12 |
| Sling arm deluxe w/pad xs HCPCS A4565 | not published | not published | $8.23 – $11.75 | 12 |
| Sling pelv split sam med HCPCS L0621 | not published | not published | $57.38 – $81.86 | 12 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $22.74 – $30.32 | 2 |
| Slp eval non-spch gen comm dev CPT 92605 | not published | not published | $65.03 – $86.70 | 2 |
| Slp pure tone screening CPT 92551 | not published | not published | $9.02 – $44.98 | 3 |
| Slp ther svc non-spch gen CPT 92606 | not published | not published | $56.03 – $74.70 | 2 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $8,373.47 – $15,113.77 | 2 |
| Small animal inoculation CPT 87003 | not published | not published | $12.93 – $95.49 | 15 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.03 – $286.20 | 4 |
| Smear fluorescent and/or acid fast stain CPT 87206 | not published | not published | $4.14 – $30.45 | 15 |
| Smear gram stain CPT 87205 | not published | not published | $3.28 – $24.20 | 15 |
| Smear nasal eosinophil CPT 89190 | not published | not published | $4.45 – $26.96 | 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.