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 |
|---|---|---|---|---|
| Straight knee joint heavy du HCPCS L2385 | not published | not published | $115.44 – $164.69 | 12 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $9.99 – $14.25 | 12 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | not published | not published | $3.53 – $5.03 | 12 |
| Strep a ag ia CPT 87430 | not published | not published | $12.91 – $64.01 | 15 |
| Strep a dna dir probe CPT 87650 | not published | not published | $15.40 – $113.76 | 15 |
| Strep a dna quant CPT 87652 | not published | not published | $32.06 – $160.98 | 15 |
| Strep b assay w/optic CPT 87802 | not published | not published | $9.77 – $62.48 | 15 |
| Strep b dna amp probe CPT 87653 | not published | not published | $26.95 – $201.82 | 15 |
| Streptokinase 1.5 m-units inj HCPCS J2995 | not published | not published | $72.34 – $72.34 | 1 |
| Streptokinase antibody CPT 86590 | not published | not published | $9.72 – $62.56 | 15 |
| Streptomycin injection HCPCS J3000 | not published | not published | $19.19 – $89.78 | 5 |
| Streptozocin injection HCPCS J9320 | not published | not published | $324.16 – $464.68 | 2 |
| Stress test pulmonary CPT 94618 | not published | not published | $511.20 – $511.20 | 1 |
| Stress tte complete CPT 93351 | not published | not published | $1,054.31 – $1,054.31 | 1 |
| Str markers spec anal addl CPT 81266 | not published | not published | $304.81 – $1,160.32 | 13 |
| Str markers specimen anal CPT 81265 | not published | not published | $233.07 – $887.24 | 14 |
| St treatment speech individual CPT 92507 | $590.66 | $590.66 | $55.78 – $86.52 | 13 |
| St treatment swallow dysfunction/oral CPT 92526 | $590.66 | $590.66 | $61.53 – $346.66 | 13 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $126.41 | $126.41 | $0.76 – $4.11 | 2 |
| Suction socket HCPCS L6686 | not published | not published | $595.17 – $849.11 | 12 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $400.31 – $571.11 | 12 |
| Sugars multiple quant CPT 84379 | not published | not published | $8.85 – $65.37 | 15 |
| Sugars single quant CPT 84378 | not published | not published | $8.85 – $65.37 | 15 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $471.57 | $471.57 | $0.04 – $0.11 | 5 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $919.79 | $919.79 | $34.34 – $502.18 | 2 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $2.60 – $3.71 | 12 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $19.40 – $27.68 | 12 |
| Support clav 29.6-40.5in med HCPCS L3650 | not published | not published | $57.31 – $81.76 | 12 |
| Supprelin la implant HCPCS J9226 | not published | not published | $33,909.00 – $114,441.15 | 5 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $44.21 – $58.95 | 2 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $38.30 – $51.06 | 2 |
| Surgical pathology level 1 gross examination only CPT 88300 | $246.56 | $246.56 | $24.67 – $120.02 | 4 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $575.42 | $575.42 | $24.67 – $120.02 | 4 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $1,130.63 | $1,130.63 | $49.76 – $242.08 | 4 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $1,325.57 | $1,325.57 | $49.76 – $242.08 | 4 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $1,567.25 | $1,567.25 | $233.13 – $1,416.98 | 4 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $2,192.81 | $2,192.81 | $305.56 – $3,192.17 | 4 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $336.92 – $336.92 | 1 |
| Susceptibility agar dilution per agent CPT 87181 | $245.38 | $245.38 | $3.65 – $26.96 | 15 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $245.43 | $245.43 | $3.65 – $26.96 | 15 |
| Susceptibility mic per plate CPT 87186 | not published | not published | $6.64 – $49.04 | 15 |
| Suscept studies macrobroth dilution ea CPT 87188 | $197.55 | $197.55 | $5.10 – $32.24 | 15 |
| Suspension sleeve lower ext HCPCS L2397 | not published | not published | $105.05 – $149.87 | 12 |
| Svc venogram s&i CPT 75827 | $8,675.81 | $8,675.81 | $200.23 – $3,163.82 | 4 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $11.25 – $242.08 | 4 |
| Symes ankle without (sach) foot HCPCS L5703 | not published | not published | $1,920.72 – $2,740.23 | 12 |
| Symes met fr leath socket ar HCPCS L5060 | not published | not published | $2,536.03 – $3,618.08 | 12 |
| Symes type medial opening so HCPCS L5636 | not published | not published | $233.95 – $333.78 | 12 |
| Symes type poster opening so HCPCS L5634 | not published | not published | $279.30 – $398.47 | 12 |
| Symes type ptb brim design s HCPCS L5632 | not published | not published | $203.87 – $290.86 | 12 |
| Syme typ expandabl wall sckt HCPCS L5630 | not published | not published | $412.08 – $587.90 | 12 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $6.32 – $8.74 | 5 |
| Synthetic sentence id test CPT 92576 | not published | not published | $77.74 – $77.74 | 1 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $6.94 – $20.03 | 5 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $156.39 | $156.39 | $3.38 – $25.01 | 15 |
| T3 (triiodothyronine) free CPT 84481 | $269.75 | $269.75 | $13.00 – $96.10 | 15 |
| T3 (triiodothyronine) total CPT 84480 | $224.49 | $224.49 | $10.89 – $80.43 | 15 |
| T4 (thyroxine) free CPT 84439 | $563.44 | $563.44 | $6.92 – $51.16 | 15 |
| T4 (thyroxine) total CPT 84436 | $190.81 | $190.81 | $5.27 – $39.02 | 15 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.43 – $1.56 | 5 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.36 – $4.96 | 5 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.14 – $0.53 | 5 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $1,562.28 | $1,562.28 | $191.30 – $695.49 | 5 |
| Tacrolimus therapeutic drug level CPT 80197 | $1,097.71 | $1,097.71 | $10.54 – $77.83 | 15 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $10.45 – $37.74 | 5 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $52.78 – $195.94 | 5 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $52.50 – $198.54 | 5 |
| Talymed HCPCS Q4127 | not published | not published | $51.37 – $336.92 | 4 |
| Tamoxifen 10 mg tabs 60 each bottle HCPCS S0187 | $30.03 | $30.03 | $0.18 – $0.18 | 1 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | not published | not published | $0.38 – $0.54 | 12 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $759.53 – $2,891.25 | 14 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | not published | not published | $2,919.60 – $11,113.92 | 13 |
| Target gsa panel organ neop CPT 81445 | not published | not published | $597.91 – $2,427.51 | 14 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,178.08 – $4,151.46 | 5 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.28 – $0.66 | 5 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $521.51 | 13 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $93.44 – $157.68 | 2 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $23.36 – $23.36 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $107.27 – $507.14 | 3 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $11.73 – $507.14 | 3 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | not published | not published | $76.78 – $430.85 | 15 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $1,775.64 | $1,775.64 | $47.59 – $356.43 | 15 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $374.34 – $1,393.18 | 2 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $899.32 – $3,434.27 | 2 |
| Tc-99m bicisate HCPCS A9557 | $3,288.01 | $3,288.01 | $2,055.13 – $3,403.08 | 2 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $599.80 – $2,121.64 | 2 |
| Tc-99m disofenin HCPCS A9510 | $132.74 | $132.74 | $64.97 – $163.74 | 2 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $1,590.91 – $2,475.44 | 2 |
| Tc-99m exametazime diag HCPCS A9521 | $4,318.82 | $4,318.82 | $1,590.91 – $2,458.43 | 2 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $870.79 – $870.79 | 1 |
| Tc-99m labeled rbc HCPCS A9560 | $3,467.57 | $3,467.57 | $86.70 – $288.56 | 2 |
| Tc-99m maa HCPCS A9540 | $501.51 | $501.51 | $27.85 – $80.53 | 2 |
| Tc-99m mebrofenin HCPCS A9537 | $783.24 | $783.24 | $51.34 – $300.67 | 2 |
| Tc-99m medronate HCPCS A9503 | $258.88 | $258.88 | $12.07 – $170.82 | 2 |
| Tc-99m mertiatide HCPCS A9562 | $3,026.10 | $3,026.10 | $2,102.17 – $2,102.17 | 1 |
| Tc-99m oxidronate HCPCS A9561 | $767.26 | $767.26 | $40.84 – $138.09 | 2 |
| Tc-99m pentetate dtpa HCPCS A9539 | $501.51 | $501.51 | $29.08 – $76.11 | 2 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $501.51 | $501.51 | $15.76 – $55.76 | 2 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $34.70 | $34.70 | $1.57 – $31.85 | 2 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $610.84 | $610.84 | $59.45 – $105.34 | 2 |
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.