Southern Virginia Medical Center
727 N Main St, Emporia, VA · Bonsecours · · NPI 1104461276
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 |
|---|---|---|---|---|
| Pt re-evaluation patient/family CPT 97164 | $190.50 | $635.00 | not published | 0 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $93.30 | $311.00 | not published | 0 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $163.50 | $545.00 | not published | 0 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $190.50 | $635.00 | not published | 0 |
| Pt wheelchair management each 15 minutes CPT 97542 | $46.50 | $155.00 | not published | 0 |
| Pulse ox continuous overnight monitoring CPT 94762 | $238.20 | $794.00 | not published | 0 |
| Pulse ox multiple CPT 94761 | $225.90 | $753.00 | not published | 0 |
| Pulse ox single CPT 94760 | $130.50 | $435.00 | not published | 0 |
| Pump on-q 100mlx2ml/hr 2 day delivery HCPCS C9804 | $1,144.87 | $3,816.25 | not published | 0 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $196.20 | $654.00 | not published | 0 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $213.60 | $712.00 | not published | 0 |
| Puncture spinal lumbar diagnostic CPT 62270 | $902.40 | $3,008.00 | not published | 0 |
| Puraply 1 sq cm HCPCS Q4195 | $13,658.62 | $45,528.75 | not published | 0 |
| Puraply xt 1 sq cm HCPCS Q4197 | $4,526.25 | $15,087.50 | not published | 0 |
| Pvb thoracic single inj site CPT 64461 | $671.70 | $2,239.00 | not published | 0 |
| Pyruvate CPT 84210 | $22.80 | $76.00 | not published | 0 |
| Quest t3 uptake CPT 84479 | $13.80 | $46.00 | not published | 0 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $8,084.31 | $13,473.85 | not published | 0 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $63,179.68 | $105,299.46 | not published | 0 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $33,767.78 | $56,279.63 | not published | 0 |
| Rapid Strep Test CPT 87880 | $58.20 | $194.00 | not published | 0 |
| Rbc count only automated CPT 85041 | $42.30 | $141.00 | not published | 0 |
| Reduction of procidentia 45900 CPT 45900 | $346.50 | $1,155.00 | not published | 0 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $271.80 | $453.00 | not published | 0 |
| Reinforced solid stirrup HCPCS L2260 | $449.96 | $1,499.88 | not published | 0 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $1,560.00 | $2,600.00 | not published | 0 |
| Remote 30 day ecg tech supp CPT 93229 | $144.30 | $481.00 | not published | 0 |
| Removal central venous catheter tunneled without port/pump CPT 36589 | $835.80 | $2,786.00 | not published | 0 |
| Removal cerumen impacted (both sides) CPT 69210 | $97.20 | $324.00 | not published | 0 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | $206.40 | $688.00 | not published | 0 |
| Removal embedded foreign body vestibule mouth smpl CPT 40804 | $344.40 | $1,148.00 | not published | 0 |
| Removal foreign body foot subcutaneous right CPT 28190 | $270.60 | $902.00 | not published | 0 |
| Removal foreign body jawbone CPT 41806 | $578.40 | $1,928.00 | not published | 0 |
| Removal skin tags fibrocutaneous any area <= 15 lesions CPT 11200 | $75.30 | $251.00 | not published | 0 |
| Removal tunnled intprtnl cath CPT 49422 | $3,103.80 | $10,346.00 | not published | 0 |
| Remove foreign body from eye CPT 65235 | $900.30 | $3,001.00 | not published | 0 |
| Renal function panel CPT 80069 | $246.00 | $820.00 | not published | 0 |
| Repair blood vessel dir lower extr CPT 35226 | $270.60 | $902.00 | not published | 0 |
| Repair blood vessel dir upper extr CPT 35206 | $1,241.70 | $4,139.00 | not published | 0 |
| Repair complex wound scalp/arms/legs 2.6 - 7.5 cm CPT 13121 | $960.90 | $3,203.00 | not published | 0 |
| Repair dental ellis ii fx CPT 41899 | $87.00 | $290.00 | not published | 0 |
| Repair extns tendon finger without grft ea CPT 26418 | $597.90 | $1,993.00 | not published | 0 |
| Repair eyelid wound CPT 67935 | $881.40 | $2,938.00 | not published | 0 |
| Repair finger/hand tendon CPT 26350 | $1,240.80 | $4,136.00 | not published | 0 |
| Repair lip full thkns =<one-half vert height CPT 40652 | $190.50 | $635.00 | not published | 0 |
| Repair rpr lac tongue floor mouth > 2.6 cm/cmplx CPT 41252 | $87.00 | $290.00 | not published | 0 |
| Repair rpr lip full thickness vermilion only CPT 40650 | $190.50 | $635.00 | not published | 0 |
| Repair tendon extensor foot 1/2 each tendon CPT 28208 | $1,240.80 | $4,136.00 | not published | 0 |
| Repair tendon/muscle forearm/wrist prime sngl ea CPT 25260 | $1,240.80 | $4,136.00 | not published | 0 |
| Repair tongue lac <2.5cm past 1/3 tongue 41251 CPT 41251 | $87.00 | $290.00 | not published | 0 |
| Replace duod/jej tube perc CPT 49451 | $344.40 | $1,148.00 | not published | 0 |
| Replace g/c tube perc CPT 49450 | $344.40 | $1,148.00 | not published | 0 |
| Replace g-j tube perc CPT 49452 | $701.40 | $2,338.00 | not published | 0 |
| Repl trach puncture dilator HCPCS L8514 | $247.61 | $825.38 | not published | 0 |
| Restorigin 1 sq cm HCPCS Q4191 | $6,390.00 | $21,300.00 | not published | 0 |
| Resuscitation cardiopulmonary CPT 92950 | $2,502.60 | $8,342.00 | not published | 0 |
| Reticulocyte automated CPT 85045 | $90.30 | $301.00 | not published | 0 |
| Revision of cervix CPT 57720 | $1,178.40 | $3,928.00 | not published | 0 |
| Revision of eyelid CPT 67961 | $881.40 | $2,938.00 | not published | 0 |
| Revision of penis CPT 54435 | $1,335.90 | $4,453.00 | not published | 0 |
| Rheumatoid factor quantitative CPT 86431 | $176.10 | $587.00 | not published | 0 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | $673.79 | $1,122.99 | not published | 0 |
| Rho d immune globulin inj HCPCS J2790 | $673.79 | $1,122.99 | not published | 0 |
| Rib gusset (elastic) each HCPCS L1280 | $209.75 | $699.17 | not published | 0 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $2,079.27 | $3,465.45 | not published | 0 |
| Ring flange plas/leather mol HCPCS L1110 | $764.38 | $2,547.92 | not published | 0 |
| Ring flange plastic/leather HCPCS L1100 | $455.90 | $1,519.67 | not published | 0 |
| Ring fx reform 11-13x17mm HCPCS L8610 | $2,345.66 | $7,818.88 | not published | 0 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $3,833.17 | $6,388.61 | not published | 0 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | $21,139.20 | $35,232.00 | not published | 0 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | $29,594.62 | $49,324.37 | not published | 0 |
| Rocker bottom, contact afo HCPCS L2232 | $233.21 | $777.36 | not published | 0 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $153.50 | $255.84 | not published | 0 |
| Rsv assay w/optic CPT 87807 | $85.20 | $284.00 | not published | 0 |
| Rubella antibody igg CPT 86762 | $65.40 | $218.00 | not published | 0 |
| Rubeola antibody igg CPT 86765 | $91.50 | $305.00 | not published | 0 |
| Russell viper venom diluted CPT 85613 | $134.10 | $447.00 | not published | 0 |
| Salmonella antibody CPT 86768 | $19.80 | $66.00 | not published | 0 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $527.10 | $1,757.00 | not published | 0 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $958.50 | $3,195.00 | not published | 0 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $1,366.20 | $4,554.00 | not published | 0 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $901.50 | $3,005.00 | not published | 0 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $222.00 | $740.00 | not published | 0 |
| Scope uretscp lithovue dig disp HCPCS C1747 | $15,575.62 | $51,918.75 | not published | 0 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $5,303.12 | $8,838.53 | $907.35 – $925.49 | 3 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $5,219.38 | $8,698.97 | $907.35 – $925.49 | 3 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | $46.50 | $155.00 | not published | 0 |
| Screening Mammogram CPT 77067 | $357.00 | $1,190.00 | not published | 0 |
| Screw cortex 2.0 x 10mm HCPCS C1713 | $287,334.34 | $957,781.13 | not published | 0 |
| Sedimentation rate erythrocyte automated CPT 85652 | $96.00 | $320.00 | not published | 0 |
| Sevelamer carbonate 800 mg tablet HCPCS J0601 | $6.00 | $10.00 | not published | 0 |
| Sevelamer carbonate pdr 20mg HCPCS J0602 | $112.34 | $187.23 | not published | 0 |
| Sewho cap design without jnts cf HCPCS L3961 | $3,670.71 | $12,235.70 | not published | 0 |
| Sf3b1 gene common variants CPT 81347 | $319.50 | $1,065.00 | not published | 0 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $155.70 | $519.00 | not published | 0 |
| Sheath below knee HCPCS L8400 | $38.71 | $129.04 | not published | 0 |
| Sheath gldlight lasr 12fx50cm HCPCS C2629 | $8,852.81 | $29,509.38 | not published | 0 |
| Sheath laser cavaclear 14f HCPCS C1603 | $13,299.19 | $44,330.63 | not published | 0 |
| Shoe clubfoot wedge HCPCS L3380 | $119.07 | $396.89 | not published | 0 |
| Shoe dennis browne splint bo HCPCS L3640 | $103.86 | $346.21 | not published | 0 |
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.