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 |
|---|---|---|---|---|
| Shoe heel new leather standa HCPCS L3455 | $97.71 | $325.71 | not published | 0 |
| Shoe heel new rubber standar HCPCS L3460 | $82.48 | $274.95 | not published | 0 |
| Shoe heel pad & depress for HCPCS L3480 | $149.58 | $498.60 | not published | 0 |
| Shoe heel sach cushion type HCPCS L3450 | $253.34 | $844.46 | not published | 0 |
| Shoe heel thomas extend to b HCPCS L3470 | $149.58 | $498.60 | not published | 0 |
| Shoe heel thomas with wedge HCPCS L3465 | $140.53 | $468.42 | not published | 0 |
| Shoe lift elev heel/sole neo HCPCS L3310 | $177.75 | $592.50 | not published | 0 |
| Shoe metatarsal bar between HCPCS L3410 | $222.85 | $742.84 | not published | 0 |
| Shoe metatarsal bar wedge ro HCPCS L3400 | $97.71 | $325.71 | not published | 0 |
| Shoe outflare wedge HCPCS L3390 | $119.07 | $396.89 | not published | 0 |
| Shoe post-op mens m HCPCS L3260 | $292.87 | $976.25 | not published | 0 |
| Shoe sole wedge between sole HCPCS L3370 | $119.07 | $396.89 | not published | 0 |
| Shoe sole wedge outside sole HCPCS L3360 | $85.47 | $284.89 | not published | 0 |
| Shoe wedge sach HCPCS L3340 | $204.61 | $682.04 | not published | 0 |
| Sho heel count plast reinfor HCPCS L3430 | $384.70 | $1,282.35 | not published | 0 |
| Sho insert w arch toe filler HCPCS L5000 | $1,242.24 | $4,140.81 | not published | 0 |
| Sho lift taper to metatarsal HCPCS L3300 | $125.19 | $417.30 | not published | 0 |
| Shoulder MRI (without contrast) CPT 73221 | $5,499.90 | $18,333.00 | not published | 0 |
| Shoulder X-ray CPT 73030 | $613.20 | $2,044.00 | not published | 0 |
| Shrinker prosth above knee HCPCS L8460 | $202.72 | $675.74 | not published | 0 |
| Shrinker prosth below knee HCPCS L8440 | $142.60 | $475.35 | not published | 0 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $7,721.25 | $25,737.50 | not published | 0 |
| Sickling rbc CPT 85660 | $85.50 | $285.00 | not published | 0 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,388.70 | $4,629.00 | not published | 0 |
| Sinus CT scan (with contrast) CPT 70487 | $758.10 | $2,527.00 | not published | 0 |
| Sinus CT scan (without contrast) CPT 70486 | $1,874.40 | $6,248.00 | not published | 0 |
| Sio flex pelvisacral custom HCPCS L0622 | $641.64 | $2,138.79 | not published | 0 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | $424.85 | $1,416.18 | not published | 0 |
| Skin Biopsy CPT 11102 | $75.30 | $251.00 | not published | 0 |
| Sleep Study (Polysomnography) CPT 95810 | $1,973.10 | $6,577.00 | not published | 0 |
| Sleep study unattended CPT 95806 | $359.40 | $1,198.00 | not published | 0 |
| Sleeve fing rolyan med HCPCS L3933 | $466.18 | $1,553.92 | not published | 0 |
| Sling pelv split sam med HCPCS L0621 | $206.98 | $689.94 | not published | 0 |
| Sling suprapubic suburetheral HCPCS C1771 | $18,103.08 | $60,343.61 | not published | 0 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $39.00 | $130.00 | not published | 0 |
| Smear gram stain CPT 87205 | $84.60 | $282.00 | not published | 0 |
| Smear wet mount CPT 87210 | $93.30 | $311.00 | not published | 0 |
| So airplane w/wo joint cf HCPCS L3674 | $2,582.47 | $8,608.22 | not published | 0 |
| So cap design without jnts cf HCPCS L3671 | $1,968.60 | $6,562.00 | not published | 0 |
| Socket insert without lock mech HCPCS L5679 | $1,304.81 | $4,349.37 | not published | 0 |
| Sock fracture or equal each HCPCS L3995 | $73.00 | $243.35 | not published | 0 |
| Sodium 24 hour urine CPT 84300 | $139.50 | $465.00 | not published | 0 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $144.00 | $240.00 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $109.80 | $183.00 | not published | 0 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $109.80 | $183.00 | not published | 0 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $432.16 | $720.27 | not published | 0 |
| Sodium serum/plasma/whole blood CPT 84295 | $159.60 | $532.00 | not published | 0 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $48.00 | $80.00 | not published | 0 |
| Soft interface below knee se HCPCS L2820 | $181.69 | $605.63 | not published | 0 |
| So neo gsap dna/dna&rna CPT 81459 | $1,977.00 | $6,590.00 | not published | 0 |
| So vest canvas/web pre ots HCPCS L3675 | $383.48 | $1,278.27 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $1,107.17 | $3,690.58 | not published | 0 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $143.51 | $478.36 | not published | 0 |
| Splint finger fold over sm HCPCS L3924 | $211.03 | $703.43 | not published | 0 |
| Splint finger frog med HCPCS L3927 | $214.76 | $715.86 | not published | 0 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $211.03 | $703.43 | not published | 0 |
| Sputum specimen collection CPT 89220 | $76.80 | $256.00 | not published | 0 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $127.80 | $426.00 | not published | 0 |
| Static or dynami afo pre ots HCPCS L4397 | $665.62 | $2,218.75 | not published | 0 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $421.20 | $1,404.00 | not published | 0 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $48,028.04 | $160,093.46 | not published | 0 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $38,606.25 | $128,687.50 | not published | 0 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $41,934.37 | $139,781.25 | not published | 0 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $931.87 | $3,106.25 | not published | 0 |
| Sterile water/saline, 10 ml HCPCS A4216 | $109.80 | $183.00 | not published | 0 |
| Sternal pad HCPCS L1050 | $240.88 | $802.92 | not published | 0 |
| St evaluate speech sound production CPT 92522 | $511.50 | $1,705.00 | not published | 0 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $511.50 | $1,705.00 | not published | 0 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $167.70 | $559.00 | not published | 0 |
| St evaluation swallow function CPT 92610 | $285.00 | $950.00 | not published | 0 |
| Stocking sup grips 4 pre ots HCPCS L0982 | $37.54 | $125.14 | not published | 0 |
| Straight knee joint heavy du HCPCS L2385 | $352.75 | $1,175.85 | not published | 0 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $60.90 | $203.00 | not published | 0 |
| Strapping of elbow or wrist 29260 CPT 29260 | $24.00 | $80.00 | not published | 0 |
| Strapping of hand or finger CPT 29280 | $24.00 | $80.00 | not published | 0 |
| Strapping of knee CPT 29530 | $48.60 | $162.00 | not published | 0 |
| Strep a ag ia CPT 87430 | $27.60 | $92.00 | not published | 0 |
| Str markers specimen anal CPT 81265 | $366.90 | $1,223.00 | not published | 0 |
| St treatment speech individual CPT 92507 | $430.80 | $1,436.00 | not published | 0 |
| St treatment swallow dysfunction/oral CPT 92526 | $430.80 | $1,436.00 | not published | 0 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $48.00 | $80.00 | not published | 0 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $85.21 | $142.02 | not published | 0 |
| Support clav 29.6-40.5in med HCPCS L3650 | $607.82 | $2,026.07 | not published | 0 |
| Surgical pathology level 1 gross examination only CPT 88300 | $68.40 | $228.00 | not published | 0 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $159.60 | $532.00 | not published | 0 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $196.20 | $654.00 | not published | 0 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $205.50 | $685.00 | not published | 0 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $382.50 | $1,275.00 | not published | 0 |
| Susceptibility agar dilution per agent CPT 87181 | $21.60 | $72.00 | not published | 0 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $11.40 | $38.00 | not published | 0 |
| Susceptibility mic per plate CPT 87186 | $131.70 | $439.00 | not published | 0 |
| Suscept studies macrobroth dilution ea CPT 87188 | $180.30 | $601.00 | not published | 0 |
| Suspension sleeve lower ext HCPCS L2397 | $255.04 | $850.14 | not published | 0 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $5.10 | $17.00 | not published | 0 |
| System cardiomems hosp electronics HCPCS C2624 | $50,587.50 | $168,625.00 | not published | 0 |
| System pacing micra av HCPCS C1786 | $44,463.75 | $148,212.50 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $21,483.71 | $71,612.38 | not published | 0 |
| System recell skin grafting/harvesting HCPCS C1832 | $18,304.69 | $61,015.63 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $255.30 | $851.00 | not published | 0 |
| T4 (thyroxine) free CPT 84439 | $266.10 | $887.00 | 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.