Southampton Medical Center
100 Fairview Dr., Franklin, VA · Bonsecours · · NPI 1851936983
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 |
|---|---|---|---|---|
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $222.90 | $743.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $222.90 | $743.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $1,964.10 | $6,547.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $14.70 | $49.00 | not published | 0 |
| Glove finger flexion right lg xl HCPCS L3912 | $143.03 | $476.77 | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $1,848.00 | $3,080.00 | not published | 0 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $990.00 | $1,650.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $9.00 | $30.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $70.50 | $235.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $51.30 | $171.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $26.07 | $43.45 | not published | 0 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $10,015.96 | $16,693.26 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $184.50 | $615.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $159.30 | $531.00 | not published | 0 |
| Goniotomy CPT 65820 | $7,977.37 | $13,295.62 | $4,319.25 – $4,405.64 | 3 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $2,819.27 | $9,397.56 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $37,995.59 | $126,651.98 | not published | 0 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $27,386.94 | $91,289.80 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $2,459.88 | $8,199.59 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $69,968.80 | $233,229.35 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $52,944.00 | $176,480.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $23,163.00 | $77,210.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $8,487.58 | $28,291.95 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $14,394.15 | $47,980.50 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $5,591.05 | $18,636.84 | not published | 0 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $2,481.75 | $8,272.50 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $52,173.00 | $173,910.01 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $4,384.42 | $14,614.75 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $52,265.65 | $174,218.85 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $24,755.46 | $82,518.19 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $222.90 | $743.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $8,576.93 | $28,589.76 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $13,202.91 | $44,009.70 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,158.15 | $3,860.50 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $11,293.62 | $37,645.39 | not published | 0 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | $64.54 | $215.14 | not published | 0 |
| Halo cervical into jckt vest HCPCS L0810 | $11,167.87 | $37,226.25 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $12.51 | $20.85 | not published | 0 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $9.00 | $15.00 | not published | 0 |
| Halo repl liner/interface HCPCS L0861 | $1,892.75 | $6,309.16 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $143.36 | $477.87 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $5,377.12 | $17,923.75 | not published | 0 |
| Hand X-ray CPT 73130 | $225.30 | $751.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $138.90 | $463.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $537.00 | $1,790.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $109.80 | $366.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $106.50 | $355.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $196.80 | $328.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $898.50 | $2,995.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $901.50 | $3,005.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $338.40 | $1,128.00 | not published | 0 |
| Heel leather reinforced HCPCS L3440 | $113.83 | $379.43 | not published | 0 |
| Helicobacter pylori antibody igm CPT 86677 | $68.10 | $227.00 | not published | 0 |
| Hematocrit CPT 85014 | $23.70 | $79.00 | not published | 0 |
| Hemodialysis one evaluation CPT 90935 | $1,367.70 | $4,559.00 | not published | 0 |
| Hemoglobin CPT 85018 | $23.70 | $79.00 | not published | 0 |
| Heparin assay CPT 85520 | $24.00 | $80.00 | not published | 0 |
| Heparin bolus from bag HCPCS J1644 | $72.60 | $121.00 | not published | 0 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $9.00 | $15.00 | not published | 0 |
| Hepatitis b core antibody total CPT 86704 | $51.00 | $170.00 | not published | 0 |
| Hepatitis b surface antibody CPT 86706 | $44.40 | $148.00 | not published | 0 |
| Hepatitis c antibody CPT 86803 | $151.50 | $505.00 | not published | 0 |
| Hepatobiliary system imaging CPT 78226 | $883.20 | $2,944.00 | not published | 0 |
| Herpes simplex type 1 antibody igg CPT 86695 | $41.70 | $139.00 | not published | 0 |
| Herpes simplex type 2 antibody igg CPT 86696 | $104.70 | $349.00 | not published | 0 |
| Herpes simplex virus isolation CPT 87255 | $90.30 | $301.00 | not published | 0 |
| Heterophile antibodies screening CPT 86308 | $80.40 | $268.00 | not published | 0 |
| Hfo nontorsion jnts pre cst HCPCS L3929 | $123.99 | $413.29 | not published | 0 |
| Hfo nontorsion jnts pre ots HCPCS L3930 | $123.99 | $413.29 | not published | 0 |
| Hinge extension/flex wrist/f HCPCS L3900 | $2,199.29 | $7,330.98 | not published | 0 |
| Hinge ext/flex wrist finger HCPCS L3901 | $2,882.29 | $9,607.63 | not published | 0 |
| Hip adj flex ext abduct cont HCPCS L2624 | $640.97 | $2,136.57 | not published | 0 |
| Hip clevis/thrust bearing fr HCPCS L2600 | $318.16 | $1,060.53 | not published | 0 |
| Hip clevis/thrust bearing lo HCPCS L2610 | $351.58 | $1,171.94 | not published | 0 |
| Hip clevis type 2 posit jnt HCPCS L2570 | $664.38 | $2,214.60 | not published | 0 |
| Hip joint adjustable flexion HCPCS L2622 | $474.67 | $1,582.25 | not published | 0 |
| Hip X-ray CPT 73502 | $192.30 | $641.00 | not published | 0 |
| Hkafo torsion ball bearing j HCPCS L2060 | $909.28 | $3,030.93 | not published | 0 |
| Hkafo torsion bil rot straps HCPCS L2040 | $301.78 | $1,005.94 | not published | 0 |
| Hkafo torsion unilat rot str HCPCS L2070 | $231.53 | $771.77 | not published | 0 |
| Hkafo unilat torsion ball br HCPCS L2090 | $741.73 | $2,472.43 | not published | 0 |
| Hla class i high defin qual CPT 86832 | $535.50 | $1,785.00 | not published | 0 |
| Hla class ii phenotype qual CPT 86831 | $135.00 | $450.00 | not published | 0 |
| Hla class i phenotype qual CPT 86830 | $158.10 | $527.00 | not published | 0 |
| Hla i low res one antigen equiv ea CPT 81374 | $103.50 | $345.00 | not published | 0 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $924.30 | $3,081.00 | not published | 0 |
| Ho abduction hip adjustable HCPCS L1650 | $367.88 | $1,226.26 | not published | 0 |
| Ho abduction static plastic HCPCS L1660 | $269.58 | $898.61 | not published | 0 |
| Ho bi thighcuffs w sprdr bar HCPCS L1652 | $531.77 | $1,772.58 | not published | 0 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $26.96 | $44.94 | not published | 0 |
| Ho flex frejka w/cov pre cst HCPCS L1600 | $192.22 | $640.73 | not published | 0 |
| Ho flex pavlik harns pre cst HCPCS L1620 | $579.07 | $1,930.25 | not published | 0 |
| Ho frejka cov only pre cst HCPCS L1610 | $81.65 | $272.17 | not published | 0 |
| Homocysteine CPT 83090 | $328.50 | $1,095.00 | not published | 0 |
| Homogenization tissue CPT 87176 | $17.70 | $59.00 | not published | 0 |
| Ho post-op hip abduction HCPCS L1686 | $2,518.15 | $8,393.83 | not published | 0 |
| Hrdtry brst ca-rlatd do 5+ CPT 81432 | $1,956.00 | $6,520.00 | not published | 0 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $15,781.50 | $26,302.50 | not published | 0 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $62.38 | $103.97 | not published | 0 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $23.10 | $38.50 | 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.