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 |
|---|---|---|---|---|
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | $189.00 | $630.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $101.10 | $337.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $96.90 | $323.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $101.10 | $337.00 | not published | 0 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $45.90 | $153.00 | not published | 0 |
| Inj, levothyroxine, freskabi HCPCS J0651 | $582.65 | $971.08 | not published | 0 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $72.86 | $121.44 | not published | 0 |
| Inj lwr xtr fscl pln blk uni w/wo image CPT 64473 | $738.90 | $2,463.00 | not published | 0 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $9.00 | $15.00 | not published | 0 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $2,178.00 | $3,630.00 | not published | 0 |
| Inj proc elbow arthro CPT 24220 | $405.00 | $1,350.00 | not published | 0 |
| Inj, releuko 1 mcg HCPCS Q5125 | $1,274.54 | $2,124.24 | not published | 0 |
| Inj sulf hexa lipid microsph HCPCS Q9950 | $950.65 | $1,584.42 | not published | 0 |
| Inj thrc fascial pln blk bi w/wo image CPT 64468 | $738.90 | $2,463.00 | not published | 0 |
| Inj thrc fascial pln blk uni w/wo image CPT 64466 | $369.90 | $1,233.00 | not published | 0 |
| Inj vancomycin (xellia) 10mg HCPCS J3375 | $184.80 | $308.00 | not published | 0 |
| Inj vocal cord bulking agent HCPCS L8607 | $1,216.06 | $4,053.53 | not published | 0 |
| Insert and remove bone pin CPT 20650 | $2,067.90 | $6,893.00 | not published | 0 |
| Insert cath pleura without image CPT 32556 | $1,209.90 | $4,033.00 | not published | 0 |
| Insert intrauterine device iud CPT 58300 | $580.80 | $1,936.00 | not published | 0 |
| Insertion catheter bladder non indwelling CPT 51701 | $28,001.85 | $46,669.75 | $13,415.89 – $13,684.21 | 3 |
| Insertion catheter bladder temporary simple CPT 51702 | $138.60 | $462.00 | not published | 0 |
| Insertion nontunneled centrally inserted central venous catheter >= 5 years old CPT 36556 | $1,386.00 | $4,620.00 | not published | 0 |
| Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years CPT 36569 | $1,083.60 | $3,612.00 | not published | 0 |
| Insertion picc without port or pump with imaging guidance=>5y CPT 36573 | $1,967.40 | $6,558.00 | not published | 0 |
| Insertion/replacement temporary single chamber electrode/pacemaker catheter CPT 33210 | $5,669.70 | $18,899.00 | not published | 0 |
| Insole orthotic freedom sz6 6816 HCPCS L3060 | $110.02 | $366.75 | not published | 0 |
| Insulin total CPT 83525 | $110.40 | $368.00 | not published | 0 |
| Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm HCPCS Q4114 | $7,643.57 | $25,478.58 | not published | 0 |
| Integra meshed bil wound mat HCPCS C9363 | $25,071.07 | $83,570.23 | not published | 0 |
| Integra os putty 2.5cc - cost per 0.5cc HCPCS C9359 | $5,765.93 | $19,219.78 | not published | 0 |
| Interdental fixation CPT 21110 | $964.50 | $3,215.00 | not published | 0 |
| Interfyl, 1 mg HCPCS Q4171 | $3,309.00 | $11,030.00 | not published | 0 |
| Intrinsic factor antibody CPT 86340 | $132.90 | $443.00 | not published | 0 |
| Intubation endotracheal emergency procedure CPT 31500 | $459.00 | $1,530.00 | not published | 0 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $675.02 | $1,125.04 | not published | 0 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $108,656.64 | $181,094.40 | not published | 0 |
| Ipratropium bromide non-comp HCPCS J7644 | $9.00 | $15.00 | not published | 0 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | $11,260.62 | $18,767.70 | not published | 0 |
| Iron CPT 83540 | $78.90 | $263.00 | not published | 0 |
| Iron binding capacity CPT 83550 | $27.60 | $92.00 | not published | 0 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $39.90 | $133.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $79.50 | $265.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $237.60 | $792.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $79.50 | $265.00 | not published | 0 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $237.60 | $792.00 | not published | 0 |
| Jak2 targeted sequence analysis CPT 81279 | $234.30 | $781.00 | not published | 0 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | $1,643.93 | $5,479.76 | not published | 0 |
| Kafo dbl solid stirrup without j HCPCS L2030 | $1,615.85 | $5,386.17 | not published | 0 |
| Kafo fem fx cast molded to p HCPCS L2128 | $2,419.85 | $8,066.18 | not published | 0 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | $1,719.09 | $5,730.31 | not published | 0 |
| Kafo fem fx cast thermoplas HCPCS L2126 | $1,708.87 | $5,696.22 | not published | 0 |
| Kafo femoral fx cast rigid HCPCS L2136 | $1,881.30 | $6,271.00 | not published | 0 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | $3,030.46 | $10,101.55 | not published | 0 |
| Kafo plas sing free knee mol HCPCS L2037 | $2,473.84 | $8,246.14 | not published | 0 |
| Kafo plastic pediatric size HCPCS L2035 | $258.43 | $861.44 | not published | 0 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | $1,668.79 | $5,562.65 | not published | 0 |
| Kafo sng/dbl mechanical act HCPCS L2005 | $6,112.81 | $20,376.05 | not published | 0 |
| Kafo sng solid stirrup without j HCPCS L2010 | $1,301.65 | $4,338.82 | not published | 0 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $24.60 | $82.00 | not published | 0 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $54.12 | $90.20 | not published | 0 |
| Kidney imag w/bld flow multi CPT 78709 | $404.10 | $1,347.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $422.70 | $1,409.00 | not published | 0 |
| Kit case 4.2mm spinejack HCPCS C1062 | $6,890.99 | $22,969.98 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $7,776.15 | $25,920.50 | not published | 0 |
| Kit hfx iq ipg bundle HCPCS C1822 | $43,678.80 | $145,596.00 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $43,017.00 | $143,390.00 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $18,199.50 | $60,665.00 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,216.06 | $4,053.53 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $22,463.13 | $74,877.10 | not published | 0 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $19,766.31 | $65,887.71 | not published | 0 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,296.58 | $4,321.94 | not published | 0 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | $7,709.45 | $12,849.08 | $3,419.10 – $3,487.49 | 3 |
| Knee arthroscopy/surgery CPT 29875 | $8,921.24 | $14,868.73 | $3,419.10 – $3,487.49 | 3 |
| Knee arthroscopy/surgery CPT 29876 | $22,666.67 | $37,777.78 | $3,419.10 – $3,487.49 | 3 |
| Knee arthroscopy/surgery CPT 29888 | $22,666.67 | $37,777.78 | $7,582.44 – $7,734.09 | 3 |
| Knee control condylar pad HCPCS L2810 | $121.84 | $406.12 | not published | 0 |
| Knee control full kneecap HCPCS L2795 | $122.33 | $407.78 | not published | 0 |
| Knee disc/dial lock/adj flex HCPCS L2425 | $213.84 | $712.81 | not published | 0 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | $213.84 | $712.81 | not published | 0 |
| Knee joint cam lock each joi HCPCS L2415 | $181.23 | $604.11 | not published | 0 |
| Knee joint drop lock ea jnt HCPCS L2405 | $118.31 | $394.38 | not published | 0 |
| Knee lift loop drop lock rin HCPCS L2492 | $174.96 | $583.21 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $1,699.80 | $5,666.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $2,542.20 | $8,474.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $730.80 | $2,436.00 | not published | 0 |
| Knee orth pos locking joint HCPCS L1831 | $439.04 | $1,463.46 | not published | 0 |
| Knee X-ray CPT 73564 | $257.40 | $858.00 | not published | 0 |
| Ko dbl upright w/air pre cst HCPCS L1847 | $858.02 | $2,860.08 | not published | 0 |
| Ko dbl upright w/air pre ots HCPCS L1848 | $858.02 | $2,860.08 | not published | 0 |
| Ko derot ant cruciate custom HCPCS L1840 | $1,402.87 | $4,676.22 | not published | 0 |
| Ko elastic w/joints pre ots HCPCS L1812 | $120.30 | $401.00 | not published | 0 |
| Ko rigid without joints pre ots HCPCS L1836 | $199.02 | $663.40 | not published | 0 |
| Ko single upright prefab ots HCPCS L1851 | $1,338.51 | $4,461.69 | not published | 0 |
| Ko supracondylar socket mold HCPCS L1860 | $1,860.19 | $6,200.62 | not published | 0 |
| Ko swedish type pre ots HCPCS L1850 | $424.99 | $1,416.64 | not published | 0 |
| Ko w/0 joint rigid molded to HCPCS L1834 | $1,192.90 | $3,976.32 | not published | 0 |
| Ko w adj flex/ext rotat mold HCPCS L1846 | $1,745.41 | $5,818.05 | not published | 0 |
| Kyphosis pad HCPCS L1020 | $160.75 | $535.84 | not published | 0 |
| Kyphosis pad floating HCPCS L1025 | $231.93 | $773.09 | 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.