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 |
|---|---|---|---|---|
| Smear wet mount CPT 87210 | $55.50 | $185.00 | not published | 0 |
| So airplane w/wo joint cf HCPCS L3674 | $1,604.77 | $5,349.22 | not published | 0 |
| So cap design without jnts cf HCPCS L3671 | $1,223.30 | $4,077.68 | not published | 0 |
| Socket insert without lock mech HCPCS L5679 | $810.82 | $2,702.74 | not published | 0 |
| Sock fracture or equal each HCPCS L3995 | $45.37 | $151.22 | not published | 0 |
| Sodium 24 hour urine CPT 84300 | $105.60 | $352.00 | not published | 0 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $84.00 | $140.00 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $84.00 | $140.00 | not published | 0 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $84.00 | $140.00 | not published | 0 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $209.88 | $349.80 | not published | 0 |
| Sodium serum/plasma/whole blood CPT 84295 | $70.50 | $235.00 | not published | 0 |
| Soft interface below knee se HCPCS L2820 | $112.90 | $376.34 | not published | 0 |
| So neo gsap dna/dna&rna CPT 81459 | $2,242.20 | $7,474.00 | not published | 0 |
| So vest canvas/web pre ots HCPCS L3675 | $238.30 | $794.33 | not published | 0 |
| Specific gravity body fluid CPT 84315 | $5.10 | $17.00 | not published | 0 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $297.00 | $990.00 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $688.01 | $2,293.36 | not published | 0 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $89.18 | $297.26 | not published | 0 |
| Splint finger fold over sm HCPCS L3924 | $131.14 | $437.12 | not published | 0 |
| Splint finger frog med HCPCS L3927 | $133.45 | $444.84 | not published | 0 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $131.14 | $437.12 | not published | 0 |
| Sputum specimen collection CPT 89220 | $164.10 | $547.00 | not published | 0 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $426.30 | $1,421.00 | not published | 0 |
| Static or dynami afo pre ots HCPCS L4397 | $413.62 | $1,378.75 | not published | 0 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $29,845.03 | $99,483.43 | not published | 0 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $23,990.25 | $79,967.50 | not published | 0 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $26,058.37 | $86,861.25 | not published | 0 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $579.07 | $1,930.25 | not published | 0 |
| Sterile water/saline, 10 ml HCPCS A4216 | $84.00 | $140.00 | not published | 0 |
| Sternal pad HCPCS L1050 | $149.68 | $498.94 | not published | 0 |
| St evaluate speech sound production CPT 92522 | $74.70 | $249.00 | not published | 0 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $426.30 | $1,421.00 | not published | 0 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $341.40 | $1,138.00 | not published | 0 |
| St evaluation swallow function CPT 92610 | $272.10 | $907.00 | not published | 0 |
| Stocking sup grips 4 pre ots HCPCS L0982 | $23.33 | $77.76 | not published | 0 |
| Straight knee joint heavy du HCPCS L2385 | $219.20 | $730.68 | not published | 0 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $101.40 | $338.00 | not published | 0 |
| Strapping of elbow or wrist 29260 CPT 29260 | $39.90 | $133.00 | not published | 0 |
| Strapping of hand or finger CPT 29280 | $39.90 | $133.00 | not published | 0 |
| Strapping of knee CPT 29530 | $81.00 | $270.00 | not published | 0 |
| Stress test pulmonary CPT 94618 | $143.70 | $479.00 | not published | 0 |
| Stress tte complete CPT 93351 | $1,714.20 | $5,714.00 | not published | 0 |
| Str markers specimen anal CPT 81265 | $366.90 | $1,223.00 | not published | 0 |
| St treatment speech individual CPT 92507 | $239.10 | $797.00 | not published | 0 |
| St treatment swallow dysfunction/oral CPT 92526 | $266.70 | $889.00 | not published | 0 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $9.00 | $15.00 | not published | 0 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $9,527.02 | $15,878.36 | not published | 0 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $240.77 | $401.28 | not published | 0 |
| Support clav 29.6-40.5in med HCPCS L3650 | $377.71 | $1,259.02 | not published | 0 |
| Surgical pathology level 1 gross examination only CPT 88300 | $55.50 | $185.00 | not published | 0 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $184.80 | $616.00 | not published | 0 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $184.80 | $616.00 | not published | 0 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $259.80 | $866.00 | not published | 0 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $225.00 | $750.00 | not published | 0 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $216.60 | $722.00 | not published | 0 |
| Susceptibility agar dilution per agent CPT 87181 | $14.10 | $47.00 | not published | 0 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $20.40 | $68.00 | not published | 0 |
| Susceptibility mic per plate CPT 87186 | $92.10 | $307.00 | not published | 0 |
| Suscept studies macrobroth dilution ea CPT 87188 | $44.70 | $149.00 | not published | 0 |
| Suspension sleeve lower ext HCPCS L2397 | $158.48 | $528.28 | not published | 0 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $25.20 | $84.00 | not published | 0 |
| System cardiomems hosp electronics HCPCS C2624 | $31,435.50 | $104,785.00 | not published | 0 |
| System pacing micra av HCPCS C1786 | $27,630.15 | $92,100.50 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $13,350.16 | $44,500.54 | not published | 0 |
| System recell skin grafting/harvesting HCPCS C1832 | $11,374.69 | $37,915.63 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $120.60 | $402.00 | not published | 0 |
| T4 (thyroxine) free CPT 84439 | $46.20 | $154.00 | not published | 0 |
| T4 (thyroxine) total CPT 84436 | $51.00 | $170.00 | not published | 0 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $9.00 | $15.00 | not published | 0 |
| Tacrolimus therapeutic drug level CPT 80197 | $22.80 | $76.00 | not published | 0 |
| Talymed HCPCS Q4127 | $2,150.85 | $7,169.50 | not published | 0 |
| Tap block bilat cont infusion 64489 CPT 64489 | $1,108.80 | $3,696.00 | not published | 0 |
| Tap block uni by cont infusion 64487 CPT 64487 | $555.00 | $1,850.00 | not published | 0 |
| Target gsa panel hmtlmph neop CPT 81450 | $1,527.30 | $5,091.00 | not published | 0 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $4,598.40 | $15,328.00 | not published | 0 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1,251.80 | $2,086.34 | not published | 0 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $200.70 | $669.00 | not published | 0 |
| Tc-99m bicisate HCPCS A9557 | $819.00 | $1,365.00 | not published | 0 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $5,046.00 | $8,410.00 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $336.01 | $560.01 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $1,333.20 | $2,222.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $336.00 | $560.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $150.60 | $251.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $1,005.01 | $1,675.01 | not published | 0 |
| Tc-99m oxidronate HCPCS A9561 | $294.48 | $490.80 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $52.20 | $87.00 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $16.20 | $27.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $433.80 | $879.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $465.00 | $775.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $94.20 | $157.00 | not published | 0 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $351.60 | $586.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $774.60 | $1,291.00 | not published | 0 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $148.20 | $494.00 | not published | 0 |
| T cells absolute cd 4 count CPT 86361 | $18.30 | $61.00 | not published | 0 |
| T cells total count CPT 86359 | $112.20 | $374.00 | not published | 0 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $41,569.28 | $69,282.13 | not published | 0 |
| Tension based scoliosis orth HCPCS L1005 | $4,774.59 | $15,915.30 | not published | 0 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $32.51 | $54.18 | not published | 0 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $33.00 | $110.00 | not published | 0 |
| Test socket below knee HCPCS L5620 | $385.03 | $1,283.45 | 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.