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 |
|---|---|---|---|---|
| Warde viscosity CPT 85810 | $139.80 | $466.00 | not published | 0 |
| Warde vitamin a CPT 84590 | $165.30 | $551.00 | not published | 0 |
| Warde vitamin b-1 (thiamine) CPT 84425 | $348.90 | $1,163.00 | not published | 0 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $251.40 | $838.00 | not published | 0 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $152.70 | $509.00 | not published | 0 |
| Warde zinc CPT 84630 | $47.70 | $159.00 | not published | 0 |
| Whfo electric custom fitted HCPCS L3904 | $4,582.54 | $15,275.12 | not published | 0 |
| Whfo nontorsion joint prefab HCPCS L3931 | $283.07 | $943.56 | not published | 0 |
| Whfo w/joint(s) custom fab HCPCS L3806 | $616.68 | $2,055.61 | not published | 0 |
| Who nontorsion jnts pre cst HCPCS L3915 | $721.68 | $2,405.59 | not published | 0 |
| Who nontorsion jnts pre ots HCPCS L3916 | $721.68 | $2,405.59 | not published | 0 |
| Woman's shoe oxford brace HCPCS L3224 | $100.79 | $335.97 | not published | 0 |
| Wrist X-ray CPT 73110 | $225.90 | $753.00 | not published | 0 |
| Xcapsl ctrc rmvl cplx wo ecp CPT 66982 | $5,842.58 | $9,737.63 | $2,411.58 – $2,459.81 | 3 |
| Xcellistem, 1 mg HCPCS A2004 | $3,332.16 | $11,107.21 | not published | 0 |
| Xe133 xenon 10mci HCPCS A9558 | $69.60 | $116.00 | not published | 0 |
| Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/< CPT 14040 | $1,198.80 | $3,996.00 | not published | 0 |
| X-ray abdomen 1 view CPT 74018 | $224.40 | $748.00 | not published | 0 |
| X-ray abdomen 2 views CPT 74019 | $396.90 | $1,323.00 | not published | 0 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $370.80 | $1,236.00 | not published | 0 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $90.60 | $302.00 | not published | 0 |
| X-ray ankle 2 views (both sides) CPT 73600 | $218.10 | $727.00 | not published | 0 |
| X-ray bone age studies CPT 77072 | $219.60 | $732.00 | not published | 0 |
| X-ray bone length studies CPT 77073 | $217.80 | $726.00 | not published | 0 |
| X-ray bone survey complete CPT 77075 | $903.00 | $3,010.00 | not published | 0 |
| X-ray bone survey infant CPT 77076 | $202.80 | $676.00 | not published | 0 |
| X-ray cervical spine 2-3 views CPT 72040 | $225.30 | $751.00 | not published | 0 |
| X-ray cervical spine 4-5 views CPT 72050 | $395.10 | $1,317.00 | not published | 0 |
| X-ray cervical spine >= 6 views CPT 72052 | $448.80 | $1,496.00 | not published | 0 |
| X-ray clavicle complete (both sides) CPT 73000 | $237.00 | $790.00 | not published | 0 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $435.60 | $1,452.00 | not published | 0 |
| X-ray elbow 2 views (both sides) CPT 73070 | $217.80 | $726.00 | not published | 0 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $225.30 | $751.00 | not published | 0 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $328.80 | $1,096.00 | not published | 0 |
| X-ray exam of arm infant CPT 73092 | $123.00 | $410.00 | not published | 0 |
| X-ray exam of eye sockets CPT 70200 | $318.90 | $1,063.00 | not published | 0 |
| X-ray exam of femur 1 CPT 73551 | $171.60 | $572.00 | not published | 0 |
| X-ray exam of sinuses CPT 70210 | $183.00 | $610.00 | not published | 0 |
| X-ray exam si joints CPT 72200 | $278.10 | $927.00 | not published | 0 |
| X-ray exam thorac spine4/>vw CPT 72074 | $387.60 | $1,292.00 | not published | 0 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $219.00 | $730.00 | not published | 0 |
| X-ray facial bones complete > 3 views CPT 70150 | $251.10 | $837.00 | not published | 0 |
| X-ray femur >=2 views (both sides) CPT 73552 | $226.20 | $754.00 | not published | 0 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $217.50 | $725.00 | not published | 0 |
| X-ray foot 2 views (both sides) CPT 73620 | $217.80 | $726.00 | not published | 0 |
| X-ray forearm 2 views (both sides) CPT 73090 | $222.90 | $743.00 | not published | 0 |
| X-ray hand 2 views (both sides) CPT 73120 | $225.00 | $750.00 | not published | 0 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $218.40 | $728.00 | not published | 0 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $121.80 | $406.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $381.30 | $1,271.00 | not published | 0 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $293.10 | $977.00 | not published | 0 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $123.30 | $411.00 | not published | 0 |
| X-ray humerus >= 2 views left CPT 73060 | $238.20 | $794.00 | not published | 0 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $232.20 | $774.00 | not published | 0 |
| X-ray knee 3 views (both sides) CPT 73562 | $222.60 | $742.00 | not published | 0 |
| X-ray knee ap standing bilateral CPT 73565 | $126.30 | $421.00 | not published | 0 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $320.40 | $1,068.00 | not published | 0 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $297.30 | $991.00 | not published | 0 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $377.10 | $1,257.00 | not published | 0 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $410.40 | $1,368.00 | not published | 0 |
| X-ray mandible ltd <4 views CPT 70100 | $127.20 | $424.00 | not published | 0 |
| X-ray nasal bones complete > 3 views CPT 70160 | $213.90 | $713.00 | not published | 0 |
| X-ray neck soft tissue CPT 70360 | $213.90 | $713.00 | not published | 0 |
| X-ray pelvis 1-2 views CPT 72170 | $210.60 | $702.00 | not published | 0 |
| X-ray pelvis complete > 3 views CPT 72190 | $214.20 | $714.00 | not published | 0 |
| X-ray ribs 2 views left CPT 71100 | $234.00 | $780.00 | not published | 0 |
| X-ray ribs 3 views bilateral CPT 71110 | $319.50 | $1,065.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $327.00 | $1,090.00 | not published | 0 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $358.80 | $1,196.00 | not published | 0 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $223.80 | $746.00 | not published | 0 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $223.80 | $746.00 | not published | 0 |
| X-ray scapula complete (both sides) CPT 73010 | $260.40 | $868.00 | not published | 0 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $169.50 | $565.00 | not published | 0 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $225.30 | $751.00 | not published | 0 |
| X-ray skull < 4 views CPT 70250 | $287.40 | $958.00 | not published | 0 |
| X-ray skull > 4 views complete CPT 70260 | $396.90 | $1,323.00 | not published | 0 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $284.10 | $947.00 | not published | 0 |
| X-ray small intestine follow-through study CPT 74248 | $140.40 | $468.00 | not published | 0 |
| X-ray spine single view CPT 72020 | $204.00 | $680.00 | not published | 0 |
| X-ray sternum > 2 views CPT 71120 | $192.90 | $643.00 | not published | 0 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $354.00 | $1,180.00 | not published | 0 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $176.70 | $589.00 | not published | 0 |
| X-ray thoracic spine 2 views CPT 72070 | $279.00 | $930.00 | not published | 0 |
| X-ray thoracic spine 3 views CPT 72072 | $306.90 | $1,023.00 | not published | 0 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $225.30 | $751.00 | not published | 0 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $224.40 | $748.00 | not published | 0 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $224.40 | $748.00 | not published | 0 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $225.90 | $753.00 | not published | 0 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $207.00 | $690.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $634.20 | $2,114.00 | not published | 0 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $544.50 | $1,815.00 | not published | 0 |
| X-ray wrist 2 views (both sides) CPT 73100 | $231.60 | $772.00 | not published | 0 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $2,194.80 | $3,658.00 | not published | 0 |
| Zika virus dna/rna amp probe CPT 87662 | $143.40 | $478.00 | not published | 0 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $310.20 | $517.00 | not published | 0 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $164.33 | $273.88 | 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.