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 |
|---|---|---|---|---|
| Blood typing abo CPT 86900 | $65.10 | $217.00 | not published | 0 |
| Blood typing ag donor ea ag CPT 86902 | $337.80 | $1,126.00 | not published | 0 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $337.80 | $1,126.00 | not published | 0 |
| Blood typing rh (d) CPT 86901 | $65.10 | $217.00 | not published | 0 |
| Body jacket mold to patient HCPCS L1300 | $2,571.01 | $8,570.03 | not published | 0 |
| Bone Density Scan (DEXA) CPT 77080 | $346.50 | $1,155.00 | not published | 0 |
| Bone filler cerament 10cc HCPCS C1602 | $12,304.52 | $41,015.06 | not published | 0 |
| Bone imaging multiple areas CPT 78305 | $453.90 | $1,513.00 | not published | 0 |
| Bone/joint imaging ltd area CPT 78300 | $358.50 | $1,195.00 | not published | 0 |
| Bone marrow imaging ltd CPT 78102 | $726.60 | $2,422.00 | not published | 0 |
| Bone tendon board add on HCPCS C9356 | $5,211.67 | $17,372.25 | not published | 0 |
| Bone void filler nanoss 10cc HCPCS C9362 | $7,445.25 | $24,817.50 | not published | 0 |
| Boot j walker l HCPCS L4386 | $842.12 | $2,807.08 | not published | 0 |
| Boot mlti podous univ xlg HCPCS L4396 | $942.65 | $3,142.17 | not published | 0 |
| Boot softgait shrt m HCPCS L4387 | $526.13 | $1,753.77 | not published | 0 |
| Boot walker genesis full shell 3-strap s HCPCS L4360 | $496.35 | $1,654.50 | not published | 0 |
| Boot walker genesis mid-calf full shell s HCPCS L4361 | $2,223.65 | $7,412.16 | not published | 0 |
| Borrelia burgdorferi (lyme disease) antibody nonspecific CPT 86618 | $63.90 | $213.00 | not published | 0 |
| Brace adj motion lerman type HCPCS L2186 | $245.00 | $816.66 | not published | 0 |
| Brace afo dbl upright cust HCPCS L1990 | $579.47 | $1,931.57 | not published | 0 |
| Brace afo lg left 6607 HCPCS L1930 | $512.89 | $1,709.65 | not published | 0 |
| Brace afopos solid ankle cust HCPCS L1960 | $768.66 | $2,562.21 | not published | 0 |
| Brace afo spiral prefab HCPCS L1951 | $1,707.44 | $5,691.48 | not published | 0 |
| Brace ank aftr bioskn med lg HCPCS L1906 | $167.73 | $559.11 | not published | 0 |
| Brace ank air stirrup univ HCPCS L4350 | $130.12 | $433.75 | not published | 0 |
| Brace ankle joint dflxn assist HCPCS L2210 | $89.46 | $298.20 | not published | 0 |
| Brace ankle stablizing lg HCPCS L1902 | $111.35 | $371.16 | not published | 0 |
| Brace back epic lo 627 HCPCS L0642 | $2,086.33 | $6,954.42 | not published | 0 |
| Brace back epic lso 637 HCPCS L0650 | $1,932.59 | $6,441.96 | not published | 0 |
| Brace back epic tslo 456 HCPCS L0457 | $1,483.67 | $4,945.58 | not published | 0 |
| Brace back pinnacle lo 627 lumbar HCPCS L0627 | $557.78 | $1,859.27 | not published | 0 |
| Brace back pinnacle tlso 464 HCPCS L0464 | $3,022.77 | $10,075.91 | not published | 0 |
| Brace back t-lso custom HCPCS L0486 | $3,285.90 | $10,953.01 | not published | 0 |
| Brace back vista 464 tlso HCPCS L0648 | $1,648.45 | $5,494.82 | not published | 0 |
| Brace cust back lso HCPCS L0631 | $305.47 | $1,018.23 | not published | 0 |
| Brace fx hum ovr shldr sm HCPCS L3980 | $914.94 | $3,049.80 | not published | 0 |
| Brace halo bremer l2830 HCPCS L2830 | $122.14 | $407.12 | not published | 0 |
| Brace kafo dbl upright cust HCPCS L2036 | $2,499.39 | $8,331.29 | not published | 0 |
| Brace knee 32in univ t-scope short lt/rt HCPCS L1852 | $1,249.61 | $4,165.37 | not published | 0 |
| Brace knee extender plus 22-30in HCPCS L1832 | $1,401.36 | $4,671.21 | not published | 0 |
| Brace knee hing pat open med HCPCS L1820 | $99.19 | $330.62 | not published | 0 |
| Brace knee playmaker ii x-rom hook and loop xl HCPCS L1833 | $1,027.53 | $3,425.09 | not published | 0 |
| Brace knee postop tscope xl HCPCS L1845 | $1,263.47 | $4,211.58 | not published | 0 |
| Brace knee support neoprene padded open patella med HCPCS L1810 | $900.88 | $3,002.92 | not published | 0 |
| Brace m arm board HCPCS L3809 | $5,985.98 | $19,953.27 | not published | 0 |
| Brace ortho exos 28-50in sm HCPCS L0637 | $357.83 | $1,192.78 | not published | 0 |
| Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr HCPCS L0456 | $2,021.80 | $6,739.33 | not published | 0 |
| Brace oths wrist hnd fngr without HCPCS L3807 | $463.26 | $1,544.20 | not published | 0 |
| Brace tlso flex cust HCPCS L0450 | $2,633.96 | $8,779.88 | not published | 0 |
| Brace wrist classic lft sm HCPCS L3908 | $99.27 | $330.90 | not published | 0 |
| Brachy source i-125 injection HCPCS C2638 | $124.09 | $413.63 | not published | 0 |
| Brachy source iodine-125 nonstranded HCPCS C2639 | $44.67 | $148.91 | not published | 0 |
| Brachy source palladium HCPCS C2640 | $190.27 | $634.23 | not published | 0 |
| Brachy source palladium-103 nonstranded HCPCS C2641 | $69.49 | $231.63 | not published | 0 |
| Brachy source yttrium-90 HCPCS C2616 | $33,635.98 | $112,119.95 | not published | 0 |
| Brachy src nonstrand c-131 HCPCS C2643 | $231.63 | $772.10 | not published | 0 |
| Brachy src stranded c-131 HCPCS C2642 | $12,684.51 | $42,281.69 | not published | 0 |
| Braf gene CPT 81210 | $137.70 | $459.00 | not published | 0 |
| Brain MRA (blood vessel MRI, with contrast) CPT 70545 | $943.50 | $3,145.00 | not published | 0 |
| Brain MRA (blood vessel MRI, without contrast) CPT 70544 | $913.50 | $3,045.00 | not published | 0 |
| Brain MRI (with and without contrast) CPT 70553 | $1,359.90 | $4,533.00 | not published | 0 |
| Brain MRI (with contrast) CPT 70552 | $943.50 | $3,145.00 | not published | 0 |
| Brain MRI (without contrast) CPT 70551 | $913.50 | $3,045.00 | not published | 0 |
| Bra surgical elizabeth pink sm HCPCS L8000 | $69.98 | $233.28 | not published | 0 |
| Budesonide non-comp unit HCPCS J7626 | $53.32 | $88.86 | not published | 0 |
| Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr HCPCS J1939 | $9.00 | $15.00 | not published | 0 |
| Bundled special stain group 1 microorganisms CPT 88312 | $62.10 | $207.00 | not published | 0 |
| Bundled special stain group 2 CPT 88313 | $124.80 | $416.00 | not published | 0 |
| Bupivacaine 0.1 % epidural pca - 1 hour dose limit HCPCS J0665 | $54.85 | $91.41 | not published | 0 |
| Buprenorphine 8 mg-naloxone 2 mg sublingual tablet HCPCS J0574 | $51.46 | $85.76 | not published | 0 |
| Buprenorphine oral 1mg HCPCS J0571 | $20.06 | $33.43 | not published | 0 |
| Bur rotalink 2.15mm HCPCS C1724 | $10,671.52 | $35,571.75 | not published | 0 |
| Bx skin incisnl ea sep/add l les CPT 11107 | $99.60 | $332.00 | not published | 0 |
| Bx skin punch ea sep/ addl les CPT 11105 | $99.60 | $332.00 | not published | 0 |
| Bx skin tangential ea sep/ addl les CPT 11103 | $99.60 | $332.00 | not published | 0 |
| Bypass temp external fem-fem CPT 37799 | $1,340.40 | $4,468.00 | not published | 0 |
| C1 esterase inhibitor func - sendout CPT 86161 | $143.10 | $477.00 | not published | 0 |
| Cabazitaxel 10 mg/ml (first dilution) intravenous solution HCPCS J9043 | $36,726.76 | $61,211.26 | not published | 0 |
| Cable cath 22-pin diag HCPCS C1730 | $22,731.18 | $75,770.59 | not published | 0 |
| Cable centrimag pressure HCPCS Q0508 | $580.73 | $1,935.77 | not published | 0 |
| Caffeine citrate 20 mg/ml inj for po HCPCS J0706 | $34.85 | $58.08 | not published | 0 |
| Calcitonin (salmon) 200 unit/ml injection solution HCPCS J0630 | $1,252.50 | $2,087.50 | not published | 0 |
| Calcium 24 hour urine CPT 82340 | $101.70 | $339.00 | not published | 0 |
| Calcium acetate(phosphate binders) 667 mg tablet HCPCS J0615 | $9.00 | $15.00 | not published | 0 |
| Calcium chloride 100 mg/ml (10 %) intravenous syringe HCPCS J0618 | $41.65 | $69.41 | not published | 0 |
| Calcium gluconate 100 mg/ml (10 %) intravenous solution HCPCS J0612 | $47.52 | $79.20 | not published | 0 |
| Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution HCPCS J0613 | $130.35 | $217.25 | not published | 0 |
| Calcium ionized CPT 82330 | $52.80 | $176.00 | not published | 0 |
| Calcium total CPT 82310 | $63.30 | $211.00 | not published | 0 |
| Calculi urinary-sendout CPT 82360 | $162.30 | $541.00 | not published | 0 |
| Calprotectin fecal CPT 83993 | $90.60 | $302.00 | not published | 0 |
| Cannula ercp contour 5-4-3 tip HCPCS C1889 | $82,725.00 | $275,750.00 | not published | 0 |
| Canthotomy 67715 CPT 67715 | $1,468.50 | $4,895.00 | not published | 0 |
| Cap nerve 2x15mm HCPCS C1763 | $76,388.26 | $254,627.55 | not published | 0 |
| Cap trach decann 15mm HCPCS C1750 | $1,378.20 | $4,594.00 | not published | 0 |
| Carbamazepine free CPT 80157 | $150.90 | $503.00 | not published | 0 |
| Carbamazepine total therapeutic drug level CPT 80156 | $170.40 | $568.00 | not published | 0 |
| Carbon dioxide CPT 82374 | $70.50 | $235.00 | not published | 0 |
| Carbon graphite lamination HCPCS L2755 | $177.28 | $590.93 | not published | 0 |
| Carboplatin 10 mg/ml desensitization HCPCS J9045 | $249.71 | $416.18 | 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.