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 |
|---|---|---|---|---|
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $222.90 | $743.00 | not published | 0 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $996.90 | $3,323.00 | not published | 0 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $222.90 | $743.00 | not published | 0 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $222.90 | $743.00 | not published | 0 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $226.80 | $756.00 | not published | 0 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $222.90 | $743.00 | not published | 0 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $222.90 | $743.00 | not published | 0 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $222.90 | $743.00 | not published | 0 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $996.90 | $3,323.00 | not published | 0 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $222.90 | $743.00 | not published | 0 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $996.90 | $3,323.00 | not published | 0 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $222.90 | $743.00 | not published | 0 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $996.90 | $3,323.00 | not published | 0 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $996.90 | $3,323.00 | not published | 0 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $996.90 | $3,323.00 | not published | 0 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $1,635.90 | $5,453.00 | not published | 0 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $222.90 | $743.00 | not published | 0 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $222.90 | $743.00 | not published | 0 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $996.90 | $3,323.00 | not published | 0 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $222.90 | $743.00 | not published | 0 |
| Clsd tx wrist ulnar styloid fx 25650 CPT 25650 | $226.80 | $756.00 | not published | 0 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $222.90 | $743.00 | not published | 0 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $996.90 | $3,323.00 | not published | 0 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $996.90 | $3,323.00 | not published | 0 |
| Cltx lunate dislc w/mnpj CPT 25690 | $996.90 | $3,323.00 | not published | 0 |
| Cltx post ankle fx w/mnpj CPT 27768 | $996.90 | $3,323.00 | not published | 0 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,494.60 | $4,982.00 | not published | 0 |
| Cltx thigh fx w/mnpj CPT 27268 | $2,709.60 | $9,032.00 | not published | 0 |
| Cmv pcr-sendout CPT 87496 | $206.40 | $688.00 | not published | 0 |
| Cocaine 4 % nasal solution HCPCS C9046 | $462.70 | $771.17 | not published | 0 |
| Coch imp ext proc/contr rplc HCPCS L8619 | $19,766.31 | $65,887.71 | not published | 0 |
| Coch implant microphone repl HCPCS L8616 | $488.08 | $1,626.93 | not published | 0 |
| Cold agglutinin screen (arc) CPT 86156 | $42.60 | $142.00 | not published | 0 |
| Collar cerv 18.25x3.5in serp firm density sm HCPCS L0120 | $140.63 | $468.78 | not published | 0 |
| Collar cerv adlt perfit ace extric HCPCS L0140 | $94.31 | $314.36 | not published | 0 |
| Collar cerv ascend 172 reg HCPCS L0172 | $227.43 | $758.09 | not published | 0 |
| Collar cerv patriot adlt HCPCS L0150 | $155.87 | $519.57 | not published | 0 |
| Collection blood specimen using established central/peripheral catheter venous nos CPT 36592 | $63.60 | $212.00 | not published | 0 |
| Collection of venous blood by venipuncture CPT 36415 | $12.30 | $41.00 | not published | 0 |
| Colonoscopy (diagnostic) CPT 45378 | $6,179.70 | $10,299.50 | $971.77 – $991.20 | 3 |
| Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah) CPT 45384 | $4,418.28 | $7,363.80 | $1,250.44 – $1,275.45 | 3 |
| Colonoscopy submucous njx CPT 45381 | $12,099.58 | $20,165.97 | $1,250.44 – $1,275.45 | 3 |
| Colonoscopy w/ablation CPT 45388 | $7,620.02 | $12,700.03 | $1,250.44 – $1,275.45 | 3 |
| Colonoscopy (with biopsy) CPT 45380 | $7,262.04 | $12,103.40 | $1,250.44 – $1,275.45 | 3 |
| Colonoscopy (with polyp removal) CPT 45385 | $7,620.02 | $12,700.03 | $1,250.44 – $1,275.45 | 3 |
| Colporrhapy/vag injury sut/non ob 57200 CPT 57200 | $1,964.10 | $6,547.00 | not published | 0 |
| Combination bilateral ho HCPCS L1690 | $2,884.70 | $9,615.68 | not published | 0 |
| Compatibility test each unit antiglobulin technique CPT 86922 | $105.00 | $350.00 | not published | 0 |
| Compatibility test each unit electronic CPT 86923 | $164.70 | $549.00 | not published | 0 |
| Compatibility test each unit immediate spin technique CPT 86920 | $99.90 | $333.00 | not published | 0 |
| Complement antigen each component c3 CPT 86160 | $143.10 | $477.00 | not published | 0 |
| Complex repair trunk 1.1-2.5cm 13120 CPT 13120 | $717.30 | $2,391.00 | not published | 0 |
| Complex repair trunk 2.6-7.5cm 13101 CPT 13101 | $717.30 | $2,391.00 | not published | 0 |
| Complx repair enel 1.1-2.5 cm 13151 CPT 13151 | $717.30 | $2,391.00 | not published | 0 |
| Complx repair fccmnaxghf 13131 CPT 13131 | $717.30 | $2,391.00 | not published | 0 |
| Complx repair fccmnaxghf 13132 CPT 13132 | $717.30 | $2,391.00 | not published | 0 |
| Complx repair fccmnaxghf 13133 CPT 13133 | $717.30 | $2,391.00 | not published | 0 |
| Complx repair sal addl 5 cm/> 13122 CPT 13122 | $717.30 | $2,391.00 | not published | 0 |
| Complx repair trunk 1.1-2.5 cm 13100 CPT 13100 | $717.30 | $2,391.00 | not published | 0 |
| Complx repair trunk addl 5cm/< 13102 CPT 13102 | $717.30 | $2,391.00 | not published | 0 |
| Component ankle afo plastic jt mold to pt mdl foot cup HCPCS L1970 | $1,376.54 | $4,588.48 | not published | 0 |
| Concentration infection agents any type CPT 87015 | $27.30 | $91.00 | not published | 0 |
| Conduit wrap neuomend 3mmx2.5cm HCPCS C9361 | $11,573.23 | $38,577.43 | not published | 0 |
| Condylomata destruction 56420 CPT 56420 | $234.90 | $783.00 | not published | 0 |
| Connect omega .5mm HCPCS L8613 | $4,838.04 | $16,126.80 | not published | 0 |
| Connector tis 2x10mm HCPCS C9352 | $5,115.71 | $17,052.38 | not published | 0 |
| Contrast x-ray of hip CPT 73525 | $320.40 | $1,068.00 | not published | 0 |
| Controler lvad heartmate 3 includes ebb HCPCS Q0481 | $11,829.67 | $39,432.25 | not published | 0 |
| Controller infinity pt dbs HCPCS C1787 | $3,049.24 | $10,164.15 | not published | 0 |
| Control nosebleed pack+caut 30905 CPT 30905 | $126.30 | $421.00 | not published | 0 |
| Control of nosebleed ant comp 30903 CPT 30903 | $81.00 | $270.00 | not published | 0 |
| Control of nosebleedantersmpl 30901 CPT 30901 | $81.00 | $270.00 | not published | 0 |
| Control oropharyngeal hemorr/simp 42960 CPT 42960 | $317.40 | $1,058.00 | not published | 0 |
| Control throat bleeding CPT 42962 | $1,976.70 | $6,589.00 | not published | 0 |
| Coombs direct CPT 86880 | $79.20 | $264.00 | not published | 0 |
| Coombs indirect qualitative each reagent red cell reference CPT 86885 | $164.10 | $547.00 | not published | 0 |
| Coombs indirect titer reference CPT 86886 | $74.10 | $247.00 | not published | 0 |
| Copper cu 64 dotatate diag HCPCS A9592 | $36,960.00 | $61,600.00 | not published | 0 |
| Cornea pre-cut midwest eye cornea pre-cut midwest eye HCPCS V2785 | $8,272.50 | $27,575.00 | not published | 0 |
| Cortisol acth stimulation test - sendout CPT 80400 | $54.00 | $180.00 | not published | 0 |
| Cortisol total am CPT 82533 | $96.00 | $320.00 | not published | 0 |
| Cosyntropin 0.25 mg solution for injection HCPCS J0834 | $170.02 | $283.36 | not published | 0 |
| Coveredge 32 lead kit 40cm 48 HCPCS C1897 | $5,269.58 | $17,565.28 | not published | 0 |
| Covers for upright each HCPCS L1120 | $56.73 | $189.11 | not published | 0 |
| Cover wrist HCPCS L3984 | $55.59 | $185.30 | not published | 0 |
| #covid19rsv-rsv CPT 87634 | $121.80 | $406.00 | not published | 0 |
| #coxa-coxsackie a serotype a16 CPT 86658 | $41.40 | $138.00 | not published | 0 |
| C-peptide CPT 84681 | $79.20 | $264.00 | not published | 0 |
| Cptr-asst dir ms px CPT 20985 | $36,356.77 | $60,594.62 | $13,415.89 – $13,684.21 | 3 |
| Cranial cervical orthosis HCPCS L0112 | $10,340.62 | $34,468.75 | not published | 0 |
| C-reactive protein CPT 86140 | $109.80 | $366.00 | not published | 0 |
| C-reactive protein high sensitivity CPT 86141 | $192.90 | $643.00 | not published | 0 |
| Creatine kinase CPT 82550 | $57.90 | $193.00 | not published | 0 |
| Creatine kinase mb CPT 82553 | $96.30 | $321.00 | not published | 0 |
| Creatinine CPT 82565 | $70.50 | $235.00 | not published | 0 |
| Creatinine 24 hour urine CPT 82570 | $67.50 | $225.00 | not published | 0 |
| Creatinine clearance urine CPT 82575 | $136.20 | $454.00 | not published | 0 |
| #creutz-prot.,western blot CPT 84182 | $204.00 | $680.00 | not published | 0 |
| Critical care 30-74 minutes CPT 99291 | $2,954.70 | $9,849.00 | not published | 0 |
| Critical care each additional 30 minutes CPT 99292 | $562.80 | $1,876.00 | 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.