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 |
|---|---|---|---|---|
| Crotalidae poly immune fab HCPCS J0840 | $16,021.98 | $26,703.30 | not published | 0 |
| Crystal identification light microscopy CPT 89060 | $39.60 | $132.00 | not published | 0 |
| CT 3d report other modality w/workstation CPT 76377 | $298.50 | $995.00 | not published | 0 |
| Cta abdomen without & /or w/contrast CPT 74175 | $898.50 | $2,995.00 | not published | 0 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $627.30 | $2,091.00 | not published | 0 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $872.10 | $2,907.00 | not published | 0 |
| Cta neck without &/or w/contrast CPT 70498 | $898.50 | $2,995.00 | not published | 0 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $898.50 | $2,995.00 | not published | 0 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $718.80 | $2,396.00 | not published | 0 |
| CT Angiogram of the Head CPT 70496 | $898.50 | $2,995.00 | not published | 0 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $305.00 | $305.00 | not published | 0 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $985.20 | $3,284.00 | not published | 0 |
| CT lower extremity without contrast (both sides) CPT 73700 | $422.70 | $1,409.00 | not published | 0 |
| Ctlso a-p-l control molded HCPCS L0700 | $2,969.73 | $9,899.09 | not published | 0 |
| Ctlso a-p-l control with inter HCPCS L0710 | $3,264.54 | $10,881.81 | not published | 0 |
| Ctlso axilla sling HCPCS L1010 | $124.81 | $416.05 | not published | 0 |
| Ctlso milwauke initial model HCPCS L1000 | $3,024.95 | $10,083.18 | not published | 0 |
| CT lwr extremity w/o&w/dye CPT 73702 | $1,268.40 | $4,228.00 | not published | 0 |
| CT neck soft tissue w/contrast CPT 70491 | $748.50 | $2,495.00 | not published | 0 |
| CT neck soft tissue without contrast CPT 70490 | $422.70 | $1,409.00 | not published | 0 |
| CT neck soft tissue without & w/contrast CPT 70492 | $898.50 | $2,995.00 | not published | 0 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $898.50 | $2,995.00 | not published | 0 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $863.40 | $2,878.00 | not published | 0 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $422.70 | $1,409.00 | not published | 0 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $144.60 | $482.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $898.50 | $2,995.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $718.80 | $2,396.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $696.30 | $2,321.00 | not published | 0 |
| CT thoracic spine w/contrast CPT 72129 | $871.20 | $2,904.00 | not published | 0 |
| CT thoracic spine without contrast CPT 72128 | $422.70 | $1,409.00 | not published | 0 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $123.60 | $412.00 | not published | 0 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $899.70 | $2,999.00 | not published | 0 |
| CT upper extremity without contrast (both sides) CPT 73200 | $422.70 | $1,409.00 | not published | 0 |
| CT uppr extremity w/o&w/dye CPT 73202 | $951.30 | $3,171.00 | not published | 0 |
| Cuffs adj lock with active con HCPCS L3740 | $1,458.76 | $4,862.52 | not published | 0 |
| Culture aerobic additional method definitive id each CPT 87077 | $70.20 | $234.00 | not published | 0 |
| Culture afb any source CPT 87116 | $124.20 | $414.00 | not published | 0 |
| Culture anaerobic additional method definitive id each CPT 87076 | $140.10 | $467.00 | not published | 0 |
| Culture anaerobic except blood CPT 87075 | $64.20 | $214.00 | not published | 0 |
| Culture body fluid CPT 87070 | $64.50 | $215.00 | not published | 0 |
| Culture fungi definitive id mold CPT 87107 | $48.30 | $161.00 | not published | 0 |
| Culture fungi definitive id yeast CPT 87106 | $96.30 | $321.00 | not published | 0 |
| Culture fungi other (except blood) CPT 87102 | $129.30 | $431.00 | not published | 0 |
| Culture screening strep group a CPT 87081 | $18.00 | $60.00 | not published | 0 |
| Culture typing added method CPT 87158 | $137.10 | $457.00 | not published | 0 |
| Culture typing immunologic CPT 87147 | $15.00 | $50.00 | not published | 0 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $378.60 | $1,262.00 | not published | 0 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $89.70 | $299.00 | not published | 0 |
| Culture urine each isolate CPT 87088 | $47.40 | $158.00 | not published | 0 |
| Cutter lead HCPCS C1773 | $5,906.56 | $19,688.55 | not published | 0 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $9.00 | $15.00 | not published | 0 |
| Cyclic citrullinated peptide antibody CPT 86200 | $123.00 | $410.00 | not published | 0 |
| Cygnus, per sq cm HCPCS Q4170 | $7,445.25 | $24,817.50 | not published | 0 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $24,107.80 | $80,359.34 | not published | 0 |
| Cyp3a4 gene common variants CPT 81230 | $262.20 | $874.00 | not published | 0 |
| Cyp3a5 gene common variants CPT 81231 | $262.20 | $874.00 | not published | 0 |
| Cystatin c CPT 82610 | $57.60 | $192.00 | not published | 0 |
| Cystoscopy and treatment CPT 52310 | $1,288.80 | $4,296.00 | not published | 0 |
| Cystoscopy and treatment CPT 52315 | $1,288.80 | $4,296.00 | not published | 0 |
| Cystoscopy (Bladder Scope) CPT 52000 | $434.70 | $1,449.00 | not published | 0 |
| Cystoscopy & ureter catheter CPT 52005 | $1,288.80 | $4,296.00 | not published | 0 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $1,288.80 | $4,296.00 | not published | 0 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $90.00 | $150.00 | not published | 0 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $38.40 | $128.00 | not published | 0 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $59.10 | $197.00 | not published | 0 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $90.60 | $302.00 | not published | 0 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $90.00 | $150.00 | not published | 0 |
| Deamidated gliadin antibody iga CPT 86258 | $20.10 | $67.00 | not published | 0 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $403.50 | $1,345.00 | not published | 0 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,041.90 | $3,473.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $14,045.87 | $23,409.78 | $3,419.10 – $3,487.49 | 2 |
| Debride skin bone at fx site CPT 11012 | $1,794.30 | $5,981.00 | not published | 0 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $403.50 | $1,345.00 | not published | 0 |
| Decalcification CPT 88311 | $18.00 | $60.00 | not published | 0 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $378.00 | $1,260.00 | not published | 0 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $148.50 | $495.00 | not published | 0 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $9,395.91 | $15,659.85 | not published | 0 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $81.00 | $270.00 | not published | 0 |
| Dermapure 1 square cm HCPCS Q4152 | $3,300.73 | $11,002.43 | not published | 0 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $62.70 | $104.50 | not published | 0 |
| Destruction benign lesions < 14 lesions CPT 17110 | $125.70 | $419.00 | not published | 0 |
| Device ablt adv novasure HCPCS C1886 | $8,024.32 | $26,747.75 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $4,136.25 | $13,787.50 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $1,892.75 | $6,309.16 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $1,532.48 | $5,108.27 | not published | 0 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | $3,667.20 | $6,112.00 | not published | 0 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | $3,927.00 | $6,545.00 | not published | 0 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $9.00 | $15.00 | not published | 0 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $14.52 | $24.20 | not published | 0 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $84.00 | $140.00 | not published | 0 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $84.00 | $140.00 | not published | 0 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $84.00 | $140.00 | not published | 0 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $105.60 | $352.00 | not published | 0 |
| Diabetes (HbA1c) Test CPT 83036 | $43.80 | $146.00 | not published | 0 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $81.00 | $270.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $124.50 | $415.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $180.60 | $602.00 | not published | 0 |
| Diagnostic Mammogram (one breast) CPT 77065 | $153.00 | $510.00 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $55.54 | $92.57 | not published | 0 |
| Diffusing capacity CPT 94729 | $240.60 | $802.00 | 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.