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 |
|---|---|---|---|---|
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $3,325.74 | $5,542.90 | not published | 0 |
| Esophagoscopy flex biopsy CPT 43202 | $1,209.90 | $4,033.00 | not published | 0 |
| Esophagoscopy flex remove fb CPT 43215 | $1,209.90 | $4,033.00 | not published | 0 |
| Esoph egd dilation <30 mm CPT 43249 | $4,914.29 | $8,190.48 | $2,005.18 – $2,045.28 | 2 |
| Estradiol total CPT 82670 | $196.20 | $654.00 | not published | 0 |
| Estrogens total-sendout CPT 82672 | $186.90 | $623.00 | not published | 0 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $143.64 | $239.40 | not published | 0 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $63.90 | $213.00 | not published | 0 |
| Ewhfo w/joint(s) cf HCPCS L3766 | $1,843.43 | $6,144.76 | not published | 0 |
| Ewho w/joint(s) cf HCPCS L3764 | $1,063.25 | $3,544.16 | not published | 0 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $450.90 | $1,503.00 | not published | 0 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $450.90 | $1,503.00 | not published | 0 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $259.20 | $864.00 | not published | 0 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $9,020.83 | $15,034.72 | $739.97 – $754.77 | 3 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $224.40 | $748.00 | not published | 0 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $3,606.81 | $12,022.70 | not published | 0 |
| Exploration of knee joint CPT 27310 | $17,924.74 | $29,874.57 | $7,582.44 – $7,734.09 | 3 |
| Exploration of toe joint CPT 28024 | $996.90 | $3,323.00 | not published | 0 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $1,041.90 | $3,473.00 | not published | 0 |
| Explore/treat finger joint CPT 26080 | $996.90 | $3,323.00 | not published | 0 |
| Extended steel shank HCPCS L2360 | $76.92 | $256.39 | not published | 0 |
| Extension per extension per HCPCS L2760 | $84.76 | $282.53 | not published | 0 |
| External pretreatment of serum for use in antibody identification by dilution CPT 86976 | $152.70 | $509.00 | not published | 0 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $167.40 | $558.00 | not published | 0 |
| Eye implant band 40 HCPCS C1784 | $2,358.13 | $7,860.42 | not published | 0 |
| F-18 fdg pet diag HCPCS A9552 | $200.40 | $334.00 | not published | 0 |
| F-18 florbetapir less than or equal to 10 mci HCPCS A9586 | $6,857.76 | $11,429.60 | not published | 0 |
| F-18 fluciclovine per mci HCPCS A9588 | $813.60 | $1,356.00 | not published | 0 |
| Facial bones <3 CPT 70140 | $191.10 | $637.00 | not published | 0 |
| Factor ix CPT 85250 | $117.90 | $393.00 | not published | 0 |
| Factor viii CPT 85240 | $120.00 | $400.00 | not published | 0 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $9.00 | $15.00 | not published | 0 |
| Fat/lipids feces qualitative CPT 82705 | $22.80 | $76.00 | not published | 0 |
| Fatty acids nonesterified CPT 82725 | $300.00 | $1,000.00 | not published | 0 |
| Fda ide #g240020 carry bag HCPCS Q0499 | $705.81 | $2,352.70 | not published | 0 |
| #fecal-sodium CPT 84302 | $19.20 | $64.00 | not published | 0 |
| Femoral lgth sock fx or equa HCPCS L2850 | $80.49 | $268.30 | not published | 0 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $508.20 | $847.00 | not published | 0 |
| Ferritin CPT 82728 | $62.10 | $207.00 | not published | 0 |
| Fetal chrmoml microdeltj CPT 81422 | $347.40 | $1,158.00 | not published | 0 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $42.00 | $140.00 | not published | 0 |
| Fibrin degradation d dimer quantitative CPT 85379 | $74.70 | $249.00 | not published | 0 |
| Fibrinogen activity CPT 85384 | $128.40 | $428.00 | not published | 0 |
| Fibrinolytic plasminogen CPT 85415 | $241.50 | $805.00 | not published | 0 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | $2,312.64 | $3,854.40 | not published | 0 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $24,755.46 | $82,518.19 | not published | 0 |
| Filter vena cava fem denali HCPCS C1880 | $3,426.47 | $11,421.57 | not published | 0 |
| Fine needle asp without image guide 10021 CPT 10021 | $165.60 | $552.00 | not published | 0 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | $3,793.80 | $12,646.01 | not published | 0 |
| Fixation of knee joint CPT 27570 | $4,648.06 | $7,746.77 | $1,680.28 – $1,713.89 | 3 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $8,337.65 | $13,896.08 | $3,419.10 – $3,487.49 | 3 |
| Flexible Sigmoidoscopy CPT 45330 | $2,987.88 | $4,979.80 | $971.77 – $991.20 | 3 |
| Flex thermoplastic collar mo HCPCS L0130 | $256.94 | $856.48 | not published | 0 |
| Floweramniopatch, per sq cm HCPCS Q4178 | $4,234.36 | $14,114.54 | not published | 0 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $59.40 | $99.00 | not published | 0 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $404.10 | $673.50 | not published | 0 |
| Fluid pressure muscle 20950 CPT 20950 | $450.90 | $1,503.00 | not published | 0 |
| Fluorescent antibody titer dna CPT 86256 | $50.10 | $167.00 | not published | 0 |
| Fluoroestradiol f 18 HCPCS A9591 | $11,076.00 | $18,460.00 | not published | 0 |
| Fluoroguide needle placement CPT 77002 | $824.10 | $2,747.00 | not published | 0 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $224.53 | $374.22 | not published | 0 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | $190,080.00 | $316,800.00 | not published | 0 |
| Folic acid CPT 82746 | $136.20 | $454.00 | not published | 0 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $9.00 | $15.00 | not published | 0 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $6,507.60 | $10,846.00 | not published | 0 |
| Fo nontorsion joint cf HCPCS L3935 | $299.93 | $999.76 | not published | 0 |
| Foot arch supp premold metat HCPCS L3050 | $70.22 | $234.06 | not published | 0 |
| Foot drp splt w/exp heel lg HCPCS L4398 | $51.39 | $171.30 | not published | 0 |
| Foot external keel sach foot HCPCS L5970 | $304.05 | $1,013.49 | not published | 0 |
| Foot insert plastazote or eq HCPCS L3002 | $240.93 | $803.09 | not published | 0 |
| Foot insert remov molded spe HCPCS L3001 | $197.32 | $657.72 | not published | 0 |
| Foot insert silicone gel eac HCPCS L3003 | $259.90 | $866.35 | not published | 0 |
| Foot lamin/prepreg composite HCPCS L3031 | $182.69 | $608.97 | not published | 0 |
| Foot plas heel stabi pre ots HCPCS L3170 | $75.88 | $252.92 | not published | 0 |
| Foot plate molded stirrup at HCPCS L2250 | $498.28 | $1,660.95 | not published | 0 |
| Foot X-ray CPT 73630 | $225.90 | $753.00 | not published | 0 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | $1,230.42 | $4,101.40 | not published | 0 |
| Forearm/arm cuffs free motio HCPCS L3720 | $886.98 | $2,956.59 | not published | 0 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $149.70 | $499.00 | not published | 0 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $36.10 | $60.17 | not published | 0 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $118.50 | $395.00 | not published | 0 |
| Fructosamine glycated protein CPT 82985 | $90.00 | $300.00 | not published | 0 |
| Ft insert ucb berkeley shell HCPCS L3000 | $468.62 | $1,562.07 | not published | 0 |
| Full sole/heel wedge btween HCPCS L3420 | $81.58 | $271.94 | not published | 0 |
| Furnsh initial orthosis only HCPCS L1200 | $2,669.53 | $8,898.45 | not published | 0 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $9.00 | $15.00 | not published | 0 |
| Fusion of big toe joint CPT 28750 | $42,720.19 | $71,200.32 | $7,582.44 – $7,734.09 | 3 |
| G6pd full gene sequence CPT 81249 | $945.00 | $3,150.00 | not published | 0 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $202.80 | $338.00 | not published | 0 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $171.10 | $285.17 | not published | 0 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | $12,545.28 | $20,908.80 | not published | 0 |
| Gammaglobulin iga CPT 82784 | $44.70 | $149.00 | not published | 0 |
| Gammaglobulin ige CPT 82785 | $171.60 | $572.00 | not published | 0 |
| Gamma glutamyltransferase CPT 82977 | $59.10 | $197.00 | not published | 0 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $191.95 | $319.92 | not published | 0 |
| Generator barostim neo2 2014 HCPCS C1767 | $64,391.49 | $214,638.29 | not published | 0 |
| Generator emblem MRI sicd subq HCPCS C1722 | $48,973.20 | $163,244.00 | not published | 0 |
| Generator stim baroreceptor neo legacy implant pulse HCPCS C1825 | $57,907.50 | $193,025.00 | not published | 0 |
| Genetic tstg severe inh cond CPT 81443 | $4,049.40 | $13,498.00 | not published | 0 |
| Gen, neuro, clo loop, rechg HCPCS C1826 | $36,399.00 | $121,330.00 | 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.