TRICITIES HOSPITAL
411 W RANDOLPH RD, HOPEWELL, VA · HCA Virginia · · NPI 1285671248
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 |
|---|---|---|---|---|
| Cytopath smear oth prep screen & interp CPT 88161 | not published | not published | $24.67 – $240.42 | 3 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $15.15 – $76.23 | 22 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $15.15 – $76.23 | 22 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $36.74 – $181.24 | 22 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $15.15 – $76.23 | 22 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $68.44 – $337.65 | 22 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $25.83 – $127.42 | 22 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $291.26 – $1,571.63 | 3 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | not published | not published | $3.82 – $10.92 | 6 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $245.48 – $816.17 | 6 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | not published | not published | $13.23 – $41.31 | 6 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $13.63 – $39.49 | 6 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $1,701.00 | $1,701.00 | $0.03 – $0.08 | 6 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.04 – $0.16 | 6 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $45.04 – $145.91 | 6 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | not published | not published | $2.48 – $8.00 | 6 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $2.48 – $8.00 | 6 |
| Dark field exam spec collj CPT 87164 | not published | not published | $9.35 – $46.11 | 22 |
| Dark field exam without collj CPT 87166 | not published | not published | $9.83 – $48.55 | 22 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $211.67 – $690.30 | 6 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | not published | not published | $22.44 – $69.77 | 6 |
| Daunorubicin citrate inj HCPCS J9151 | not published | not published | $60.54 – $60.54 | 1 |
| Dch glucoscan CPT 82948 | not published | not published | $4.39 – $21.67 | 22 |
| Dch validity tests CPT 81002 | not published | not published | $3.03 – $14.93 | 22 |
| Deamidated gliadin antibody iga CPT 86258 | not published | not published | $10.49 – $51.71 | 22 |
| Debridement (>20 cm) charge pt CPT 97598 | not published | not published | $49.76 – $67.18 | 15 |
| Decalcification CPT 88311 | $154.00 | $154.00 | $8.72 – $36.52 | 3 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | not published | not published | $1.50 – $1.86 | 6 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $1,074.00 | $1,074.00 | $6.98 – $22.45 | 6 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | not published | not published | $3.71 – $11.79 | 6 |
| Dengue vacc quad 3 dose subq CPT 90587 | not published | not published | $59.47 – $209.88 | 6 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $7,599.00 | $7,599.00 | $23.64 – $78.07 | 6 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | not published | not published | $3.14 – $4.98 | 19 |
| Depo-estradiol cypionate inj HCPCS J1000 | not published | not published | $35.97 – $137.32 | 6 |
| Derma-gide, 1 sq cm HCPCS Q4203 | not published | not published | $255.15 – $336.92 | 5 |
| Dermagraft HCPCS Q4106 | not published | not published | $47.19 – $47.19 | 1 |
| Dermapure 1 square cm HCPCS Q4152 | not published | not published | $46.43 – $336.92 | 5 |
| Dermavest, plurivest sq cm HCPCS Q4153 | not published | not published | $108.87 – $336.92 | 5 |
| Derm-maxx, per sq cm HCPCS Q4238 | not published | not published | $336.92 – $1,644.99 | 5 |
| Description not available HCPCS S0013 | not published | not published | $15.96 – $15.96 | 1 |
| Design mlc device for imrt CPT 77338 | not published | not published | $626.23 – $626.23 | 1 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $375.00 | $375.00 | $3.82 – $9.04 | 6 |
| Desoxycorticosterone CPT 82633 | not published | not published | $26.96 – $133.02 | 22 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $26.13 – $128.94 | 22 |
| Detect agnt mult dna direc CPT 87800 | not published | not published | $38.00 – $187.51 | 22 |
| Device intraute mirena HCPCS J7298 | not published | not published | $1,300.88 – $4,046.36 | 2 |
| Dev interrog remote 1/2/mlt CPT 93295 | not published | not published | $24.70 – $29.06 | 4 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $25.83 – $182.03 | 3 |
| Dexametha opth insert 0.1 mg HCPCS J1096 | not published | not published | $94.08 – $261.45 | 6 |
| Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr HCPCS J1095 | not published | not published | $1.23 – $7.18 | 2 |
| Dexamethasone 4 mg tablet HCPCS J8540 | not published | not published | $0.03 – $0.06 | 6 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | not published | not published | $0.08 – $0.29 | 6 |
| Dexamethasone intra implant HCPCS J7312 | not published | not published | $174.45 – $542.03 | 6 |
| Dexamethasone panel CPT 80420 | not published | not published | $140.87 – $694.98 | 22 |
| Dexmedetomidine film, 1 mcg HCPCS J1105 | not published | not published | $2.33 – $2.33 | 1 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | not published | not published | $68.82 – $153.73 | 6 |
| Dextran 40 infusion HCPCS J7100 | $1,456.00 | $1,456.00 | $45.99 – $1,009.62 | 2 |
| Dextran 75 infusion HCPCS J7110 | not published | not published | $15.25 – $15.25 | 1 |
| Dextroamphetamine HCPCS S0160 | not published | not published | $0.75 – $0.75 | 1 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | not published | not published | $1.06 – $3.47 | 6 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $1,495.00 | $1,495.00 | $8.55 – $16.03 | 2 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | not published | not published | $1.55 – $4.64 | 6 |
| Dextrose 5 % IV bolus HCPCS J7070 | $1,361.00 | $1,361.00 | $3.09 – $7.79 | 6 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | not published | not published | $19.35 – $95.45 | 22 |
| Diabetes (HbA1c) Test CPT 83036 | $438.00 | $438.00 | $8.45 – $41.69 | 22 |
| Diabetic custom molded shoe HCPCS A5501 | not published | not published | $231.03 – $366.93 | 19 |
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $38.92 – $61.82 | 19 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $38.92 – $61.82 | 19 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $38.92 – $61.82 | 19 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $12.78 – $22.14 | 19 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $77.04 – $122.35 | 19 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $38.92 – $61.82 | 19 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $103.22 – $725.90 | 6 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $83.74 – $566.33 | 6 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $750.00 | $750.00 | $90.51 – $725.90 | 21 |
| Diagnostic Mammogram (one breast) CPT 77065 | not published | not published | $71.03 – $566.33 | 21 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $182.03 – $530.70 | 2 |
| Diathermy eg microwave CPT 97024 | not published | not published | $5.92 – $10.37 | 19 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $417.00 | $417.00 | $0.07 – $0.19 | 6 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $285.00 | $285.00 | $4.92 – $17.73 | 6 |
| Dicyclomine injection HCPCS J0500 | $513.00 | $513.00 | $10.93 – $30.02 | 6 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.25 – $0.74 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $504.00 | $504.00 | $4.15 – $25.36 | 6 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $19,002.00 | $19,002.00 | $4,223.29 – $13,692.52 | 6 |
| Digoxin total therapeutic drug level CPT 80162 | $574.00 | $574.00 | $11.56 – $57.00 | 22 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $1,696.00 | $1,696.00 | $72.89 – $151.26 | 6 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.08 – $0.08 | 1 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $57.28 – $57.28 | 1 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $2.44 – $8.77 | 6 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $607.51 – $1,985.46 | 6 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.02 – $3.76 | 2 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $367.00 | $367.00 | $0.56 – $1.88 | 6 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $48.68 – $77.72 | 2 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $3.26 – $22.29 | 6 |
| Disaccharidases CPT 82657 | not published | not published | $19.29 – $95.17 | 22 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $158.70 – $3,947.38 | 3 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $90.00 – $142.94 | 19 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $213.64 – $339.31 | 19 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $67.22 – $79.08 | 4 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $279.00 – $1,197.80 | 19 |
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.