Rappahannock General Hospital
101 Harris Rd., Kilmarnock, VA · Bonsecours · · NPI 1699125526
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $108.60 | $181.00 | not published | 0 |
| 17-hydroxypregnenolone CPT 84143 | $84.60 | $141.00 | not published | 0 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $1,540.20 | $2,567.00 | not published | 0 |
| 5' nucleotidase - sendout CPT 83915 | $42.00 | $70.00 | not published | 0 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $2,511.00 | $4,185.00 | not published | 0 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $1,033.20 | $1,722.00 | not published | 0 |
| Abdominal CT scan (with contrast) CPT 74160 | $834.00 | $1,390.00 | not published | 0 |
| Abdominal CT scan (without contrast) CPT 74150 | $690.00 | $1,150.00 | not published | 0 |
| Abdominal MRI (with and without contrast) CPT 74183 | $2,855.40 | $4,759.00 | not published | 0 |
| Abdominal MRI (without contrast) CPT 74181 | $1,353.00 | $2,255.00 | not published | 0 |
| Abdominal pad HCPCS L1270 | $295.78 | $492.96 | not published | 0 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,011.60 | $1,686.00 | not published | 0 |
| Abdominal Ultrasound (complete) CPT 76700 | $241.80 | $403.00 | not published | 0 |
| Abdominal Ultrasound (limited) CPT 76705 | $342.00 | $570.00 | not published | 0 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $703.80 | $1,173.00 | not published | 0 |
| Abduct control hip semi-flex HCPCS L1630 | $753.90 | $1,256.50 | not published | 0 |
| Abduction bar jointed adjust HCPCS L2300 | $898.40 | $1,497.34 | not published | 0 |
| Abduction rotation bar shoe HCPCS L3140 | $317.70 | $529.50 | not published | 0 |
| Abduct rotation bar without shoe HCPCS L3150 | $290.51 | $484.18 | not published | 0 |
| Abl1 gene CPT 81170 | $900.00 | $1,500.00 | not published | 0 |
| Ablation of upper extremity nerves rf CPT 64999 | $549.60 | $916.00 | not published | 0 |
| Acetaminophen level CPT 80143 | $59.40 | $99.00 | not published | 0 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $163.20 | $272.00 | not published | 0 |
| Acetone qualitative CPT 82009 | $18.60 | $31.00 | not published | 0 |
| Acetylcholine receptor modulating antibody CPT 86043 | $208.20 | $347.00 | not published | 0 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $13.84 | $23.06 | not published | 0 |
| Acetylcysteine non-comp unit HCPCS J7608 | $36.44 | $60.74 | not published | 0 |
| Acne surgery 10040 CPT 10040 | $527.40 | $879.00 | not published | 0 |
| Acute hepatitis panel CPT 80074 | $185.40 | $309.00 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $62.40 | $104.00 | not published | 0 |
| Adapter b 8 channel 10cm HCPCS C1883 | $15,134.02 | $25,223.37 | not published | 0 |
| Add le poly knee custom kafo HCPCS L2387 | $681.23 | $1,135.39 | not published | 0 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $22.34 | $37.23 | not published | 0 |
| Adh-sendout CPT 84588 | $127.20 | $212.00 | not published | 0 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $307.48 | $512.46 | not published | 0 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $159.00 | $265.00 | not published | 0 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $342.60 | $571.00 | not published | 0 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $910.80 | $1,518.00 | not published | 0 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $582.00 | $970.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $169.80 | $283.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $246.00 | $410.00 | not published | 0 |
| Administration immunization 1 vaccine CPT 90471 | $46.20 | $77.00 | not published | 0 |
| Administration immunization each additional vaccine CPT 90472 | $18.60 | $31.00 | not published | 0 |
| Administration vaccine influenza virus HCPCS G0008 | $22.80 | $38.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $11,490.12 | $19,150.20 | not published | 0 |
| _afb id by dna probe rflx ast CPT 87149 | $74.40 | $124.00 | not published | 0 |
| #afb mycobacteria suscep. #1 CPT 87190 | $22.20 | $37.00 | not published | 0 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $445.80 | $743.00 | not published | 0 |
| Afo molded ankle gauntlet HCPCS L1904 | $1,610.75 | $2,684.58 | not published | 0 |
| Afo molded plas rig ant tib HCPCS L1945 | $3,676.93 | $6,128.21 | not published | 0 |
| Afo molded to patient plasti HCPCS L1940 | $1,537.96 | $2,563.27 | not published | 0 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $3,184.37 | $5,307.28 | not published | 0 |
| Afo sing bar clasp attach sh HCPCS L1910 | $1,000.79 | $1,667.99 | not published | 0 |
| Afo sing solid stirrup calf HCPCS L1980 | $1,440.88 | $2,401.46 | not published | 0 |
| Afo sing upright with adjust s HCPCS L1920 | $1,466.00 | $2,443.34 | not published | 0 |
| Afo spiral molded to pt plas HCPCS L1950 | $2,744.45 | $4,574.08 | not published | 0 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | $1,018.13 | $1,696.88 | not published | 0 |
| Afo supramalleolar custom HCPCS L1907 | $2,008.08 | $3,346.80 | not published | 0 |
| Afo tib fx cast plaster mold HCPCS L2106 | $2,812.80 | $4,688.00 | not published | 0 |
| Afo tibial fracture rigid HCPCS L2116 | $2,750.50 | $4,584.17 | not published | 0 |
| Afo tibial fracture soft HCPCS L2112 | $1,800.37 | $3,000.62 | not published | 0 |
| Afo, walk boot type, cus fab HCPCS L4631 | $5,662.81 | $9,438.01 | not published | 0 |
| Afo w/ankle joint, prefab HCPCS L1971 | $2,279.75 | $3,799.58 | not published | 0 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $12,680.50 | $21,134.17 | not published | 0 |
| Ak/knee disartic pelvic band HCPCS L5697 | $279.86 | $466.44 | not published | 0 |
| Ak/knee disartic silesian ba HCPCS L5698 | $348.06 | $580.10 | not published | 0 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | $630.53 | $1,050.89 | not published | 0 |
| Albumin body fluid quantitative each specimen CPT 82042 | $26.40 | $44.00 | not published | 0 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $189.92 | $316.54 | not published | 0 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $22.80 | $38.00 | not published | 0 |
| Albumin serum plasma or whole blood CPT 82040 | $19.80 | $33.00 | not published | 0 |
| Albuterol ipratrop non-comp HCPCS J7620 | $4.80 | $8.00 | not published | 0 |
| Albuterol non-comp con HCPCS J7611 | $4.80 | $8.00 | not published | 0 |
| Albuterol non-comp unit HCPCS J7613 | $4.80 | $8.00 | not published | 0 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $55.20 | $92.00 | not published | 0 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $48,185.67 | $80,309.45 | not published | 0 |
| Alkaline phosphatase CPT 84075 | $21.00 | $35.00 | not published | 0 |
| Allergen alpha lactalbumin ige CPT 86008 | $66.60 | $111.00 | not published | 0 |
| Allergen egg white ige CPT 86003 | $42.60 | $71.00 | not published | 0 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $9,971.14 | $16,618.56 | not published | 0 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $19,662.85 | $32,771.41 | not published | 0 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $24,673.27 | $41,122.12 | not published | 0 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $15,344.78 | $25,574.63 | not published | 0 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $69,657.77 | $116,096.29 | not published | 0 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $46,764.57 | $77,940.95 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $39,575.04 | $65,958.40 | not published | 0 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $37,366.54 | $62,277.56 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $12,249.70 | $20,416.17 | not published | 0 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $13,991.18 | $23,318.63 | not published | 0 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $972.00 | $1,620.00 | not published | 0 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $215.40 | $359.00 | not published | 0 |
| Alpha-fetoprotein tumor marker CPT 82105 | $165.00 | $275.00 | not published | 0 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $35,905.47 | $59,842.45 | not published | 0 |
| Alt/sgpt CPT 84460 | $21.00 | $35.00 | not published | 0 |
| Aluminum - quest CPT 82108 | $94.80 | $158.00 | not published | 0 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $47.53 | $79.22 | not published | 0 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $29.71 | $49.51 | not published | 0 |
| Aminolevulinic acid delta CPT 82135 | $61.20 | $102.00 | not published | 0 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $16.31 | $27.19 | not published | 0 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $17.96 | $29.93 | 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.