St Francis Medical Center
13710 St. Francis Boulevard, Midlothian, VA · Bonsecours · · NPI 1447212592
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 |
|---|---|---|---|---|
| Diagnostic anoscopy spx 46600 CPT 46600 | $97.20 | $162.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $149.40 | $249.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $433.80 | $723.00 | not published | 0 |
| Diagnostic Mammogram (one breast) CPT 77065 | $340.80 | $568.00 | not published | 0 |
| Dialysis one evaluation CPT 90945 | $2,635.20 | $4,392.00 | not published | 0 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $447.12 | $745.20 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $64.60 | $107.67 | not published | 0 |
| Dicyclomine injection HCPCS J0500 | $129.15 | $215.25 | not published | 0 |
| Diffusing capacity CPT 94729 | $642.60 | $1,071.00 | not published | 0 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $27,158.04 | $45,263.40 | not published | 0 |
| Digoxin total therapeutic drug level CPT 80162 | $53.40 | $89.00 | not published | 0 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $551.25 | $918.75 | not published | 0 |
| Dilation of vagina CPT 57400 | $9,743.46 | $16,239.10 | $3,158.41 – $3,158.41 | 3 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $521.40 | $869.00 | not published | 0 |
| Dilator fascial 10fx20cm HCPCS C2627 | $1,650.16 | $2,750.27 | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $119.81 | $199.68 | not published | 0 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $48.00 | $80.00 | not published | 0 |
| Dipyridamole injection HCPCS J1245 | $117.02 | $195.03 | not published | 0 |
| Disaccharidases CPT 82657 | $114.60 | $191.00 | not published | 0 |
| Dise eval slp do brth flx dx CPT 42975 | $5,865.83 | $9,776.38 | $1,736.62 – $1,771.35 | 3 |
| Dist revas ligation hemo CPT 36838 | $20,716.56 | $34,527.60 | $5,429.18 – $5,537.77 | 3 |
| Dmpk gene detc abnor allele CPT 81234 | $431.40 | $719.00 | not published | 0 |
| Dna antibody native/double stranded CPT 86225 | $70.20 | $117.00 | not published | 0 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $409.50 | $682.50 | not published | 0 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,140.00 | $1,900.00 | not published | 0 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $207.38 | $345.63 | not published | 0 |
| Doppler echo complete CPT 93320 | $1,312.80 | $2,188.00 | not published | 0 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $4,588.20 | $7,647.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $444.00 | $740.00 | not published | 0 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $640.80 | $1,068.00 | not published | 0 |
| Dornase alfa non-comp unit HCPCS J7639 | $1,404.59 | $2,340.98 | not published | 0 |
| Dornhoffer fixed part w/window HCPCS L8614 | $133,874.25 | $223,123.75 | not published | 0 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $253.68 | $422.80 | not published | 0 |
| Dpyd gene common variants CPT 81232 | $669.60 | $1,116.00 | not published | 0 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $541.20 | $902.00 | not published | 0 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $541.20 | $902.00 | not published | 0 |
| Drainage external ear complex 69005 CPT 69005 | $1,456.80 | $2,428.00 | not published | 0 |
| Drainage external ear simple 69000 CPT 69000 | $541.20 | $902.00 | not published | 0 |
| Drainage mouth roof lesion CPT 42000 | $174.00 | $290.00 | not published | 0 |
| Drainage of arm bursa 23931 CPT 23931 | $1,250.40 | $2,084.00 | not published | 0 |
| Drainage of mouth lesion CPT 41009 | $962.40 | $1,604.00 | not published | 0 |
| Drainage of rectal abscess CPT 45005 | $1,122.00 | $1,870.00 | not published | 0 |
| Drain blood from under nail 11740 CPT 11740 | $272.40 | $454.00 | not published | 0 |
| Drain cath image guided visceral pq CPT 49405 | $3,176.40 | $5,294.00 | not published | 0 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,105.80 | $1,843.00 | not published | 0 |
| Drain finger abscess;simple 26010 CPT 26010 | $603.60 | $1,006.00 | not published | 0 |
| Drain neck/chest lesion 21501 CPT 21501 | $11,942.66 | $19,904.43 | $2,834.09 – $2,834.09 | 3 |
| Drain thigh/knee lesion 27301 CPT 27301 | $15,704.30 | $26,173.83 | $2,834.09 – $2,834.09 | 3 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $392.40 | $654.00 | not published | 0 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $286.20 | $477.00 | not published | 0 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $311.40 | $519.00 | not published | 0 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $64,500.72 | $107,501.20 | not published | 0 |
| Drng of eyelid abscess 67700 CPT 67700 | $221.40 | $369.00 | not published | 0 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,401.20 | $4,002.00 | not published | 0 |
| Drng of scrotum abscess 55100 CPT 55100 | $3,495.60 | $5,826.00 | not published | 0 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $65.18 | $108.64 | not published | 0 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $48.00 | $80.00 | not published | 0 |
| Drop lock knee HCPCS L2182 | $406.04 | $676.74 | not published | 0 |
| Drop lock retainer each HCPCS L2785 | $138.92 | $231.53 | not published | 0 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $13,517.40 | $22,529.00 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $8,961.77 | $14,936.29 | not published | 0 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $36,263.03 | $60,438.38 | not published | 0 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $8,474.74 | $14,124.56 | not published | 0 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | $50,695.45 | $84,492.42 | not published | 0 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $72,205.37 | $120,342.29 | not published | 0 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | $50,898.21 | $84,830.35 | not published | 0 |
| Drug assay caffeine CPT 80155 | $90.60 | $151.00 | not published | 0 |
| Drug assay rufinamide CPT 80210 | $62.40 | $104.00 | not published | 0 |
| Drug assay vedolizumab CPT 80280 | $460.20 | $767.00 | not published | 0 |
| Drug assay voriconazole CPT 80285 | $90.60 | $151.00 | not published | 0 |
| Drug asy hydroxychloroquine CPT 80220 | $127.80 | $213.00 | not published | 0 |
| Drug of abuse screen urine CPT 80305 | $53.40 | $89.00 | not published | 0 |
| Drug test def 1-7 classes HCPCS G0480 | $600.60 | $1,001.00 | not published | 0 |
| Drug test prsmv instrmnt CPT 80306 | $372.60 | $621.00 | not published | 0 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $660.60 | $1,101.00 | not published | 0 |
| Drvvt confirm - quest CPT 85597 | $118.80 | $198.00 | not published | 0 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $3,745.80 | $6,243.00 | not published | 0 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $35,257.12 | $58,761.87 | not published | 0 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $24,479.56 | $40,799.27 | not published | 0 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $5,466.62 | $9,111.03 | $1,736.62 – $1,736.62 | 3 |
| Dx bronchoscope/wash 31622 CPT 31622 | $7,419.62 | $12,366.03 | $1,736.62 – $1,736.62 | 3 |
| Dx laryngoscopy w/oper scope CPT 31526 | $20,643.17 | $34,405.28 | $3,234.84 – $3,299.54 | 3 |
| Ear irrigation 69209 CPT 69209 | $48.00 | $80.00 | not published | 0 |
| Ecg 12 lead tracing only CPT 93005 | $226.20 | $377.00 | not published | 0 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $190.80 | $318.00 | not published | 0 |
| Ecg < 30 days transmission & analysis CPT 93271 | $393.60 | $656.00 | not published | 0 |
| Ecg external < 48 hours recording CPT 93225 | $525.00 | $875.00 | not published | 0 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $3,630.60 | $6,051.00 | not published | 0 |
| Echocardiography doppler color flow mapping CPT 93325 | $672.60 | $1,121.00 | not published | 0 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,967.60 | $4,946.00 | not published | 0 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $1,197.00 | $1,995.00 | not published | 0 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $402.00 | $670.00 | not published | 0 |
| Echo exam of fetal heart CPT 76825 | $1,419.60 | $2,366.00 | not published | 0 |
| Echo exam of fetal heart CPT 76826 | $405.60 | $676.00 | not published | 0 |
| Echo exam of fetal heart CPT 76827 | $223.20 | $372.00 | not published | 0 |
| Echo exam of fetal heart CPT 76828 | $223.20 | $372.00 | not published | 0 |
| Echo exam uterus 76831- CPT 76831 | $190.80 | $318.00 | not published | 0 |
| Echo guide for amniocentesis CPT 76946 | $1,315.20 | $2,192.00 | not published | 0 |
| Echo guide for artery repair CPT 76936 | $640.80 | $1,068.00 | not published | 0 |
| Echo guide villus sampling CPT 76945 | $372.60 | $621.00 | 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.