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 |
|---|---|---|---|---|
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $941.40 | $1,569.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $226.80 | $378.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | $477.60 | $796.00 | not published | 0 |
| Ghs st - re-eval for alt comm CPT 92597 | $279.60 | $466.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $10,879.18 | $18,131.97 | $721.10 – $721.10 | 3 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $795.00 | $1,325.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,156.80 | $1,928.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $172.80 | $288.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $172.80 | $288.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $126.60 | $211.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $4,052.40 | $6,754.00 | not published | 0 |
| Ghs windowing of cast CPT 29730 | $237.00 | $395.00 | not published | 0 |
| Giardia lamblia antibody CPT 86674 | $57.60 | $96.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $30.60 | $51.00 | not published | 0 |
| Gi wireless capsule measure CPT 91112 | $12,163.48 | $20,272.47 | $884.93 – $884.93 | 3 |
| Glove finger flexion right lg xl HCPCS L3912 | $449.45 | $749.09 | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $2,940.00 | $4,900.00 | not published | 0 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $2,937.90 | $4,896.50 | not published | 0 |
| Glucagon plasma - sendout CPT 82943 | $135.60 | $226.00 | not published | 0 |
| Glucose 1 hr post dose CPT 82950 | $49.20 | $82.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $46.20 | $77.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $39.60 | $66.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $242.40 | $404.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $69.60 | $116.00 | not published | 0 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $28.20 | $47.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $48.00 | $80.00 | not published | 0 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $10,915.59 | $18,192.65 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $142.80 | $238.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $134.40 | $224.00 | not published | 0 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $17,626.11 | $29,376.85 | not published | 0 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $8,859.10 | $14,765.16 | not published | 0 |
| Graft axiofill 1000mg HCPCS J3590 | $13,929.55 | $23,215.92 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $119,395.04 | $198,991.73 | not published | 0 |
| Graft hand or finger tendon CPT 26416 | $18,324.64 | $30,541.07 | $3,192.44 – $3,192.44 | 3 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $86,059.05 | $143,431.75 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $7,729.77 | $12,882.95 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $219,865.71 | $366,442.85 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $166,368.00 | $277,280.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $72,786.00 | $121,310.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $26,670.87 | $44,451.45 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $45,231.30 | $75,385.50 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $17,568.98 | $29,281.63 | not published | 0 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $7,798.50 | $12,997.50 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $163,945.27 | $273,242.11 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $13,777.35 | $22,962.25 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $164,236.41 | $273,727.35 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $77,790.04 | $129,650.06 | not published | 0 |
| Granisetron hcl injection HCPCS J1626 | $90.00 | $150.00 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $172.80 | $288.00 | not published | 0 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | $27,577.07 | $45,961.78 | $2,013.11 – $2,053.37 | 3 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $73,608.08 | $122,680.13 | $7,974.65 – $7,974.65 | 1 |
| Grfg autol fat lipo ea addl CPT 15772 | $49,883.71 | $83,139.52 | $7,974.65 – $7,974.65 | 1 |
| Grfg autol soft tiss dir exc CPT 15769 | $47,224.70 | $78,707.83 | $3,457.56 – $3,457.56 | 3 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,856.60 | $4,761.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $26,951.62 | $44,919.36 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $41,488.02 | $69,146.70 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $3,639.30 | $6,065.50 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $35,488.37 | $59,147.29 | not published | 0 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | $202.81 | $338.02 | not published | 0 |
| Halo cervical into jckt vest HCPCS L0810 | $35,093.25 | $58,488.75 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $115.50 | $192.50 | not published | 0 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $48.00 | $80.00 | not published | 0 |
| Halo repl liner/interface HCPCS L0861 | $5,947.66 | $9,912.76 | not published | 0 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $27.60 | $46.00 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $450.49 | $750.82 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $16,896.75 | $28,161.25 | not published | 0 |
| Hand tendon reconstruction CPT 26500 | $36,378.89 | $60,631.48 | $7,079.78 – $7,079.78 | 3 |
| Hand X-ray CPT 73130 | $712.80 | $1,188.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $171.00 | $285.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $1,074.00 | $1,790.00 | not published | 0 |
| Hbot, full body chamber, 30m HCPCS G0277 | $496.20 | $827.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $186.60 | $311.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $222.60 | $371.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $218.40 | $364.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $2,741.40 | $4,569.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $2,964.00 | $4,940.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $1,683.00 | $2,805.00 | not published | 0 |
| Heel leather reinforced HCPCS L3440 | $357.69 | $596.15 | not published | 0 |
| Heinz bodies direct CPT 85441 | $26.40 | $44.00 | not published | 0 |
| Heinz bodies induced CPT 85445 | $79.20 | $132.00 | not published | 0 |
| Helicobacter pylori antibody igm CPT 86677 | $89.40 | $149.00 | not published | 0 |
| Hematocrit CPT 85014 | $39.60 | $66.00 | not published | 0 |
| Hemodialysis one evaluation CPT 90935 | $1,338.00 | $2,230.00 | not published | 0 |
| Hemoglobin CPT 85018 | $57.60 | $96.00 | not published | 0 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $93.00 | $155.00 | not published | 0 |
| Hemoglobin plasma CPT 83051 | $74.40 | $124.00 | not published | 0 |
| Heparin assay CPT 85520 | $264.00 | $440.00 | not published | 0 |
| Heparin bolus from bag HCPCS J1644 | $173.25 | $288.75 | not published | 0 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $48.00 | $80.00 | not published | 0 |
| Hepatitis a antibody igm CPT 86709 | $70.20 | $117.00 | not published | 0 |
| Hepatitis b core antibody igm CPT 86705 | $167.40 | $279.00 | not published | 0 |
| Hepatitis b core antibody total CPT 86704 | $50.40 | $84.00 | not published | 0 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $2,897.62 | $4,829.37 | not published | 0 |
| Hepatitis b surface antibody CPT 86706 | $142.20 | $237.00 | not published | 0 |
| Hepatitis c antibody CPT 86803 | $178.80 | $298.00 | 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.