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 |
|---|---|---|---|---|
| Allergy injections; 2 or more 95117 CPT 95117 | $25.20 | $42.00 | not published | 0 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $13,097.84 | $21,829.73 | not published | 0 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $25,828.63 | $43,047.72 | not published | 0 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $32,410.20 | $54,017.00 | not published | 0 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $20,156.53 | $33,594.21 | not published | 0 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $91,500.74 | $152,501.23 | not published | 0 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $61,428.79 | $102,381.31 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $51,984.80 | $86,641.34 | not published | 0 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $49,083.76 | $81,806.27 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $16,090.91 | $26,818.18 | not published | 0 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $18,378.47 | $30,630.78 | not published | 0 |
| Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution HCPCS J0256 | $3,276.00 | $5,460.00 | not published | 0 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $399.00 | $665.00 | not published | 0 |
| Alpha-fetoprotein tumor marker CPT 82105 | $181.80 | $303.00 | not published | 0 |
| Alprostadil for injection HCPCS J0270 | $1,778.11 | $2,963.52 | not published | 0 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $92,403.78 | $154,006.30 | not published | 0 |
| Alt/sgpt CPT 84460 | $54.00 | $90.00 | not published | 0 |
| Aluminum - quest CPT 82108 | $95.40 | $159.00 | not published | 0 |
| Amantadine (symmetrel)-sendout CPT 80375 | $105.60 | $176.00 | not published | 0 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $75.08 | $125.13 | not published | 0 |
| Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr HCPCS J0281 | $76.44 | $127.40 | not published | 0 |
| Aminolevulinic acid delta CPT 82135 | $100.20 | $167.00 | not published | 0 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $48.00 | $80.00 | not published | 0 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $48.00 | $80.00 | not published | 0 |
| Ammonia CPT 82140 | $178.80 | $298.00 | not published | 0 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $3,607.80 | $6,013.00 | not published | 0 |
| Amniocentesis therapeutic CPT 59001 | $3,428.40 | $5,714.00 | not published | 0 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $2,481.60 | $4,136.00 | not published | 0 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $504.00 | $840.00 | not published | 0 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $1,713.73 | $2,856.21 | not published | 0 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $72.53 | $120.89 | not published | 0 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $96.99 | $161.65 | not published | 0 |
| Amputation toe interphalangeal joint CPT 28825 | $10,060.30 | $16,767.17 | $3,192.44 – $3,192.44 | 3 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $9,815.03 | $16,358.38 | $3,192.44 – $3,192.44 | 3 |
| Amylase CPT 82150 | $148.20 | $247.00 | not published | 0 |
| Analysis gene f2 20210g>a variant CPT 81240 | $683.40 | $1,139.00 | not published | 0 |
| Analysis gene f5 leiden variant CPT 81241 | $775.20 | $1,292.00 | not published | 0 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $115.80 | $193.00 | not published | 0 |
| Anca screen with reflex to titer -quest CPT 86021 | $92.40 | $154.00 | not published | 0 |
| An fluoro guide for cvp CPT 77001 | $755.40 | $1,259.00 | not published | 0 |
| Angio balloon ctrl dialysis seg add-on CPT 36907 | $10,991.40 | $18,319.00 | not published | 0 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $1,968.96 | $3,281.60 | not published | 0 |
| Angio trnslmnl balloon same artery ini CPT 37246 | $14,073.00 | $23,455.00 | not published | 0 |
| Angio trnslmnl balloon same vein ea addl CPT 37249 | $10,368.60 | $17,281.00 | not published | 0 |
| Angio trnslmnl balloon same vein ini CPT 37248 | $11,625.00 | $19,375.00 | not published | 0 |
| Anidulafungin injection HCPCS J0348 | $2,004.35 | $3,340.58 | not published | 0 |
| Ankle X-ray CPT 73610 | $569.40 | $949.00 | not published | 0 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $213.60 | $356.00 | not published | 0 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $213.60 | $356.00 | not published | 0 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $213.60 | $356.00 | not published | 0 |
| Anoscopy remove fb 46608 CPT 46608 | $1,728.00 | $2,880.00 | not published | 0 |
| Anterior asis pad HCPCS L1250 | $370.74 | $617.90 | not published | 0 |
| Anterior swing band HCPCS L2335 | $1,317.74 | $2,196.23 | not published | 0 |
| Anterior thoracic derotation HCPCS L1260 | $442.12 | $736.87 | not published | 0 |
| Anterior thoracic extension HCPCS L1220 | $1,021.03 | $1,701.72 | not published | 0 |
| Antibody elution rbc reference CPT 86860 | $150.00 | $250.00 | not published | 0 |
| Antibody htlv-i CPT 86687 | $52.20 | $87.00 | not published | 0 |
| Antibody htlv-ii CPT 86688 | $86.40 | $144.00 | not published | 0 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | $99.60 | $166.00 | not published | 0 |
| Antibody id rbc panel CPT 86870 | $675.60 | $1,126.00 | not published | 0 |
| Antibody screen rbc CPT 86850 | $133.20 | $222.00 | not published | 0 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | $10,810.80 | $18,018.00 | not published | 0 |
| Anti mog serum - sendout CPT 86362 | $495.00 | $825.00 | not published | 0 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | $42.00 | $70.00 | not published | 0 |
| Ant instr 2-3 vert segm 22845 CPT 22845 | $171,677.97 | $286,129.95 | $12,526.51 – $12,526.51 | 3 |
| Ant instrumentation/4-7 vert seg 22846 CPT 22846 | $142,892.44 | $238,154.07 | $12,526.51 – $12,526.51 | 2 |
| Antinuclear antibodies CPT 86038 | $145.20 | $242.00 | not published | 0 |
| Antiphosphatidylserine antibody CPT 86148 | $50.40 | $84.00 | not published | 0 |
| Antistreptolysin o titer CPT 86060 | $130.20 | $217.00 | not published | 0 |
| Antithrombin iii activity CPT 85300 | $77.40 | $129.00 | not published | 0 |
| Apheresis plasma CPT 36514 | $3,548.40 | $5,914.00 | not published | 0 |
| Apheresis wbc CPT 36511 | $4,722.60 | $7,871.00 | not published | 0 |
| Apl(pml-rara) quant - sendout CPT 81315 | $1,061.40 | $1,769.00 | not published | 0 |
| Appendix Removal (Laparoscopic) CPT 44970 | $22,677.98 | $37,796.63 | $5,898.53 – $5,898.53 | 3 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | $250.80 | $418.00 | not published | 0 |
| App high cost ss t/a/l <100sq cm addl <25sq cm CPT 15272 | $28,100.71 | $46,834.52 | $121.42 – $121.42 | 3 |
| Appl hip spica cast 1 leg CPT 29305 | $237.00 | $395.00 | not published | 0 |
| Application finger splntstatic 29130 CPT 29130 | $477.60 | $796.00 | not published | 0 |
| Application long leg splint 29505 CPT 29505 | $477.60 | $796.00 | not published | 0 |
| Application lower leg splint 29515 CPT 29515 | $477.60 | $796.00 | not published | 0 |
| Application multi layer compression below knee (both sides) CPT 29581 | $579.60 | $966.00 | not published | 0 |
| Application of cylinder cast 29365 CPT 29365 | $237.00 | $395.00 | not published | 0 |
| Application of forearm cast 29075 CPT 29075 | $237.00 | $395.00 | not published | 0 |
| Application of long arm cast 29065 CPT 29065 | $237.00 | $395.00 | not published | 0 |
| Application of long leg cast CPT 29355 | $237.00 | $395.00 | not published | 0 |
| Application of long leg cast 29345 CPT 29345 | $237.00 | $395.00 | not published | 0 |
| Application of paste boot 29580 CPT 29580 | $376.80 | $628.00 | not published | 0 |
| Application short leg cast 29405 CPT 29405 | $237.00 | $395.00 | not published | 0 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $7,313.85 | $12,189.75 | $721.10 – $721.10 | 3 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | $13,314.74 | $22,191.23 | $721.10 – $721.10 | 3 |
| Applicator tag rfid localizer 12gx7cm HCPCS C1819 | $12,971.51 | $21,619.18 | not published | 0 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $89.40 | $149.00 | not published | 0 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | $208.80 | $348.00 | not published | 0 |
| Appl modality 1+lllt po pain CPT 97037 | $76.20 | $127.00 | not published | 0 |
| Apply forearm splintdynamic 29126 CPT 29126 | $477.60 | $796.00 | not published | 0 |
| Apply hand/wrist cast 29085 CPT 29085 | $237.00 | $395.00 | not published | 0 |
| Apply of finger splint 29131 CPT 29131 | $477.60 | $796.00 | not published | 0 |
| Apply rigid leg cast 29445 CPT 29445 | $345.00 | $575.00 | not published | 0 |
| Apply short leg castambul type 29425 CPT 29425 | $237.00 | $395.00 | not published | 0 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | $3,672.56 | $6,120.94 | 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.