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 |
|---|---|---|---|---|
| Lengthening of hand tendon CPT 26478 | $22,095.76 | $36,826.27 | $7,079.78 – $7,079.78 | 3 |
| Lens, intraocular (new tech) HCPCS C1780 | $441.92 | $736.53 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $5,199.00 | $8,665.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $6,212.81 | $10,354.68 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $1,559.70 | $2,599.50 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $470.60 | $784.33 | not published | 0 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $7,799.98 | $12,999.96 | not published | 0 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $30,799.21 | $51,332.02 | not published | 0 |
| Levalbuterol non-comp con HCPCS J7612 | $48.24 | $80.40 | not published | 0 |
| Levalbuterol non-comp unit HCPCS J7614 | $14.39 | $23.99 | not published | 0 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $299.25 | $498.75 | not published | 0 |
| Levetiracetam therapeutic drug level CPT 80177 | $118.20 | $197.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $64.05 | $106.75 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $160,831.07 | $268,051.78 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $48.00 | $80.00 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $89.25 | $148.75 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $162.00 | $270.00 | not published | 0 |
| Lift heel adj small gl60404sm HCPCS L3332 | $345.73 | $576.22 | not published | 0 |
| Lift heel adjustable med HCPCS L3334 | $178.74 | $297.90 | not published | 0 |
| Lifts elevation metal extens HCPCS L3330 | $2,652.89 | $4,421.49 | not published | 0 |
| Ligation internal/common carotid artery 37605 CPT 37605 | $2,483.40 | $4,139.00 | not published | 0 |
| Ligation/major artery/extremity 37618 CPT 37618 | $5,023.20 | $8,372.00 | not published | 0 |
| Lig/band angioaccess av fistula CPT 37607 | $6,207.60 | $10,346.00 | not published | 0 |
| Liletta, 52 mg HCPCS J7297 | $9,783.17 | $16,305.28 | not published | 0 |
| Limited ankle motion ea jnt HCPCS L2200 | $194.23 | $323.72 | not published | 0 |
| Limited motion knee joint HCPCS L2184 | $542.98 | $904.97 | not published | 0 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $88.20 | $147.00 | not published | 0 |
| Lipase CPT 83690 | $228.00 | $380.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $168.60 | $281.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $45.60 | $76.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $101.40 | $169.00 | not published | 0 |
| Lip surgery procedure CPT 40799 | $174.00 | $290.00 | not published | 0 |
| Listeria monocytogenes CPT 86723 | $143.40 | $239.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $37.20 | $62.00 | not published | 0 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $9,229.80 | $15,383.00 | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $528.60 | $881.00 | not published | 0 |
| Liver Function Test CPT 80076 | $208.20 | $347.00 | not published | 0 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $43,906.91 | $73,178.18 | $7,079.78 – $7,221.37 | 3 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $324.41 | $540.68 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $48.00 | $80.00 | not published | 0 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | $808.65 | $1,347.75 | not published | 0 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $332.32 | $553.87 | not published | 0 |
| Low back disk surgery CPT 63030 | $34,488.27 | $57,480.45 | $7,079.78 – $7,079.78 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,975.40 | $4,959.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,447.80 | $2,413.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,340.20 | $5,567.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $3,280.80 | $5,468.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,954.80 | $3,258.00 | $232.80 – $232.80 | 3 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $1,279.80 | $2,133.00 | not published | 0 |
| Lso corset front HCPCS L0972 | $493.39 | $822.31 | not published | 0 |
| Lso flex no ri stays pre ots HCPCS L0628 | $533.11 | $888.51 | not published | 0 |
| Lso full corset HCPCS L0976 | $700.88 | $1,168.13 | not published | 0 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $795.45 | $1,325.75 | not published | 0 |
| Lso sag-coronal panel custom HCPCS L0638 | $7,866.09 | $13,110.15 | not published | 0 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | $6,072.85 | $10,121.41 | not published | 0 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | $759.26 | $1,265.44 | not published | 0 |
| Lso sagit rigid panel prefab HCPCS L0635 | $4,683.99 | $7,806.65 | not published | 0 |
| Lso sagittal rigid panel cus HCPCS L0636 | $6,355.42 | $10,592.36 | not published | 0 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $1,222.75 | $2,037.92 | not published | 0 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | $1,344.20 | $2,240.34 | not published | 0 |
| Lso s/c shell/panel custom HCPCS L0640 | $4,461.89 | $7,436.48 | not published | 0 |
| Lumbar bolster pad HCPCS L1030 | $367.05 | $611.75 | not published | 0 |
| Lumbar derotation pad HCPCS L1240 | $426.32 | $710.53 | not published | 0 |
| Lumbar or lumbar rib pad HCPCS L1040 | $415.61 | $692.68 | not published | 0 |
| Lumbar sling HCPCS L1090 | $471.71 | $786.18 | not published | 0 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $161,460.39 | $269,100.65 | $17,449.63 – $17,449.63 | 1 |
| Lung function test (mbc/mvv) CPT 94200 | $115.80 | $193.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $374.40 | $624.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,385.40 | $2,309.00 | not published | 0 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $47,025.00 | $78,375.00 | not published | 0 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $128,110.27 | $213,517.12 | not published | 0 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,559.70 | $2,599.50 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $2,111.40 | $3,519.00 | not published | 0 |
| Lysis intranasal synechia 30560 CPT 30560 | $20,003.92 | $33,339.87 | $3,234.84 – $3,299.54 | 3 |
| Macroscopic exam arthropod CPT 87168 | $70.20 | $117.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $24.00 | $40.00 | not published | 0 |
| Magnesium CPT 83735 | $121.20 | $202.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $165.90 | $276.50 | not published | 0 |
| Mammosite ced HCPCS C1728 | $15,726.98 | $26,211.63 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $149.40 | $249.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $190.80 | $318.00 | not published | 0 |
| Man's shoe oxford brace HCPCS L3225 | $346.00 | $576.66 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $24,471.57 | $40,785.95 | $6,478.71 – $6,478.71 | 2 |
| Marker biop eviva buckle ss HCPCS A4648 | $29,374.35 | $48,957.25 | not published | 0 |
| Mastectomy partial CPT 19301 | $31,535.05 | $52,558.42 | $6,478.71 – $6,478.71 | 3 |
| Mast mod rad CPT 19307 | $142,646.86 | $237,744.77 | $6,478.71 – $6,478.71 | 3 |
| Mastoids complete CPT 70130 | $540.00 | $900.00 | not published | 0 |
| Mastopexy CPT 19316 | $60,564.43 | $100,940.72 | $6,478.71 – $6,478.71 | 3 |
| Mast simple complete CPT 19303 | $59,266.39 | $98,777.32 | $6,478.71 – $6,478.71 | 3 |
| Matrion 1 sq cm HCPCS Q4201 | $40,214.27 | $67,023.78 | not published | 0 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $168,915.51 | $281,525.85 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $75.00 | $125.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $83.40 | $139.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $318.60 | $531.00 | not published | 0 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $120.00 | $200.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $136.80 | $228.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $80.40 | $134.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $149.40 | $249.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $69.60 | $116.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $675.00 | $1,125.00 | 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.