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 |
|---|---|---|---|---|
| Susceptibility agar dilution per agent CPT 87181 | $43.20 | $72.00 | not published | 0 |
| Susceptibility mic per plate CPT 87186 | $202.80 | $338.00 | not published | 0 |
| Suscept studies macrobroth dilution ea CPT 87188 | $360.60 | $601.00 | not published | 0 |
| Suspension sleeve lower ext HCPCS L2397 | $498.01 | $830.02 | not published | 0 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $27.60 | $46.00 | not published | 0 |
| System cardiomems hosp electronics HCPCS C2624 | $98,781.00 | $164,635.00 | not published | 0 |
| System pacing micra av HCPCS C1786 | $86,823.30 | $144,705.50 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $41,950.73 | $69,917.89 | not published | 0 |
| System recell skin grafting/harvesting HCPCS C1832 | $35,743.13 | $59,571.88 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $205.20 | $342.00 | not published | 0 |
| T3 (triiodothyronine) total CPT 84480 | $99.60 | $166.00 | not published | 0 |
| T4 (thyroxine) free CPT 84439 | $85.20 | $142.00 | not published | 0 |
| T4 (thyroxine) total CPT 84436 | $42.00 | $70.00 | not published | 0 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $63.67 | $106.11 | not published | 0 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $81.49 | $135.82 | not published | 0 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $2,677.79 | $4,462.99 | not published | 0 |
| Tacrolimus therapeutic drug level CPT 80197 | $301.20 | $502.00 | not published | 0 |
| Talymed HCPCS Q4127 | $6,758.70 | $11,264.50 | not published | 0 |
| Tap block bilat cont infusion 64489 CPT 64489 | $1,407.60 | $2,346.00 | not published | 0 |
| Tap block uni by cont infusion 64487 CPT 64487 | $756.00 | $1,260.00 | not published | 0 |
| Target gsa panel hmtlmph neop CPT 81450 | $4,625.40 | $7,709.00 | not published | 0 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $9,196.80 | $15,328.00 | not published | 0 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $2,604.97 | $4,341.61 | not published | 0 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $330.60 | $551.00 | not published | 0 |
| Tc-99m bicisate HCPCS A9557 | $726.00 | $1,210.00 | not published | 0 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $2,385.60 | $3,976.00 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $276.60 | $461.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $822.00 | $1,370.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $121.20 | $202.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $60.60 | $101.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $438.01 | $730.01 | not published | 0 |
| Tc-99m oxidronate HCPCS A9561 | $1,031.10 | $1,718.50 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $35.70 | $59.50 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $36.00 | $60.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $209.40 | $349.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $358.20 | $597.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $52.80 | $88.00 | not published | 0 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $155.40 | $259.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $1,480.80 | $2,468.00 | not published | 0 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $160.20 | $267.00 | not published | 0 |
| T cells absolute cd 4 count CPT 86361 | $126.60 | $211.00 | not published | 0 |
| T cells total count CPT 86359 | $158.40 | $264.00 | not published | 0 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $11,401.82 | $19,003.04 | not published | 0 |
| Tendon lngth upr a/e ea tdn CPT 24305 | $38,858.36 | $64,763.93 | $3,192.44 – $3,256.29 | 3 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $45,303.04 | $75,505.07 | not published | 0 |
| Tenosynovectomy radic 26145 CPT 26145 | $10,246.62 | $17,077.70 | $1,568.89 – $1,568.89 | 3 |
| Tension based scoliosis orth HCPCS L1005 | $15,003.38 | $25,005.63 | not published | 0 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $48.00 | $80.00 | not published | 0 |
| Test socket below knee HCPCS L5620 | $1,209.91 | $2,016.52 | not published | 0 |
| Test stress cardiovascular tracing only CPT 93017 | $1,669.80 | $2,783.00 | not published | 0 |
| Tetanus immune globulin inj HCPCS J1670 | $3,544.47 | $5,907.45 | not published | 0 |
| Tgsap so neo 5-50 rna alys CPT 81449 | $2,929.80 | $4,883.00 | not published | 0 |
| Theophylline therapeutic drug level CPT 80198 | $74.40 | $124.00 | not published | 0 |
| Therapeutic procd strg endur HCPCS G0237 | $116.40 | $194.00 | not published | 0 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $126.60 | $211.00 | not published | 0 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $140.40 | $234.00 | not published | 0 |
| Ther fx nasal inf turbinate CPT 30930 | $25,587.67 | $42,646.12 | $3,234.84 – $3,234.84 | 2 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $48.00 | $80.00 | not published | 0 |
| Thigh/wght bear high roll cu HCPCS L2550 | $1,594.95 | $2,658.25 | not published | 0 |
| Thigh/wght bear lacer molded HCPCS L2540 | $2,127.28 | $3,545.46 | not published | 0 |
| Thigh/wght bear lacer non-mo HCPCS L2530 | $1,124.18 | $1,873.63 | not published | 0 |
| Thi/glut/ischia wgt bearing HCPCS L2500 | $1,466.90 | $2,444.83 | not published | 0 |
| Thorac cont lat support upri HCPCS L2680 | $685.90 | $1,143.17 | not published | 0 |
| Thorac cont paraspinal uprig HCPCS L2670 | $747.67 | $1,246.11 | not published | 0 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $2,614.68 | $4,357.80 | $612.05 – $612.05 | 2 |
| Thoracic control thoracic ba HCPCS L2660 | $839.90 | $1,399.83 | not published | 0 |
| Thoracic pad HCPCS L1060 | $507.68 | $846.14 | not published | 0 |
| Thor rib belt custom fabrica HCPCS L0220 | $5,389.07 | $8,981.79 | not published | 0 |
| Thrombectmy crnry perq mechanical CPT 92973 | $1,732.80 | $2,888.00 | not published | 0 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $20,259.00 | $33,765.00 | not published | 0 |
| Thrombin time CPT 85670 | $58.20 | $97.00 | not published | 0 |
| Thromboplastin inhibition CPT 85705 | $55.20 | $92.00 | not published | 0 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $58.20 | $97.00 | not published | 0 |
| Th/wght bear nar m-l brim cu HCPCS L2526 | $3,002.21 | $5,003.69 | not published | 0 |
| Th/wght bear nar m-l brim mo HCPCS L2525 | $5,342.91 | $8,904.85 | not published | 0 |
| Th/wght bear quad-lat brim c HCPCS L2520 | $2,519.59 | $4,199.32 | not published | 0 |
| Th/wght bear quad-lat brim m HCPCS L2510 | $3,780.61 | $6,301.01 | not published | 0 |
| Thyroglobulin antibody CPT 86800 | $84.00 | $140.00 | not published | 0 |
| Thyroid (TSH) Test CPT 84443 | $250.20 | $417.00 | not published | 0 |
| Thyroid Ultrasound CPT 76536 | $945.60 | $1,576.00 | not published | 0 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $2,042.10 | $3,403.50 | not published | 0 |
| Thyroxine binding globulin (tbg) CPT 84442 | $135.00 | $225.00 | not published | 0 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | $15,079.70 | $25,132.83 | not published | 0 |
| Tissue culture skin/biopsy CPT 88233 | $300.00 | $500.00 | not published | 0 |
| Tissue exam koh skin/hair/nails CPT 87220 | $69.60 | $116.00 | not published | 0 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | $66,123.28 | $110,205.46 | not published | 0 |
| Tissue transglutaminase iga CPT 86364 | $40.20 | $67.00 | not published | 0 |
| Tlh w/t/o 250 g or less CPT 58571 | $28,161.66 | $46,936.10 | $10,371.37 – $10,578.79 | 3 |
| Tlh w/t/o uterus over 250 g CPT 58573 | $28,866.32 | $48,110.53 | $10,371.37 – $10,371.37 | 3 |
| Tlso 2mod symphis-xipho pre HCPCS L0458 | $4,180.67 | $6,967.79 | not published | 0 |
| Tlso 2 piece rigid shell HCPCS L0491 | $3,600.05 | $6,000.08 | not published | 0 |
| Tlso 2 shl symphys-stern cst HCPCS L0460 | $4,280.23 | $7,133.72 | not published | 0 |
| Tlso 3mod sacro-scap pre HCPCS L0462 | $5,324.09 | $8,873.48 | not published | 0 |
| Tlso 3 piece rigid shell HCPCS L0492 | $2,344.28 | $3,907.14 | not published | 0 |
| Tlso corset front HCPCS L0970 | $500.92 | $834.87 | not published | 0 |
| Tlso flex trnk sj-t9 pre ots HCPCS L0455 | $1,625.73 | $2,709.55 | not published | 0 |
| Tlso full corset HCPCS L0974 | $819.16 | $1,365.26 | not published | 0 |
| Tlso r fram soft ant pre cst HCPCS L0466 | $1,778.53 | $2,964.21 | not published | 0 |
| Tlso r fram soft pre ots HCPCS L0467 | $1,778.53 | $2,964.21 | not published | 0 |
| Tlso rig fram pelvic pre cst HCPCS L0468 | $2,228.86 | $3,714.77 | 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.