Southside Regional Medical Center
200 Medical Park Blvd., Petersburg, VA · Bonsecours · · NPI 1720623853
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 |
|---|---|---|---|---|
| Ep & ablate supravent arrhyt CPT 93653 | $23,543.70 | $78,479.00 | not published | 0 |
| Ep & ablate ventric tachy CPT 93654 | $17,236.50 | $57,455.00 | not published | 0 |
| Epidural/lumbar/sacral/ea add level64484 CPT 64484 | $701.70 | $2,339.00 | not published | 0 |
| Epilepsy gen seq alys panel CPT 81419 | $3,856.50 | $12,855.00 | not published | 0 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | $1,476.00 | $2,460.00 | not published | 0 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | $265.51 | $442.52 | not published | 0 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | $751.07 | $1,251.79 | not published | 0 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | $1,998.64 | $3,331.06 | not published | 0 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | $484.26 | $807.10 | not published | 0 |
| Epstein barr early antigen antibody CPT 86663 | $138.60 | $462.00 | not published | 0 |
| Epstein barr nuclear antigen antibody CPT 86664 | $127.20 | $424.00 | not published | 0 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $122.40 | $408.00 | not published | 0 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | $984.00 | $1,640.00 | not published | 0 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | $22,629.19 | $37,715.32 | $5,923.28 – $6,041.75 | 3 |
| Ercp remove duct calculi 43264 CPT 43264 | $22,629.19 | $37,715.32 | $5,923.28 – $6,041.75 | 3 |
| Ercp w/specimen collection CPT 43260 | $19,091.94 | $31,819.90 | $3,761.73 – $3,836.96 | 3 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | $7,783.20 | $12,972.00 | not published | 0 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $138.71 | $231.18 | not published | 0 |
| ER Visit (level 1, minor) CPT 99281 | $189.00 | $630.00 | not published | 0 |
| ER Visit (level 2) CPT 99282 | $617.40 | $2,058.00 | not published | 0 |
| ER Visit (level 3) CPT 99283 | $972.90 | $3,243.00 | not published | 0 |
| ER Visit (level 4) CPT 99284 | $16,121.68 | $26,869.47 | $2,039.56 – $2,080.35 | 2 |
| ER Visit (level 5, high severity) CPT 99285 | $2,316.60 | $7,722.00 | not published | 0 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $1,079.84 | $1,799.74 | not published | 0 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $1,175.88 | $1,959.80 | not published | 0 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $1,274.28 | $2,123.80 | not published | 0 |
| Esophagoscop ultrasound exam CPT 43231 | $11,822.40 | $19,704.00 | $1,872.25 – $1,909.69 | 3 |
| Esophagoscopy flex biopsy CPT 43202 | $726.00 | $2,420.00 | not published | 0 |
| Esophagoscopy flex remove fb CPT 43215 | $726.00 | $2,420.00 | not published | 0 |
| Esoph egd dilation <30 mm CPT 43249 | $12,885.60 | $21,476.00 | $1,872.25 – $1,909.69 | 3 |
| Established Patient Office Visit (level 1) CPT 99211 | $306.90 | $1,023.00 | not published | 0 |
| Established Patient Office Visit (level 2) CPT 99212 | $211.50 | $705.00 | not published | 0 |
| Established Patient Office Visit (level 3) CPT 99213 | $257.70 | $859.00 | not published | 0 |
| Established Patient Office Visit (level 4) CPT 99214 | $288.90 | $963.00 | not published | 0 |
| Established Patient Office Visit (level 5) CPT 99215 | $363.30 | $1,211.00 | not published | 0 |
| Estradiol total CPT 82670 | $65.10 | $217.00 | not published | 0 |
| Estrogens total-sendout CPT 82672 | $131.10 | $437.00 | not published | 0 |
| Ethylene glycol -sendout CPT 82693 | $23.70 | $79.00 | not published | 0 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $90.00 | $150.00 | not published | 0 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $106.80 | $356.00 | not published | 0 |
| Evaluation of speech fluency 92521 CPT 92521 | $123.60 | $412.00 | not published | 0 |
| Evaluation psychiatric diagnostic CPT 90791 | $153.90 | $513.00 | not published | 0 |
| Ewhfo w/joint(s) cf HCPCS L3766 | $2,966.53 | $9,888.44 | not published | 0 |
| Ewho w/joint(s) cf HCPCS L3764 | $1,711.03 | $5,703.43 | not published | 0 |
| Exam plvc w/anes othr thn lcl CPT 57410 | $3,741.00 | $6,235.00 | $3,158.41 – $3,221.58 | 3 |
| Ex arm/elbow tum deep < 5 cm CPT 24076 | $11,490.11 | $19,150.18 | $2,834.09 – $2,890.77 | 3 |
| Exc abd les sc 3 cm/> CPT 22903 | $10,664.22 | $17,773.70 | $2,834.09 – $2,890.77 | 3 |
| Exc arm/elbo les sc >=3cm 24071 CPT 24071 | $9,643.01 | $16,071.68 | $2,834.09 – $2,890.77 | 3 |
| Exc back les sbq <3 cm 21930 CPT 21930 | $14,709.75 | $24,516.25 | $1,611.44 – $1,643.67 | 2 |
| Exc back tum deep 5 cm/> CPT 21933 | $11,431.40 | $19,052.33 | $2,834.09 – $2,834.09 | 1 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | $11,105.96 | $18,509.93 | $1,611.44 – $1,643.67 | 3 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $13,875.91 | $23,126.52 | $3,439.27 – $3,508.06 | 2 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $10,567.38 | $17,612.30 | $690.91 – $704.73 | 3 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $13,401.71 | $22,336.18 | $1,611.44 – $1,643.67 | 3 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $6,798.03 | $11,330.05 | $690.91 – $704.73 | 3 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $10,571.90 | $17,619.83 | $2,834.09 – $2,890.77 | 3 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $12,322.46 | $20,537.43 | $1,611.44 – $1,643.67 | 3 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $10,840.23 | $18,067.05 | $690.91 – $704.73 | 3 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | $9,443.25 | $15,738.75 | $1,611.44 – $1,643.67 | 3 |
| Exc forearm les sc 3 cm/> CPT 25071 | $13,304.51 | $22,174.18 | $1,611.44 – $1,643.67 | 3 |
| Exc hand les sc < 1.5 cm CPT 26115 | $12,400.02 | $20,666.70 | $1,611.44 – $1,643.67 | 2 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | $8,033.46 | $13,389.10 | $1,611.44 – $1,643.67 | 3 |
| Exchange biliary drg cath CPT 47536 | $3,100.80 | $10,336.00 | not published | 0 |
| Exchange drainage catheter CPT 49423 | $1,342.20 | $4,474.00 | not published | 0 |
| Exchange nephrostomy cath CPT 50435 | $1,386.90 | $4,623.00 | not published | 0 |
| Exc hidradenitis ing simpl 11462 CPT 11462 | $104,850.58 | $174,750.97 | $2,834.09 – $2,890.77 | 3 |
| Exc hidradenitis peri/umb comp 11471 CPT 11471 | $36,505.37 | $60,842.28 | not published | 0 |
| Excise anal ext tag/papilla CPT 46220 | $12,342.52 | $20,570.87 | $1,167.54 – $1,190.90 | 3 |
| Excise inferior turbinate CPT 30130 | $20,067.67 | $33,446.12 | $3,637.69 – $3,710.44 | 3 |
| Excise parotid gland/lesion CPT 42415 | $29,227.74 | $48,712.90 | $5,775.89 – $5,891.41 | 3 |
| Excise parotid gland/lesion CPT 42420 | $36,466.45 | $60,777.42 | $5,775.89 – $5,891.41 | 3 |
| Excise parotid gland/lesion CPT 42426 | $32,202.91 | $53,671.52 | $349.73 – $356.73 | 2 |
| Excise submaxillary gland CPT 42440 | $24,087.71 | $40,146.18 | $5,775.89 – $5,891.41 | 3 |
| Excise wrist tendon sheath CPT 25118 | $19,795.59 | $32,992.65 | $3,192.44 – $3,256.29 | 3 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $10,563.61 | $17,606.02 | $1,611.44 – $1,643.67 | 3 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $8,863.13 | $14,771.88 | $690.91 – $704.73 | 3 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $14,499.23 | $24,165.38 | $1,611.44 – $1,643.67 | 3 |
| Excision breast lesion CPT 19125 | $12,739.30 | $21,232.17 | $3,820.23 – $3,896.63 | 2 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | $12,266.27 | $20,443.78 | $1,611.44 – $1,643.67 | 3 |
| Exc malig feenl >4cm 11646 CPT 11646 | $30,177.32 | $50,295.53 | $2,890.77 – $2,890.77 | 1 |
| Exc neck tum deep 5 cm/> CPT 21554 | $13,160.50 | $21,934.17 | $2,834.09 – $2,834.09 | 1 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $13,326.92 | $22,211.53 | $2,834.09 – $2,890.77 | 3 |
| Exc prtl bn phlnx toe CPT 28124 | $54,090.32 | $90,150.53 | $7,079.78 – $12,526.51 | 3 |
| Exc skn hdrdnt ax complex CPT 11451 | $25,533.45 | $42,555.75 | $2,834.09 – $2,890.77 | 3 |
| Exc skn hdrdnt ax smpl/ntrm CPT 11450 | $17,950.92 | $29,918.20 | $2,834.09 – $2,890.77 | 3 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | $12,775.35 | $21,292.25 | $3,080.71 – $3,080.71 | 2 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | $13,528.47 | $22,547.45 | $2,834.09 – $2,890.77 | 3 |
| Exc sq tum/vasc malform/hand/fngr 26111 CPT 26111 | $11,909.24 | $19,848.73 | $1,611.44 – $1,611.44 | 1 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | $12,778.71 | $21,297.85 | $1,568.89 – $1,600.27 | 3 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | $7,063.50 | $11,772.50 | $1,611.44 – $1,643.67 | 3 |
| Exc tmr sft tiss shldr subq <3cm CPT 23075 | $9,543.43 | $15,905.72 | $1,611.44 – $1,643.67 | 3 |
| Expander tiss 133s-mv-12-t 300ml natrelle smth HCPCS C1789 | $5,804.25 | $19,347.50 | not published | 0 |
| Exploration maxillary sinus CPT 31256 | $29,864.40 | $49,774.00 | $3,637.69 – $3,710.44 | 3 |
| Exploration of toe joint CPT 28024 | $597.90 | $1,993.00 | not published | 0 |
| Explore parathyroid glands CPT 60500 | $28,736.88 | $47,894.80 | $5,775.89 – $5,891.41 | 3 |
| Explore penetrating wnd/extremity 20103 CPT 20103 | $625.20 | $2,084.00 | not published | 0 |
| Explore/treat finger joint CPT 26080 | $597.90 | $1,993.00 | not published | 0 |
| Expose art endoprosth iliac 34820 CPT 34820 | $1,408.80 | $4,696.00 | not published | 0 |
| Ex sq tumor/face or scalp 2 cm/> 21012 CPT 21012 | $19,215.57 | $32,025.95 | $1,611.44 – $1,611.44 | 2 |
| Extended steel shank HCPCS L2360 | $123.78 | $412.60 | 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.