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 |
|---|---|---|---|---|
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $27.60 | $92.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $23.10 | $77.00 | not published | 0 |
| Ghs removal intranasal foreign body CPT 30300 | $5,297.64 | $8,829.40 | $129.81 – $132.41 | 3 |
| Ghs removal pharyngeal foreign body CPT 42809 | $213.60 | $712.00 | not published | 0 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $19,795.59 | $32,992.65 | $3,192.44 – $3,256.29 | 3 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $22.20 | $74.00 | not published | 0 |
| Ghs sedimentation rate CPT 85651 | $32.40 | $108.00 | not published | 0 |
| Ghs sensitivity (per antimicro) CPT 87184 | $54.30 | $181.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $470.70 | $1,569.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $470.70 | $1,569.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $113.40 | $378.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | $243.60 | $812.00 | not published | 0 |
| Ghs st - re-eval for alt comm CPT 92597 | $136.80 | $456.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $242.70 | $809.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $578.40 | $1,928.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $86.40 | $288.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $86.40 | $288.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $1,178.40 | $3,928.00 | not published | 0 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $3,730.50 | $6,217.50 | $884.93 – $902.63 | 3 |
| Glove finger flexion right lg xl HCPCS L3912 | $230.17 | $767.24 | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $2,755.20 | $4,592.00 | not published | 0 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $2,486.38 | $4,143.96 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $37.80 | $126.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $27.90 | $93.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $121.20 | $404.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $208.50 | $695.00 | not published | 0 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $48.90 | $163.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $48.00 | $80.00 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $126.90 | $423.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $136.80 | $456.00 | not published | 0 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $4,536.90 | $15,123.00 | not published | 0 |
| Graft axiofill 1000mg HCPCS J3590 | $11,556.94 | $19,261.56 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $61,144.31 | $203,814.38 | not published | 0 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $44,072.36 | $146,907.88 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $3,958.55 | $13,195.17 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $112,597.12 | $375,323.75 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $85,200.00 | $284,000.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $37,275.00 | $124,250.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $13,658.62 | $45,528.75 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $23,163.75 | $77,212.50 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $8,997.39 | $29,991.29 | not published | 0 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $3,993.75 | $13,312.50 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $83,959.27 | $279,864.25 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $7,055.62 | $23,518.75 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $84,108.37 | $280,361.25 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $39,837.66 | $132,792.19 | not published | 0 |
| Granisetron 1 mg tab HCPCS Q0166 | $33.26 | $55.44 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $86.40 | $288.00 | not published | 0 |
| G-tube reposition CPT 43761 | $805.50 | $2,685.00 | not published | 0 |
| Guided cath fluid drainage 10030 CPT 10030 | $286.80 | $956.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $13,802.40 | $46,008.00 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $21,246.75 | $70,822.50 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $1,863.75 | $6,212.50 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $18,174.22 | $60,580.75 | not published | 0 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | $103.86 | $346.21 | not published | 0 |
| Halo cervical into jckt vest HCPCS L0810 | $17,971.87 | $59,906.25 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $138.16 | $230.26 | 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 | $3,045.90 | $10,153.00 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $230.71 | $769.02 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $8,653.12 | $28,843.75 | not published | 0 |
| Hand X-ray CPT 73130 | $556.80 | $1,856.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $289.80 | $966.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $537.00 | $1,790.00 | not published | 0 |
| Hbot, full body chamber, 30m HCPCS G0277 | $960.90 | $3,203.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $140.40 | $468.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $384.90 | $1,283.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $21.00 | $35.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $899.70 | $2,999.00 | not published | 0 |
| Hdr rdncl skn surf brachytx CPT 77767 | $273.60 | $912.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $4,264.80 | $14,216.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $3,471.60 | $11,572.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $2,471.10 | $8,237.00 | not published | 0 |
| Heel leather reinforced HCPCS L3440 | $183.18 | $610.60 | not published | 0 |
| Helicobacter pylori antibody igm CPT 86677 | $225.00 | $750.00 | not published | 0 |
| Hematocrit CPT 85014 | $70.50 | $235.00 | not published | 0 |
| Hemodialysis one evaluation CPT 90935 | $4,193.40 | $13,978.00 | not published | 0 |
| Hemoglobin CPT 85018 | $66.60 | $222.00 | not published | 0 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $174.30 | $581.00 | not published | 0 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $14,992.54 | $24,987.57 | $907.35 – $925.49 | 3 |
| Heparin assay CPT 85520 | $24.00 | $80.00 | not published | 0 |
| Heparin bolus from bag HCPCS J1644 | $108.24 | $180.40 | 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 | $191.70 | $639.00 | not published | 0 |
| Hepatitis b core antibody igm CPT 86705 | $41.40 | $138.00 | not published | 0 |
| Hepatitis b core antibody total CPT 86704 | $25.20 | $84.00 | not published | 0 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $2,404.07 | $4,006.79 | not published | 0 |
| Hepatitis b surface antibody CPT 86706 | $66.90 | $223.00 | not published | 0 |
| Hepatitis c antibody CPT 86803 | $318.60 | $1,062.00 | not published | 0 |
| Hepatobiliary system imaging CPT 78226 | $1,734.30 | $5,781.00 | not published | 0 |
| Hepb vacc 3 dose immunsup im CPT 90740 | $270.90 | $451.50 | not published | 0 |
| Hernia Repair (Inguinal) CPT 49505 | $16,353.98 | $27,256.63 | $3,493.34 – $3,563.21 | 3 |
| Herpes simplex type 1 antibody igg CPT 86695 | $59.40 | $198.00 | 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.