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 |
|---|---|---|---|---|
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $48.00 | $80.00 | not published | 0 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $1,530.60 | $5,102.00 | not published | 0 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $1,150.50 | $3,835.00 | not published | 0 |
| Kit case 4.2mm spinejack HCPCS C1062 | $11,089.31 | $36,964.38 | not published | 0 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $12,513.75 | $41,712.50 | not published | 0 |
| Kit hfx iq ipg bundle HCPCS C1822 | $70,290.00 | $234,300.00 | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $69,225.00 | $230,750.00 | not published | 0 |
| Kit lead specify 5-6-5 HCPCS C1778 | $29,287.50 | $97,625.00 | not published | 0 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $1,956.94 | $6,523.13 | not published | 0 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $36,148.74 | $120,495.79 | not published | 0 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | $31,808.89 | $106,029.63 | not published | 0 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,086.52 | $6,955.07 | not published | 0 |
| Knee Arthroscopy (Cartilage Repair) CPT 29877 | $95,083.76 | $158,472.93 | $3,192.44 – $3,256.29 | 3 |
| Knee Arthroscopy (Meniscus Repair) CPT 29881 | $13,131.31 | $21,885.52 | $3,192.44 – $3,256.29 | 3 |
| Knee arthroscopy/surgery CPT 29880 | $17,610.51 | $29,350.85 | $3,192.44 – $3,256.29 | 3 |
| Knee arthroscopy/surgery CPT 29882 | $32,249.32 | $53,748.87 | $3,192.44 – $3,256.29 | 3 |
| Knee arthroscopy/surgery CPT 29888 | $32,249.32 | $53,748.87 | $12,526.51 – $12,777.04 | 2 |
| Knee control condylar pad HCPCS L2810 | $196.07 | $653.56 | not published | 0 |
| Knee control full kneecap HCPCS L2795 | $196.87 | $656.22 | not published | 0 |
| Knee disc/dial lock/adj flex HCPCS L2425 | $344.13 | $1,147.09 | not published | 0 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | $344.13 | $1,147.09 | not published | 0 |
| Knee joint cam lock each joi HCPCS L2415 | $291.65 | $972.17 | not published | 0 |
| Knee joint drop lock ea jnt HCPCS L2405 | $190.39 | $634.65 | not published | 0 |
| Knee lift loop drop lock rin HCPCS L2492 | $281.56 | $938.53 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $6,580.80 | $21,936.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $6,052.80 | $20,176.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $5,133.60 | $17,112.00 | not published | 0 |
| Knee orth pos locking joint HCPCS L1831 | $706.52 | $2,355.07 | not published | 0 |
| Knee X-ray CPT 73564 | $788.40 | $2,628.00 | not published | 0 |
| Ko dbl upright w/air pre cst HCPCS L1847 | $1,380.77 | $4,602.58 | not published | 0 |
| Ko dbl upright w/air pre ots HCPCS L1848 | $1,380.77 | $4,602.58 | not published | 0 |
| Ko derot ant cruciate custom HCPCS L1840 | $2,257.56 | $7,525.20 | not published | 0 |
| Ko elastic w/joints pre ots HCPCS L1812 | $193.59 | $645.30 | not published | 0 |
| Ko rigid without joints pre ots HCPCS L1836 | $320.27 | $1,067.57 | not published | 0 |
| Ko single upright prefab ots HCPCS L1851 | $2,153.99 | $7,179.96 | not published | 0 |
| Ko supracondylar socket mold HCPCS L1860 | $2,993.50 | $9,978.34 | not published | 0 |
| Ko swedish type pre ots HCPCS L1850 | $683.92 | $2,279.72 | not published | 0 |
| Ko w/0 joint rigid molded to HCPCS L1834 | $1,919.66 | $6,398.88 | not published | 0 |
| Ko w adj flex/ext rotat mold HCPCS L1846 | $2,808.80 | $9,362.68 | not published | 0 |
| Kyphosis pad HCPCS L1020 | $258.69 | $862.30 | not published | 0 |
| Kyphosis pad floating HCPCS L1025 | $373.23 | $1,244.10 | not published | 0 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $48.00 | $80.00 | not published | 0 |
| Lacer molded to patient mode HCPCS L2330 | $881.39 | $2,937.98 | not published | 0 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $73.75 | $122.92 | not published | 0 |
| Lactate dehydrogenase (ldh) CPT 83615 | $53.10 | $177.00 | not published | 0 |
| Lactated ringers intravenous solution HCPCS J7120 | $162.00 | $270.00 | not published | 0 |
| Lactic acid CPT 83605 | $96.00 | $320.00 | not published | 0 |
| Lactoferrin fecal quant CPT 83631 | $100.20 | $334.00 | not published | 0 |
| Laparo ablate renal mass CPT 50542 | $52,845.16 | $88,075.27 | $10,371.37 – $10,578.79 | 3 |
| Laparo-asst vag hysterectomy CPT 58550 | $19,534.99 | $32,558.32 | $5,898.53 – $6,016.50 | 3 |
| Laparo cholecystectomy/graph CPT 47563 | $22,798.16 | $37,996.93 | $5,898.53 – $6,016.50 | 3 |
| Laparo partial nephrectomy CPT 50543 | $33,517.97 | $55,863.28 | $10,371.37 – $10,578.79 | 3 |
| Laparo proc abdm/per/oment 49329 CPT 49329 | $21,203.28 | $35,338.80 | $5,898.53 – $6,016.50 | 3 |
| Laparo radical nephrectomy CPT 50545 | $56,068.09 | $93,446.82 | $349.73 – $356.73 | 2 |
| Laparoscopic myomectomy CPT 58545 | $18,334.84 | $30,558.07 | $5,898.53 – $6,016.50 | 3 |
| Laparoscopy biopsy CPT 49321 | $28,393.81 | $47,323.02 | $5,898.53 – $5,898.53 | 2 |
| Laparoscopy excise lesions CPT 58662 | $21,655.35 | $36,092.25 | $5,898.53 – $6,016.50 | 3 |
| Laparoscopy lymphadenectomy CPT 38571 | $34,545.54 | $57,575.90 | $10,371.37 – $10,578.79 | 3 |
| Laparoscopy pyeloplasty CPT 50544 | $28,042.81 | $46,738.02 | $10,371.37 – $10,578.79 | 3 |
| Laparoscopy remove adnexa CPT 58661 | $19,526.97 | $32,544.95 | $5,898.53 – $6,016.50 | 3 |
| Laparoscopy surg colpopexy CPT 57425 | $24,729.48 | $41,215.80 | $10,371.37 – $10,578.79 | 3 |
| Laparoscopy ureterolithotomy CPT 50945 | $26,065.76 | $43,442.93 | $10,371.37 – $10,578.79 | 3 |
| Laparo urethral suspension CPT 51990 | $32,116.58 | $53,527.63 | $5,898.53 – $6,016.50 | 3 |
| Laparo-vag hyst incl t/o CPT 58552 | $25,526.81 | $42,544.68 | $10,371.37 – $10,578.79 | 3 |
| Lap enterolysis CPT 44180 | $21,203.28 | $35,338.80 | $5,898.53 – $6,016.50 | 3 |
| Lap gastric bypass/roux-en-y CPT 43644 | $39,177.12 | $65,295.20 | $10,371.37 – $10,578.79 | 3 |
| Lap ing hernia repair init CPT 49650 | $23,457.35 | $39,095.58 | $5,898.53 – $6,016.50 | 3 |
| Lap ing hernia repair recur CPT 49651 | $30,239.00 | $50,398.33 | $5,898.53 – $6,016.50 | 3 |
| Laps abltj uterine fibroids CPT 58674 | $18,235.46 | $30,392.43 | $10,371.37 – $10,578.79 | 3 |
| Lap sleeve gastrectomy CPT 43775 | $33,766.61 | $56,277.68 | $349.73 – $356.73 | 2 |
| Laps surg prst8ect rpbic rad CPT 55866 | $33,883.09 | $56,471.82 | $10,371.37 – $10,578.79 | 3 |
| Laps surg prst8ect smpl stot CPT 55867 | $33,855.83 | $56,426.38 | $10,371.37 – $10,578.79 | 2 |
| Laryngoscopy w/biopsy CPT 31535 | $11,261.18 | $18,768.63 | $3,637.69 – $3,710.44 | 3 |
| Laryngoscopy w/bx & op scope CPT 31536 | $9,640.98 | $16,068.30 | $3,637.69 – $3,710.44 | 3 |
| Laryngoscopy w/exc of tumor CPT 31540 | $14,187.54 | $23,645.90 | $3,637.69 – $3,710.44 | 3 |
| Larynscop w/tumr exc + scope CPT 31541 | $15,360.89 | $25,601.48 | $3,637.69 – $3,710.44 | 3 |
| Lateral thoracic extension HCPCS L1210 | $587.35 | $1,957.83 | not published | 0 |
| Lateral trochanteric pad HCPCS L1290 | $186.53 | $621.78 | not published | 0 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $53,250.00 | $177,500.00 | not published | 0 |
| Lead capillary CPT 83655 | $144.30 | $481.00 | not published | 0 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $58,955.74 | $196,519.13 | not published | 0 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $14,643.75 | $48,812.50 | not published | 0 |
| Legg perthes orthosis trilat HCPCS L1720 | $3,541.31 | $11,804.37 | not published | 0 |
| Legg perthes orth scottish r HCPCS L1730 | $2,989.67 | $9,965.56 | not published | 0 |
| Legg perthes patten bottom t HCPCS L1755 | $4,298.29 | $14,327.62 | not published | 0 |
| Leg perthes orth toronto typ HCPCS L1700 | $3,734.93 | $12,449.76 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $1,764.60 | $5,882.00 | not published | 0 |
| Lens, intraocular (new tech) HCPCS C1780 | $226.31 | $754.38 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $2,662.50 | $8,875.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $3,181.69 | $10,605.63 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $798.75 | $2,662.50 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $104.47 | $174.11 | not published | 0 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $280.44 | $467.40 | not published | 0 |
| Levetiracetam therapeutic drug level CPT 80177 | $125.70 | $419.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $107.75 | $179.58 | not published | 0 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $2,077.82 | $3,463.03 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $82,364.44 | $274,548.13 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $59.00 | $98.34 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $76.26 | $127.10 | not published | 0 |
| Lift heel adj small gl60404sm HCPCS L3332 | $177.06 | $590.19 | 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.