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 |
|---|---|---|---|---|
| Lift heel adjustable med HCPCS L3334 | $91.54 | $305.12 | not published | 0 |
| Lifts elevation metal extens HCPCS L3330 | $1,358.59 | $4,528.65 | not published | 0 |
| Ligate/strip long leg vein CPT 37722 | $12,775.35 | $21,292.25 | $3,080.71 – $3,142.32 | 3 |
| Ligation internal/common carotid artery 37605 CPT 37605 | $1,241.70 | $4,139.00 | not published | 0 |
| Ligation/major artery/extremity 37618 CPT 37618 | $2,511.60 | $8,372.00 | not published | 0 |
| Liletta, 52 mg HCPCS J7297 | $9,168.23 | $15,280.38 | not published | 0 |
| Limited ankle motion ea jnt HCPCS L2200 | $99.47 | $331.57 | not published | 0 |
| Limited motion knee joint HCPCS L2184 | $278.07 | $926.91 | not published | 0 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $138.74 | $231.24 | not published | 0 |
| Lipase CPT 83690 | $159.30 | $531.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $74.40 | $248.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $121.80 | $406.00 | not published | 0 |
| Lip surgery procedure CPT 40799 | $87.00 | $290.00 | not published | 0 |
| Listeria monocytogenes CPT 86723 | $71.70 | $239.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $167.10 | $557.00 | not published | 0 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $4,395.00 | $14,650.00 | not published | 0 |
| Liver Function Test CPT 80076 | $209.40 | $698.00 | not published | 0 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $24,109.39 | $40,182.32 | $3,192.44 – $3,256.29 | 3 |
| 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 | $414.13 | $1,380.42 | not published | 0 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $170.19 | $567.29 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,352.80 | $11,176.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $3,352.80 | $11,176.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $3,150.60 | $10,502.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $8,307.00 | $27,690.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $778.50 | $2,595.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $5,799.60 | $19,332.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $512.10 | $1,707.00 | not published | 0 |
| Lso corset front HCPCS L0972 | $252.67 | $842.24 | not published | 0 |
| Lso flex no ri stays pre ots HCPCS L0628 | $273.01 | $910.04 | not published | 0 |
| Lso full corset HCPCS L0976 | $358.93 | $1,196.44 | not published | 0 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $407.36 | $1,357.88 | not published | 0 |
| Lso sag-coronal panel custom HCPCS L0638 | $4,028.36 | $13,427.88 | not published | 0 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | $3,110.01 | $10,366.71 | not published | 0 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | $388.83 | $1,296.11 | not published | 0 |
| Lso sagit rigid panel prefab HCPCS L0635 | $2,398.75 | $7,995.84 | not published | 0 |
| Lso sagittal rigid panel cus HCPCS L0636 | $3,254.72 | $10,849.07 | not published | 0 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $626.19 | $2,087.31 | not published | 0 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | $688.39 | $2,294.63 | not published | 0 |
| Lso s/c shell/panel custom HCPCS L0640 | $2,285.01 | $7,616.70 | not published | 0 |
| Lumbar bolster pad HCPCS L1030 | $187.97 | $626.58 | not published | 0 |
| Lumbar derotation pad HCPCS L1240 | $218.32 | $727.75 | not published | 0 |
| Lumbar or lumbar rib pad HCPCS L1040 | $212.84 | $709.47 | not published | 0 |
| Lumbar sling HCPCS L1090 | $241.57 | $805.23 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $377.40 | $1,258.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,277.70 | $4,259.00 | 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 | $798.75 | $2,662.50 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $1,277.70 | $4,259.00 | not published | 0 |
| Macroscopic exam arthropod CPT 87168 | $37.80 | $126.00 | not published | 0 |
| Magnesium CPT 83735 | $75.00 | $250.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $155.47 | $259.12 | not published | 0 |
| Mammosite ced HCPCS C1728 | $8,054.06 | $26,846.88 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $88.80 | $296.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $140.40 | $468.00 | not published | 0 |
| Man's shoe oxford brace HCPCS L3225 | $177.19 | $590.63 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $20,952.61 | $34,921.02 | $6,478.71 – $6,608.28 | 3 |
| Map tachycard site(s) CPT 93609 | $2,681.40 | $8,938.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $15,043.12 | $50,143.75 | not published | 0 |
| Mastectomy partial CPT 19301 | $20,952.61 | $34,921.02 | $3,820.23 – $6,608.28 | 3 |
| Mast mod rad CPT 19307 | $25,923.17 | $43,205.28 | $6,478.71 – $6,608.28 | 3 |
| Mast simple complete CPT 19303 | $33,149.79 | $55,249.65 | $6,478.71 – $6,608.28 | 3 |
| Matrion 1 sq cm HCPCS Q4201 | $20,594.44 | $68,648.13 | not published | 0 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $86,504.62 | $288,348.75 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $38.40 | $128.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $97.80 | $326.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $68.40 | $228.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $159.30 | $531.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $108.60 | $362.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $273.30 | $911.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $345.00 | $1,150.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $30.60 | $102.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $222.30 | $741.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $629.40 | $2,098.00 | not published | 0 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $415.50 | $1,385.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,827.00 | $6,090.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $61.20 | $204.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $302.70 | $1,009.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $238.80 | $796.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $215.10 | $717.00 | not published | 0 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $43.80 | $146.00 | not published | 0 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $35.10 | $117.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $361.20 | $1,204.00 | not published | 0 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $57.30 | $191.00 | not published | 0 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $11.10 | $37.00 | not published | 0 |
| Mayo brcmg brucella antibody igm CPT 86622 | $27.60 | $92.00 | not published | 0 |
| Mayo c1 esterase inhibitor CPT 83883 | $25.20 | $84.00 | not published | 0 |
| Mayo ceruloplasmin CPT 82390 | $89.70 | $299.00 | not published | 0 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $425.40 | $1,418.00 | not published | 0 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | $51.00 | $170.00 | not published | 0 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | $205.50 | $685.00 | not published | 0 |
| Mayo chromium CPT 82495 | $60.60 | $202.00 | not published | 0 |
| Mayo coccidioides antibody CPT 86635 | $50.40 | $168.00 | not published | 0 |
| Mayo cocou cortisone urine CPT 82542 | $210.00 | $700.00 | not published | 0 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $20.40 | $68.00 | not published | 0 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $37.50 | $125.00 | not published | 0 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $104.10 | $347.00 | not published | 0 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $180.60 | $602.00 | not published | 0 |
| Mayo estriol CPT 82677 | $56.70 | $189.00 | not published | 0 |
| Mayo factor vii CPT 85230 | $150.00 | $500.00 | 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.