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 |
|---|---|---|---|---|
| Sheath laser cavaclear 14f HCPCS C1603 | $13,299.19 | $44,330.63 | not published | 0 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $37,678.43 | $62,797.38 | $7,079.78 – $7,221.37 | 3 |
| Sho arthrs srg capsulorraphy CPT 29806 | $42,480.62 | $70,801.03 | $7,079.78 – $7,079.78 | 2 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $22,580.70 | $37,634.50 | $3,192.44 – $3,256.29 | 3 |
| Sho arthrs srg rpr slap les CPT 29807 | $45,870.02 | $76,450.03 | $7,079.78 – $7,221.37 | 3 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $26,350.66 | $43,917.77 | $7,079.78 – $7,221.37 | 3 |
| Shoe clubfoot wedge HCPCS L3380 | $119.07 | $396.89 | not published | 0 |
| Shoe dennis browne splint bo HCPCS L3640 | $103.86 | $346.21 | not published | 0 |
| Shoe heel new leather standa HCPCS L3455 | $97.71 | $325.71 | not published | 0 |
| Shoe heel new rubber standar HCPCS L3460 | $82.48 | $274.95 | not published | 0 |
| Shoe heel pad & depress for HCPCS L3480 | $149.58 | $498.60 | not published | 0 |
| Shoe heel sach cushion type HCPCS L3450 | $253.34 | $844.46 | not published | 0 |
| Shoe heel thomas extend to b HCPCS L3470 | $149.58 | $498.60 | not published | 0 |
| Shoe heel thomas with wedge HCPCS L3465 | $140.53 | $468.42 | not published | 0 |
| Shoe lift elev heel/sole neo HCPCS L3310 | $177.75 | $592.50 | not published | 0 |
| Shoe metatarsal bar between HCPCS L3410 | $222.85 | $742.84 | not published | 0 |
| Shoe metatarsal bar wedge ro HCPCS L3400 | $97.71 | $325.71 | not published | 0 |
| Shoe outflare wedge HCPCS L3390 | $119.07 | $396.89 | not published | 0 |
| Shoe post-op mens m HCPCS L3260 | $292.87 | $976.25 | not published | 0 |
| Shoe sole wedge between sole HCPCS L3370 | $119.07 | $396.89 | not published | 0 |
| Shoe sole wedge outside sole HCPCS L3360 | $85.47 | $284.89 | not published | 0 |
| Shoe wedge sach HCPCS L3340 | $204.61 | $682.04 | not published | 0 |
| Sho heel count plast reinfor HCPCS L3430 | $384.70 | $1,282.35 | not published | 0 |
| Sho insert w arch toe filler HCPCS L5000 | $1,242.24 | $4,140.81 | not published | 0 |
| Sho lift taper to metatarsal HCPCS L3300 | $125.19 | $417.30 | not published | 0 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $35,204.11 | $58,673.52 | $7,079.78 – $7,221.37 | 3 |
| Shoulder MRI (with and without contrast) CPT 73223 | $5,405.70 | $18,019.00 | not published | 0 |
| Shoulder MRI (with contrast) CPT 73222 | $5,258.70 | $17,529.00 | not published | 0 |
| Shoulder MRI (without contrast) CPT 73221 | $5,133.60 | $17,112.00 | not published | 0 |
| Shoulder X-ray CPT 73030 | $596.70 | $1,989.00 | not published | 0 |
| Shrinker prosth above knee HCPCS L8460 | $202.72 | $675.74 | not published | 0 |
| Shrinker prosth below knee HCPCS L8440 | $142.60 | $475.35 | not published | 0 |
| Shunt glaucoma baerveldt 350mm HCPCS C1783 | $7,721.25 | $25,737.50 | not published | 0 |
| Sickling rbc CPT 85660 | $55.20 | $184.00 | not published | 0 |
| Sigmoidoscopy and biopsy CPT 45331 | $12,901.65 | $21,502.75 | $907.35 – $925.49 | 3 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $9,084.72 | $15,141.20 | $907.35 – $925.49 | 3 |
| Simple cystometrogram 51725 CPT 51725 | $7,464.04 | $12,440.07 | $2,039.56 – $2,080.35 | 3 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $1,221.44 | $2,035.74 | not published | 0 |
| Sinus CT scan (with and without contrast) CPT 70488 | $3,889.20 | $12,964.00 | not published | 0 |
| Sinus CT scan (with contrast) CPT 70487 | $1,690.50 | $5,635.00 | not published | 0 |
| Sinus CT scan (without contrast) CPT 70486 | $2,276.40 | $7,588.00 | not published | 0 |
| Sinus/juglr venogram s&i CPT 75860 | $2,337.60 | $7,792.00 | not published | 0 |
| Sio flex pelvisacral custom HCPCS L0622 | $641.64 | $2,138.79 | not published | 0 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | $424.85 | $1,416.18 | not published | 0 |
| Sirolimus, oral HCPCS J7520 | $128.27 | $213.79 | not published | 0 |
| Skin Biopsy CPT 11102 | $75.30 | $251.00 | not published | 0 |
| Sleeve fing rolyan med HCPCS L3933 | $466.18 | $1,553.92 | not published | 0 |
| Sling pelv split sam med HCPCS L0621 | $206.98 | $689.94 | not published | 0 |
| Sling suprapubic suburetheral HCPCS C1771 | $18,103.08 | $60,343.61 | not published | 0 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $18.90 | $63.00 | not published | 0 |
| Smear gram stain CPT 87205 | $110.40 | $368.00 | not published | 0 |
| Smear wet mount CPT 87210 | $18.60 | $62.00 | not published | 0 |
| So airplane w/wo joint cf HCPCS L3674 | $2,582.47 | $8,608.22 | not published | 0 |
| So cap design without jnts cf HCPCS L3671 | $1,968.60 | $6,562.00 | not published | 0 |
| Socket insert without lock mech HCPCS L5679 | $1,304.81 | $4,349.37 | not published | 0 |
| Sock fracture or equal each HCPCS L3995 | $73.00 | $243.35 | not published | 0 |
| Sodium 24 hour urine CPT 84300 | $69.90 | $233.00 | not published | 0 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $111.00 | $185.00 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $113.40 | $189.00 | not published | 0 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $111.00 | $185.00 | not published | 0 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $111.00 | $185.00 | not published | 0 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $312.91 | $521.52 | not published | 0 |
| Sodium serum/plasma/whole blood CPT 84295 | $50.40 | $168.00 | not published | 0 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $48.00 | $80.00 | not published | 0 |
| Soft interface below knee se HCPCS L2820 | $181.69 | $605.63 | not published | 0 |
| So neo gsap dna/dna&rna CPT 81459 | $1,977.00 | $6,590.00 | not published | 0 |
| So vest canvas/web pre ots HCPCS L3675 | $383.48 | $1,278.27 | not published | 0 |
| Special physics consult CPT 77370 | $1,421.70 | $4,739.00 | not published | 0 |
| Special radiation dosimetry CPT 77331 | $319.80 | $1,066.00 | not published | 0 |
| Special radiation treatment CPT 77470 | $4,164.60 | $13,882.00 | not published | 0 |
| Special teletx port plan CPT 77321 | $3,033.60 | $10,112.00 | not published | 0 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $970.20 | $3,234.00 | not published | 0 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | $1,107.17 | $3,690.58 | not published | 0 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | $143.51 | $478.36 | not published | 0 |
| Splint finger fold over sm HCPCS L3924 | $211.03 | $703.43 | not published | 0 |
| Splint finger frog med HCPCS L3927 | $214.76 | $715.86 | not published | 0 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | $211.03 | $703.43 | not published | 0 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $22,065.26 | $36,775.43 | $3,457.56 – $3,526.71 | 3 |
| Sputum specimen collection CPT 89220 | $76.80 | $256.00 | not published | 0 |
| Srs linear based CPT 77372 | $14,815.50 | $49,385.00 | not published | 0 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $277.50 | $925.00 | not published | 0 |
| Static or dynami afo pre ots HCPCS L4397 | $665.62 | $2,218.75 | not published | 0 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $48,028.04 | $160,093.46 | not published | 0 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $38,606.25 | $128,687.50 | not published | 0 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $41,934.37 | $139,781.25 | not published | 0 |
| Stent bronch dumon sil 10x40mm HCPCS C1875 | $931.87 | $3,106.25 | not published | 0 |
| Sterile water/saline, 10 ml HCPCS A4216 | $111.00 | $185.00 | not published | 0 |
| Sternal pad HCPCS L1050 | $240.88 | $802.92 | not published | 0 |
| St evaluate speech sound production CPT 92522 | $277.50 | $925.00 | not published | 0 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $346.50 | $1,155.00 | not published | 0 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $484.20 | $1,614.00 | not published | 0 |
| St evaluation swallow function CPT 92610 | $397.50 | $1,325.00 | not published | 0 |
| Stocking sup grips 4 pre ots HCPCS L0982 | $37.54 | $125.14 | not published | 0 |
| Straight knee joint heavy du HCPCS L2385 | $352.75 | $1,175.85 | not published | 0 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $60.90 | $203.00 | not published | 0 |
| Strapping of elbow or wrist 29260 CPT 29260 | $24.00 | $80.00 | not published | 0 |
| Strapping of hand or finger CPT 29280 | $24.00 | $80.00 | not published | 0 |
| Strapping of knee CPT 29530 | $48.60 | $162.00 | not published | 0 |
| Strep a ag ia CPT 87430 | $27.60 | $92.00 | not published | 0 |
| Stress test pulmonary CPT 94618 | $120.60 | $402.00 | 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.