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 |
|---|---|---|---|---|
| Stress tte complete CPT 93351 | $3,686.10 | $12,287.00 | not published | 0 |
| Str markers specimen anal CPT 81265 | $366.90 | $1,223.00 | not published | 0 |
| St treatment speech individual CPT 92507 | $445.50 | $1,485.00 | not published | 0 |
| St treatment swallow dysfunction/oral CPT 92526 | $271.20 | $904.00 | not published | 0 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $48.00 | $80.00 | not published | 0 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $3,823.32 | $6,372.20 | not published | 0 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $123.40 | $205.66 | not published | 0 |
| Support clav 29.6-40.5in med HCPCS L3650 | $607.82 | $2,026.07 | not published | 0 |
| Surgery to stop leg growth CPT 27485 | $55,463.56 | $92,439.27 | not published | 0 |
| Surgical pathology level 1 gross examination only CPT 88300 | $57.00 | $190.00 | not published | 0 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $77.40 | $258.00 | not published | 0 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $167.10 | $557.00 | not published | 0 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $270.00 | $900.00 | not published | 0 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $356.10 | $1,187.00 | not published | 0 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $522.90 | $1,743.00 | not published | 0 |
| Susceptibility agar dilution per agent CPT 87181 | $21.60 | $72.00 | not published | 0 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $11.40 | $38.00 | not published | 0 |
| Susceptibility mic per plate CPT 87186 | $90.00 | $300.00 | not published | 0 |
| Suscept studies macrobroth dilution ea CPT 87188 | $20.40 | $68.00 | not published | 0 |
| Suspension sleeve lower ext HCPCS L2397 | $255.04 | $850.14 | not published | 0 |
| Svc venogram s&i CPT 75827 | $1,550.10 | $5,167.00 | not published | 0 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $32.10 | $107.00 | not published | 0 |
| System cardiomems hosp electronics HCPCS C2624 | $50,587.50 | $168,625.00 | not published | 0 |
| System pacing micra av HCPCS C1786 | $44,463.75 | $148,212.50 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $21,483.71 | $71,612.38 | not published | 0 |
| System recell skin grafting/harvesting HCPCS C1832 | $18,304.69 | $61,015.63 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $204.00 | $680.00 | not published | 0 |
| T4 (thyroxine) free CPT 84439 | $194.40 | $648.00 | not published | 0 |
| T4 (thyroxine) total CPT 84436 | $52.80 | $176.00 | not published | 0 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $76.37 | $127.29 | not published | 0 |
| Tacrolimus therapeutic drug level CPT 80197 | $22.80 | $76.00 | not published | 0 |
| Talymed HCPCS Q4127 | $3,461.25 | $11,537.50 | not published | 0 |
| Tap block bilat cont infusion 64489 CPT 64489 | $703.80 | $2,346.00 | not published | 0 |
| Tap block uni by cont infusion 64487 CPT 64487 | $378.00 | $1,260.00 | not published | 0 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,312.70 | $7,709.00 | not published | 0 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $4,598.40 | $15,328.00 | not published | 0 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $1,131.87 | $1,886.45 | not published | 0 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $144.90 | $483.00 | not published | 0 |
| Tc-99m bicisate HCPCS A9557 | $4,840.80 | $8,068.00 | not published | 0 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $6,472.20 | $10,787.00 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $52.20 | $87.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $156.60 | $261.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $48.60 | $81.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $179.40 | $299.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $848.43 | $1,414.05 | not published | 0 |
| Tc-99m oxidronate HCPCS A9561 | $1,031.10 | $1,718.50 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $29.40 | $49.00 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $129.13 | $215.21 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $1,194.00 | $1,990.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $1,258.78 | $2,097.97 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $179.40 | $299.00 | not published | 0 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $1,194.00 | $1,990.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $782.40 | $1,304.00 | not published | 0 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $80.10 | $267.00 | not published | 0 |
| T cells absolute cd 4 count CPT 86361 | $45.90 | $153.00 | not published | 0 |
| T cells total count CPT 86359 | $356.70 | $1,189.00 | not published | 0 |
| Telethx isodose plan cplx CPT 77307 | $1,303.80 | $4,346.00 | not published | 0 |
| Telethx isodose plan simple CPT 77306 | $349.20 | $1,164.00 | not published | 0 |
| Temozolomide HCPCS J8700 | $33.73 | $56.22 | not published | 0 |
| Temsirolimus 30 mg/3 ml (10 mg/ml) (first dilution) intravenous soln HCPCS J9330 | $11,041.77 | $18,402.95 | not published | 0 |
| Tendon lngth upr a/e ea tdn CPT 24305 | $34,229.71 | $57,049.52 | $7,079.78 – $7,079.78 | 1 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $37,586.59 | $62,644.32 | not published | 0 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $1,494.60 | $4,982.00 | not published | 0 |
| Tension based scoliosis orth HCPCS L1005 | $7,683.49 | $25,611.65 | not published | 0 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $48.00 | $80.00 | not published | 0 |
| Test pathogen(s) for platelets reference HCPCS P9100 | $33.00 | $110.00 | not published | 0 |
| Test socket below knee HCPCS L5620 | $619.62 | $2,065.39 | not published | 0 |
| Test stress cardiovascular tracing only CPT 93017 | $1,303.80 | $4,346.00 | not published | 0 |
| Tetanus immune globulin inj HCPCS J1670 | $2,940.74 | $4,901.24 | not published | 0 |
| Tgsap so neo 5-50 rna alys CPT 81449 | $1,464.90 | $4,883.00 | not published | 0 |
| Theophylline therapeutic drug level CPT 80198 | $130.20 | $434.00 | not published | 0 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $60.30 | $201.00 | not published | 0 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $54.30 | $181.00 | not published | 0 |
| Ther fx nasal inf turbinate CPT 30930 | $17,304.37 | $28,840.62 | $3,234.84 – $3,299.54 | 3 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $48.00 | $80.00 | not published | 0 |
| Thigh/wght bear high roll cu HCPCS L2550 | $816.80 | $2,722.67 | not published | 0 |
| Thigh/wght bear lacer molded HCPCS L2540 | $1,089.41 | $3,631.38 | not published | 0 |
| Thigh/wght bear lacer non-mo HCPCS L2530 | $575.71 | $1,919.04 | not published | 0 |
| Thi/glut/ischia wgt bearing HCPCS L2500 | $751.22 | $2,504.08 | not published | 0 |
| Thorac cont lat support upri HCPCS L2680 | $351.26 | $1,170.88 | not published | 0 |
| Thorac cont paraspinal uprig HCPCS L2670 | $382.89 | $1,276.31 | not published | 0 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $3,599.70 | $11,999.00 | not published | 0 |
| Thoracic control thoracic ba HCPCS L2660 | $430.13 | $1,433.76 | not published | 0 |
| Thoracic pad HCPCS L1060 | $259.99 | $866.64 | not published | 0 |
| Thoracotomy with cardiac massage CPT 32160 | $984.60 | $3,282.00 | not published | 0 |
| Thor rib belt custom fabrica HCPCS L0220 | $2,759.84 | $9,199.47 | not published | 0 |
| Thrombectmy crnry perq mechanical CPT 92973 | $866.40 | $2,888.00 | not published | 0 |
| Thrombectomy/inf pq dialysis circuit CPT 36904 | $4,073.40 | $13,578.00 | not published | 0 |
| Thrombectomy/inf pq dialysis circuit w/pta CPT 36905 | $10,129.50 | $33,765.00 | not published | 0 |
| Thrombin time CPT 85670 | $29.10 | $97.00 | not published | 0 |
| Thromboplastin inhibition CPT 85705 | $27.60 | $92.00 | not published | 0 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $116.70 | $389.00 | not published | 0 |
| Th/wght bear nar m-l brim cu HCPCS L2526 | $1,537.49 | $5,124.96 | not published | 0 |
| Th/wght bear nar m-l brim mo HCPCS L2525 | $2,736.20 | $9,120.66 | not published | 0 |
| Th/wght bear quad-lat brim c HCPCS L2520 | $1,290.33 | $4,301.09 | not published | 0 |
| Th/wght bear quad-lat brim m HCPCS L2510 | $1,936.12 | $6,453.72 | not published | 0 |
| Thyroglobulin antibody CPT 86800 | $131.40 | $438.00 | not published | 0 |
| Thyroidectomy inc substrnl split/trans approch 60270 CPT 60270 | $21,856.96 | $36,428.27 | $349.73 – $356.73 | 2 |
| Thyroid (TSH) Test CPT 84443 | $183.00 | $610.00 | not published | 0 |
| Thyroid Ultrasound CPT 76536 | $817.50 | $2,725.00 | 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.