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 |
|---|---|---|---|---|
| Change ureter stent percut CPT 50382 | $9,998.09 | $16,663.48 | $2,039.56 – $2,080.35 | 3 |
| Chest 2 vws w oblique CPT 71048 | $888.90 | $2,963.00 | not published | 0 |
| Chest apical lordotic proj CPT 71047 | $266.70 | $889.00 | not published | 0 |
| Chest CT scan (with and without contrast) CPT 71270 | $3,960.60 | $13,202.00 | not published | 0 |
| Chest CT scan (with contrast) CPT 71260 | $4,011.30 | $13,371.00 | not published | 0 |
| Chest CT scan (without contrast) CPT 71250 | $2,265.00 | $7,550.00 | not published | 0 |
| Chest X-ray CPT 71046 | $806.40 | $2,688.00 | not published | 0 |
| Chest X-ray (single view) CPT 71045 | $351.60 | $1,172.00 | not published | 0 |
| Chg pr pul rehab for copd patients CPT 94626 | $63.30 | $211.00 | not published | 0 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $187.80 | $626.00 | not published | 0 |
| Chimerism anal w/cell select CPT 81268 | $410.70 | $1,369.00 | not published | 0 |
| Chlamydia culture CPT 87110 | $30.90 | $103.00 | not published | 0 |
| Chlamydia type CPT 87140 | $8.70 | $29.00 | not published | 0 |
| Chloride 24 hour urine CPT 82436 | $56.70 | $189.00 | not published | 0 |
| Chloroprocaine hcl injection HCPCS J2401 | $358.67 | $597.78 | not published | 0 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | $336.97 | $561.61 | not published | 0 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $113.71 | $189.52 | not published | 0 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $3,210.60 | $10,702.00 | not published | 0 |
| Cholesterol CPT 82465 | $37.80 | $126.00 | not published | 0 |
| Cholesterol body fluid CPT 84999 | $54.30 | $181.00 | not published | 0 |
| Cholesterol (Lipid) Test CPT 80061 | $189.00 | $630.00 | not published | 0 |
| Cholinesterase CPT 82480 | $12.30 | $41.00 | not published | 0 |
| Chromatography CPT 83021 | $165.90 | $553.00 | not published | 0 |
| Chromosome karyotype study CPT 88280 | $240.30 | $801.00 | not published | 0 |
| Chronic urticaria - sendout CPT 86343 | $86.10 | $287.00 | not published | 0 |
| Chylomicron screen, bf - sendout CPT 82664 | $106.20 | $354.00 | not published | 0 |
| Cilastatin sodium injection HCPCS J0743 | $101.00 | $168.34 | not published | 0 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $48.00 | $80.00 | not published | 0 |
| Circum 28 days or older CPT 54161 | $12,055.05 | $20,091.75 | $2,039.56 – $2,080.35 | 3 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $651.60 | $2,172.00 | not published | 0 |
| Circumcision (newborn) CPT 54150 | $1,932.60 | $6,442.00 | not published | 0 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $607.20 | $1,012.00 | not published | 0 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | $533.23 | $888.72 | not published | 0 |
| Clamp isol transpolr 5mmx6.5cm transpolar HCPCS C1733 | $29,287.50 | $97,625.00 | not published | 0 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $142.68 | $237.80 | not published | 0 |
| Clip ligating vesolock lg HCPCS C1760 | $5,138.62 | $17,128.75 | not published | 0 |
| Cllr miami j sm HCPCS L0174 | $911.21 | $3,037.38 | not published | 0 |
| Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution HCPCS J0735 | $48.00 | $80.00 | not published | 0 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | $86.40 | $288.00 | not published | 0 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | $597.90 | $1,993.00 | not published | 0 |
| Closed tx humerus fx with manip 23605 CPT 23605 | $597.90 | $1,993.00 | not published | 0 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | $597.90 | $1,993.00 | not published | 0 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | $86.40 | $288.00 | not published | 0 |
| Closed tx orbit without manipulj CPT 21400 | $190.50 | $635.00 | not published | 0 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | $1,519.50 | $5,065.00 | not published | 0 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | $87.00 | $290.00 | not published | 0 |
| Clos txnose fx without stablz 21315 CPT 21315 | $1,023.90 | $3,413.00 | not published | 0 |
| Closure paravalvlr leak pq CPT 33999 | $4,641.30 | $15,471.00 | not published | 0 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | $86.40 | $288.00 | not published | 0 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | $86.40 | $288.00 | not published | 0 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | $86.40 | $288.00 | not published | 0 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | $86.40 | $288.00 | not published | 0 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | $238.20 | $794.00 | not published | 0 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | $86.40 | $288.00 | not published | 0 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | $86.40 | $288.00 | not published | 0 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | $215.70 | $719.00 | not published | 0 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | $86.40 | $288.00 | not published | 0 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | $86.40 | $288.00 | not published | 0 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | $86.40 | $288.00 | not published | 0 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | $86.40 | $288.00 | not published | 0 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | $86.40 | $288.00 | not published | 0 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | $86.40 | $288.00 | not published | 0 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | $226.80 | $756.00 | not published | 0 |
| Clsd tx/metacarpal fx/sg without manip 26600 CPT 26600 | $86.40 | $288.00 | not published | 0 |
| Clsd tx/metacarpal fx/sng/w manip 26605 CPT 26605 | $86.40 | $288.00 | not published | 0 |
| Clsd tx metatarsal fracture w/manip 28475 CPT 28475 | $86.40 | $288.00 | not published | 0 |
| Clsd tx/nasal bone fx/stabilize 21320 CPT 21320 | $10,894.70 | $18,157.83 | $3,234.84 – $3,299.54 | 3 |
| Clsd tx of ankle fracture w/manip 28435 CPT 28435 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx patella disloc without anes 27560 CPT 27560 | $86.40 | $288.00 | not published | 0 |
| Clsd tx/patellar fx without manip 27520 CPT 27520 | $215.70 | $719.00 | not published | 0 |
| Clsd tx prox fib/shaft fx w/manip 27781 CPT 27781 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx/radial head/neck fx/no manip 24650 CPT 24650 | $86.40 | $288.00 | not published | 0 |
| Clsd tx radius fracture w/manip 24655 CPT 24655 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx shoulder dislc/fx 23665 CPT 23665 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx shoulder disloc w/anatom neck fx w/manip 23675 CPT 23675 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx/shoulder dislo/manip/anest 23655 CPT 23655 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx temporomandibular dislocat 21480 CPT 21480 | $86.40 | $288.00 | not published | 0 |
| Clsd tx toe dislocation without anes28660 CPT 28660 | $86.40 | $288.00 | not published | 0 |
| Clsd tx trimall ankle fx w/manip 27818 CPT 27818 | $597.90 | $1,993.00 | not published | 0 |
| Clsd tx wrist trans-scaph fx w/manip 25680 CPT 25680 | $86.40 | $288.00 | not published | 0 |
| Clsd/ulnar fx/prox end without manip 24670 CPT 24670 | $238.20 | $794.00 | not published | 0 |
| Cls tx of heel fracture w/manip 28405 CPT 28405 | $86.40 | $288.00 | not published | 0 |
| Cltx carpl scphd fx w/mnpj CPT 25624 | $597.90 | $1,993.00 | not published | 0 |
| Cltx humrl cndylr fx w/mnpj CPT 24577 | $1,023.90 | $3,413.00 | not published | 0 |
| Cltx lunate dislc w/mnpj CPT 25690 | $597.90 | $1,993.00 | not published | 0 |
| Cltx post ankle fx w/mnpj CPT 27768 | $597.90 | $1,993.00 | not published | 0 |
| Cltx scap fx w/mnpj +-tractj CPT 23575 | $1,494.60 | $4,982.00 | not published | 0 |
| #cmvcul-virus inoculation shell CPT 87254 | $90.90 | $303.00 | not published | 0 |
| Cmv pcr-sendout CPT 87496 | $128.40 | $428.00 | not published | 0 |
| Coagulation factor viia 1,000 mcg/ml inj 1 ml HCPCS J7189 | $63,646.50 | $106,077.50 | not published | 0 |
| Coagulation time activated teg CPT 85347 | $27.90 | $93.00 | not published | 0 |
| Cocaine 4 % nasal solution HCPCS C9046 | $829.29 | $1,382.15 | not published | 0 |
| Coch imp ext proc/contr rplc HCPCS L8619 | $31,808.89 | $106,029.63 | not published | 0 |
| Coch implant microphone repl HCPCS L8616 | $785.44 | $2,618.13 | not published | 0 |
| Cold agglutinin screen (arc) CPT 86156 | $36.00 | $120.00 | not published | 0 |
| Colistimethate sodium inj HCPCS J0770 | $275.52 | $459.20 | 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.