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 |
|---|---|---|---|---|
| CT angio pelvis CPT 72191 | $1,479.60 | $4,932.00 | not published | 0 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,479.60 | $4,932.00 | not published | 0 |
| CT guidance for needle placement CPT 77012 | $2,460.60 | $8,202.00 | not published | 0 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $1,650.60 | $5,502.00 | not published | 0 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $1,301.00 | $1,301.00 | not published | 0 |
| CT limited or localized follow-up study CPT 76380 | $1,046.10 | $3,487.00 | not published | 0 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $3,680.40 | $12,268.00 | not published | 0 |
| CT lower extremity without contrast (both sides) CPT 73700 | $2,373.60 | $7,912.00 | not published | 0 |
| Ctlso a-p-l control molded HCPCS L0700 | $4,779.03 | $15,930.09 | not published | 0 |
| Ctlso a-p-l control with inter HCPCS L0710 | $5,253.46 | $17,511.53 | not published | 0 |
| Ctlso axilla sling HCPCS L1010 | $200.86 | $669.53 | not published | 0 |
| Ctlso milwauke initial model HCPCS L1000 | $4,867.90 | $16,226.34 | not published | 0 |
| CT lwr extremity w/o&w/dye CPT 73702 | $4,014.90 | $13,383.00 | not published | 0 |
| CT neck soft tissue w/contrast CPT 70491 | $3,889.20 | $12,964.00 | not published | 0 |
| CT neck soft tissue without contrast CPT 70490 | $3,889.20 | $12,964.00 | not published | 0 |
| CT neck soft tissue without & w/contrast CPT 70492 | $2,112.30 | $7,041.00 | not published | 0 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $3,287.10 | $10,957.00 | not published | 0 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $489.00 | $1,630.00 | not published | 0 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $2,032.80 | $6,776.00 | not published | 0 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | $87.00 | $290.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $4,098.90 | $13,663.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,614.10 | $12,047.00 | not published | 0 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,698.50 | $8,995.00 | not published | 0 |
| CT thoracic spine w/contrast CPT 72129 | $2,722.20 | $9,074.00 | not published | 0 |
| CT thoracic spine without contrast CPT 72128 | $2,671.20 | $8,904.00 | not published | 0 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $1,899.00 | $6,330.00 | not published | 0 |
| CT t-spine w /wo contrast CPT 72130 | $595.50 | $1,985.00 | not published | 0 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $2,987.40 | $9,958.00 | not published | 0 |
| CT upper extremity without contrast (both sides) CPT 73200 | $2,120.40 | $7,068.00 | not published | 0 |
| CT uppr extremity w/o&w/dye CPT 73202 | $3,258.90 | $10,863.00 | not published | 0 |
| Cuffs adj lock with active con HCPCS L3740 | $2,347.50 | $7,825.00 | not published | 0 |
| Culture aerobic additional method definitive id each CPT 87077 | $132.00 | $440.00 | not published | 0 |
| Culture afb any source CPT 87116 | $98.70 | $329.00 | not published | 0 |
| Culture anaerobic additional method definitive id each CPT 87076 | $140.10 | $467.00 | not published | 0 |
| Culture anaerobic except blood CPT 87075 | $200.70 | $669.00 | not published | 0 |
| Culture bact stool aero addl path ea CPT 87046 | $11.40 | $38.00 | not published | 0 |
| Culture body fluid CPT 87070 | $71.40 | $238.00 | not published | 0 |
| Culture fungi definitive id mold CPT 87107 | $137.10 | $457.00 | not published | 0 |
| Culture fungi definitive id yeast CPT 87106 | $140.10 | $467.00 | not published | 0 |
| Culture fungi other (except blood) CPT 87102 | $106.80 | $356.00 | not published | 0 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $140.10 | $467.00 | not published | 0 |
| Culture mycoplasma any source CPT 87109 | $30.30 | $101.00 | not published | 0 |
| Culture screening strep group a CPT 87081 | $13.50 | $45.00 | not published | 0 |
| Culture typing added method CPT 87158 | $137.10 | $457.00 | not published | 0 |
| Culture typing immunologic CPT 87147 | $70.20 | $234.00 | not published | 0 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $378.60 | $1,262.00 | not published | 0 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $166.50 | $555.00 | not published | 0 |
| Culture urine each isolate CPT 87088 | $47.40 | $158.00 | not published | 0 |
| Cutter lead HCPCS C1773 | $9,505.12 | $31,683.75 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $1,550.10 | $5,167.00 | not published | 0 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $48.00 | $80.00 | not published | 0 |
| Cyclic citrullinated peptide antibody CPT 86200 | $188.10 | $627.00 | not published | 0 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $651.36 | $1,085.60 | not published | 0 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $69.20 | $115.34 | not published | 0 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $44.26 | $73.77 | not published | 0 |
| Cyclosporine oral 100 mg HCPCS J7502 | $152.89 | $254.81 | not published | 0 |
| Cygnus, per sq cm HCPCS Q4170 | $11,981.25 | $39,937.50 | not published | 0 |
| Cylinder pump set 20cm titan zero angl HCPCS C1813 | $38,795.42 | $129,318.07 | not published | 0 |
| Cyp2c9 gene com variants CPT 81227 | $275.40 | $918.00 | not published | 0 |
| Cyp3a4 gene common variants CPT 81230 | $262.20 | $874.00 | not published | 0 |
| Cyp3a5 gene common variants CPT 81231 | $262.20 | $874.00 | not published | 0 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $519.30 | $1,731.00 | not published | 0 |
| Cysto impl 4 or more HCPCS C9740 | $35,758.27 | $59,597.12 | $9,236.28 – $9,421.01 | 3 |
| Cystoscopy and treatment CPT 52214 | $10,319.15 | $17,198.58 | $3,439.27 – $3,508.06 | 3 |
| Cystoscopy and treatment CPT 52224 | $10,452.42 | $17,420.70 | $3,439.27 – $3,508.06 | 3 |
| Cystoscopy and treatment CPT 52234 | $18,942.46 | $31,570.77 | $3,439.27 – $3,508.06 | 3 |
| Cystoscopy and treatment CPT 52235 | $13,871.70 | $23,119.50 | $3,439.27 – $3,508.06 | 3 |
| Cystoscopy and treatment CPT 52240 | $18,632.41 | $31,054.02 | $5,231.42 – $5,336.05 | 3 |
| Cystoscopy and treatment CPT 52260 | $9,090.64 | $15,151.07 | $2,039.56 – $2,080.35 | 3 |
| Cystoscopy and treatment CPT 52276 | $18,972.92 | $31,621.53 | $2,039.56 – $2,080.35 | 3 |
| Cystoscopy and treatment CPT 52310 | $9,564.12 | $15,940.20 | $2,039.56 – $2,080.35 | 3 |
| Cystoscopy and treatment CPT 52315 | $773.10 | $2,577.00 | not published | 0 |
| Cystoscopy (Bladder Scope) CPT 52000 | $8,212.54 | $13,687.57 | $680.34 – $693.95 | 3 |
| Cystoscopy chemodenervation CPT 52287 | $14,979.64 | $24,966.07 | $2,039.56 – $3,439.27 | 3 |
| Cystoscopy removal of clots CPT 52001 | $16,542.16 | $27,570.27 | $5,231.42 – $5,336.05 | 3 |
| Cystoscopy & revise urethra CPT 52275 | $13,780.72 | $22,967.87 | $2,039.56 – $2,080.35 | 3 |
| Cystoscopy & ureter catheter CPT 52005 | $18,632.41 | $31,054.02 | $2,039.56 – $2,080.35 | 3 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $16,121.68 | $26,869.47 | $2,039.56 – $2,080.35 | 3 |
| Cystouretero & or pyeloscope CPT 52351 | $15,301.09 | $25,501.82 | $3,439.27 – $3,508.06 | 3 |
| Cysto/uretero stricture tx CPT 52344 | $23,500.16 | $39,166.93 | $3,439.27 – $5,231.42 | 3 |
| Cystouretero w/biopsy CPT 52354 | $14,228.31 | $23,713.85 | $5,231.42 – $5,336.05 | 2 |
| Cysto/uretero w/lithotripsy CPT 52356 | $25,379.37 | $42,298.95 | $5,231.42 – $5,336.05 | 3 |
| Cystouretero w/lithotripsy CPT 52353 | $15,766.66 | $26,277.77 | $5,231.42 – $5,336.05 | 3 |
| Cystouretero w/stone remove CPT 52352 | $18,686.08 | $31,143.47 | $3,439.27 – $3,508.06 | 3 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $9,213.41 | $15,355.68 | $2,039.56 – $2,080.35 | 3 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $11,643.45 | $19,405.75 | $2,039.56 – $2,080.35 | 3 |
| Cystourethro w/addl implant 52442 CPT 52442 | $29,886.55 | $49,810.92 | $3,439.27 – $3,508.06 | 3 |
| Cystourethro w/implant CPT 52441 | $29,886.55 | $49,810.92 | $3,439.27 – $3,508.06 | 3 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $112.17 | $186.95 | not published | 0 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $172.50 | $575.00 | not published | 0 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $128.40 | $428.00 | not published | 0 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $87.00 | $290.00 | not published | 0 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $73.80 | $246.00 | not published | 0 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $22.20 | $74.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $164.10 | $547.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $52.20 | $174.00 | not published | 0 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $90.00 | $150.00 | not published | 0 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $8,059.46 | $13,432.44 | not published | 0 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $2,103.73 | $3,506.22 | not published | 0 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $10,512.90 | $17,521.50 | $3,158.41 – $3,221.58 | 3 |
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.