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 |
|---|---|---|---|---|
| Dch pulmonary stress test CPT 94621 | $223.80 | $746.00 | not published | 0 |
| Dch validity tests CPT 81002 | $12.00 | $40.00 | not published | 0 |
| Deamidated gliadin antibody iga CPT 86258 | $20.10 | $67.00 | not published | 0 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $242.70 | $809.00 | not published | 0 |
| Debridement (>20 cm) charge pt CPT 97598 | $152.70 | $509.00 | not published | 0 |
| Debridement bone <= 20 sq cm CPT 11044 | $24,761.29 | $41,268.82 | $1,611.44 – $1,643.67 | 3 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $6,160.20 | $10,267.00 | $721.10 – $735.52 | 3 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $3,077.10 | $10,257.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $21,154.59 | $35,257.65 | $396.63 – $404.56 | 3 |
| Debride nail1-5 11720 CPT 11720 | $44.70 | $149.00 | not published | 0 |
| Debride nail6 or more 11721 CPT 11721 | $114.90 | $383.00 | not published | 0 |
| Debride skin bone at fx site CPT 11012 | $1,076.70 | $3,589.00 | not published | 0 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $104,850.58 | $174,750.97 | $396.63 – $404.56 | 3 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $7,006.80 | $11,678.00 | $721.10 – $735.52 | 3 |
| Decalcification CPT 88311 | $39.30 | $131.00 | not published | 0 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $255.95 | $426.59 | not published | 0 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $1,421.40 | $4,738.00 | not published | 0 |
| Decompression of tibia nerve CPT 28035 | $40,106.89 | $66,844.82 | $7,079.78 – $7,079.78 | 1 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $145.24 | $242.07 | not published | 0 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $275.40 | $918.00 | not published | 0 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $8,495.70 | $14,159.50 | not published | 0 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $48.60 | $162.00 | not published | 0 |
| Dermapure 1 square cm HCPCS Q4152 | $5,311.69 | $17,705.63 | not published | 0 |
| Design mlc device for imrt CPT 77338 | $765.00 | $2,550.00 | not published | 0 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $199.61 | $332.68 | not published | 0 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | $17,103.49 | $28,505.82 | $1,167.54 – $1,190.90 | 3 |
| Destruction benign lesions < 14 lesions CPT 17110 | $75.30 | $251.00 | not published | 0 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | $32,399.72 | $53,999.53 | $2,834.09 – $2,890.77 | 2 |
| Device ablt adv novasure HCPCS C1886 | $12,913.12 | $43,043.75 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $6,656.25 | $22,187.50 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $3,045.90 | $10,153.00 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $2,466.14 | $8,220.47 | not published | 0 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $220.37 | $367.29 | not published | 0 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $48.00 | $80.00 | not published | 0 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $1,043.21 | $1,738.69 | not published | 0 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $194.40 | $324.00 | not published | 0 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $194.40 | $324.00 | not published | 0 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $121.50 | $202.50 | not published | 0 |
| Dextrose 5 % IV bolus HCPCS J7070 | $194.40 | $324.00 | not published | 0 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $225.00 | $750.00 | not published | 0 |
| Diabetes (HbA1c) Test CPT 83036 | $82.20 | $274.00 | not published | 0 |
| Diag laparo separate proc 49320 CPT 49320 | $16,720.09 | $27,866.82 | $5,898.53 – $6,016.50 | 3 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $48.60 | $162.00 | not published | 0 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $187.20 | $624.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $74.70 | $249.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $637.50 | $2,125.00 | not published | 0 |
| Diagnostic Mammogram (one breast) CPT 77065 | $543.60 | $1,812.00 | not published | 0 |
| Dialysis one evaluation CPT 90945 | $1,131.00 | $3,770.00 | not published | 0 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $196.20 | $327.00 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $82.81 | $138.01 | not published | 0 |
| Dicyclomine injection HCPCS J0500 | $119.26 | $198.77 | not published | 0 |
| Diffusing capacity CPT 94729 | $682.20 | $2,274.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $1,409.35 | $2,348.91 | not published | 0 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $22,532.22 | $37,553.70 | not published | 0 |
| Digoxin total therapeutic drug level CPT 80162 | $147.60 | $492.00 | not published | 0 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $516.60 | $861.00 | not published | 0 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $260.70 | $869.00 | not published | 0 |
| Dilator fascial 10fx20cm HCPCS C2627 | $845.08 | $2,816.93 | not published | 0 |
| Dilat xst trc new access rcs CPT 50437 | $43,682.95 | $72,804.92 | $9,236.28 – $9,421.01 | 2 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $112.28 | $187.13 | not published | 0 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $7,180.74 | $11,967.90 | not published | 0 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $48.00 | $80.00 | not published | 0 |
| Dipyridamole injection HCPCS J1245 | $117.02 | $195.03 | not published | 0 |
| Disability dlco CPT 94727 | $682.20 | $2,274.00 | not published | 0 |
| Dise eval slp do brth flx dx CPT 42975 | $7,075.15 | $11,791.92 | $1,736.62 – $1,771.35 | 3 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $1,562.70 | $5,209.00 | not published | 0 |
| Dmpk gene detc abnor allele CPT 81234 | $215.70 | $719.00 | not published | 0 |
| Dna antibody native/double stranded CPT 86225 | $277.80 | $926.00 | not published | 0 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $383.76 | $639.60 | not published | 0 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,391.39 | $2,318.99 | not published | 0 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $223.86 | $373.10 | not published | 0 |
| Doppler echo complete CPT 93320 | $371.10 | $1,237.00 | not published | 0 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $4,113.30 | $13,711.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $1,905.90 | $6,353.00 | not published | 0 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $861.60 | $2,872.00 | not published | 0 |
| Dornase alfa non-comp unit HCPCS J7639 | $1,316.35 | $2,193.91 | not published | 0 |
| Dornhoffer fixed part w/window HCPCS L8614 | $68,559.37 | $228,531.25 | not published | 0 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $361.01 | $601.68 | not published | 0 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $1,767.29 | $2,945.48 | not published | 0 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $237.74 | $396.23 | not published | 0 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $270.60 | $902.00 | not published | 0 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $270.60 | $902.00 | not published | 0 |
| Drainage external ear complex 69005 CPT 69005 | $625.20 | $2,084.00 | not published | 0 |
| Drainage external ear simple 69000 CPT 69000 | $270.60 | $902.00 | not published | 0 |
| Drainage mouth roof lesion CPT 42000 | $87.00 | $290.00 | not published | 0 |
| Drainage of arm bursa 23931 CPT 23931 | $625.20 | $2,084.00 | not published | 0 |
| Drainage of kidney lesion CPT 50390 | $675.90 | $2,253.00 | not published | 0 |
| Drainage of mouth lesion CPT 41008 | $2,964.30 | $9,881.00 | not published | 0 |
| Drainage of mouth lesion CPT 41009 | $481.20 | $1,604.00 | not published | 0 |
| Drainage of rectal abscess CPT 45005 | $561.00 | $1,870.00 | not published | 0 |
| Drain blood from under nail 11740 CPT 11740 | $137.10 | $457.00 | not published | 0 |
| Drain cath image guided visceral pq CPT 49405 | $1,562.40 | $5,208.00 | not published | 0 |
| Drain finger abscess;simple 26010 CPT 26010 | $216.60 | $722.00 | not published | 0 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $75.30 | $251.00 | not published | 0 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $143.10 | $477.00 | not published | 0 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $155.70 | $519.00 | not published | 0 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $33,031.96 | $110,106.53 | not published | 0 |
| Drng of eyelid abscess 67700 CPT 67700 | $110.70 | $369.00 | not published | 0 |
| Drng of finger abscess comp 26011 CPT 26011 | $625.20 | $2,084.00 | not published | 0 |
| Drng of scrotum abscess 55100 CPT 55100 | $10,277.07 | $17,128.45 | $2,039.56 – $2,080.35 | 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.