Maryview Hospital
3636 High St., Portsmouth, VA · Bonsecours · · NPI 1750399192
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 |
|---|---|---|---|---|
| Ghs removal intranasal foreign body CPT 30300 | $192.00 | $320.00 | not published | 0 |
| Ghs removal pharyngeal foreign body CPT 42809 | $1,309.80 | $2,183.00 | not published | 0 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $52.80 | $88.00 | not published | 0 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $44.40 | $74.00 | not published | 0 |
| Ghs sensitivity (per antimicro) CPT 87184 | $76.80 | $128.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $760.80 | $1,268.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $760.80 | $1,268.00 | not published | 0 |
| Ghs sleep study unattended CPT 95800 | $561.00 | $935.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $378.00 | $630.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | $334.20 | $557.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $807.00 | $1,345.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,929.00 | $3,215.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $445.80 | $743.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $445.80 | $743.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $118.20 | $197.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $1,027.80 | $1,713.00 | not published | 0 |
| Giardia lamblia antibody CPT 86674 | $70.20 | $117.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $29.40 | $49.00 | not published | 0 |
| Gjb2 gene full sequence CPT 81252 | $604.80 | $1,008.00 | not published | 0 |
| Glove finger flexion right lg xl HCPCS L3912 | $373.21 | $622.01 | not published | 0 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $1,796.32 | $2,993.86 | not published | 0 |
| Glucagon plasma - sendout CPT 82943 | $82.80 | $138.00 | not published | 0 |
| Glucose 1 hr post dose CPT 82950 | $40.80 | $68.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $35.40 | $59.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $53.40 | $89.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $242.40 | $404.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $41.73 | $69.55 | not published | 0 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $7,496.97 | $12,494.95 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $142.20 | $237.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $133.80 | $223.00 | not published | 0 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $4,417.13 | $7,361.88 | not published | 0 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $7,356.17 | $12,260.28 | not published | 0 |
| Graft axiofill 1000mg HCPCS J3590 | $67,150.47 | $111,917.45 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $99,139.91 | $165,233.18 | not published | 0 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $71,459.30 | $119,098.84 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $6,418.43 | $10,697.38 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $182,565.93 | $304,276.55 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $138,144.00 | $230,240.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $60,438.00 | $100,730.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $22,146.21 | $36,910.35 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $37,557.90 | $62,596.50 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $14,588.44 | $24,314.06 | not published | 0 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $6,475.50 | $10,792.50 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $136,132.28 | $226,887.13 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $11,440.05 | $19,066.75 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $136,374.03 | $227,290.05 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $64,593.11 | $107,655.19 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $445.80 | $743.00 | not published | 0 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $40,327.41 | $67,212.35 | $7,974.65 – $7,974.65 | 1 |
| Grfg autol fat lipo ea addl CPT 15772 | $40,327.41 | $67,212.35 | $7,974.65 – $8,134.14 | 3 |
| G-tube reposition CPT 43761 | $374.40 | $624.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $22,379.33 | $37,298.88 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $34,449.66 | $57,416.10 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $3,021.90 | $5,036.50 | not published | 0 |
| Gw stiffened micro access kit HCPCS C1894 | $29,467.84 | $49,113.07 | not published | 0 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | $168.41 | $280.68 | not published | 0 |
| Halo cervical into jckt vest HCPCS L0810 | $29,139.75 | $48,566.25 | not published | 0 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $90.14 | $150.23 | not published | 0 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $24.00 | $40.00 | not published | 0 |
| Halo repl liner/interface HCPCS L0861 | $4,938.65 | $8,231.08 | not published | 0 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $25.80 | $43.00 | not published | 0 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | $374.07 | $623.45 | not published | 0 |
| Handpiece aquabeam hp2000 HCPCS C2596 | $14,030.25 | $23,383.75 | not published | 0 |
| Hand X-ray CPT 73130 | $480.60 | $801.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $91.80 | $153.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $1,074.00 | $1,790.00 | not published | 0 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | $908.40 | $1,514.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $118.80 | $198.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $179.40 | $299.00 | not published | 0 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $196.80 | $328.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $4,903.20 | $8,172.00 | not published | 0 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $2,915.40 | $4,859.00 | not published | 0 |
| Hdr rdncl skn surf brachytx CPT 77767 | $493.80 | $823.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $2,436.00 | $4,060.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $1,986.60 | $3,311.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $1,420.20 | $2,367.00 | not published | 0 |
| Heel leather reinforced HCPCS L3440 | $297.01 | $495.02 | not published | 0 |
| Heinz bodies direct CPT 85441 | $24.00 | $40.00 | not published | 0 |
| Heinz bodies induced CPT 85445 | $37.20 | $62.00 | not published | 0 |
| Helicobacter pylori antibody igm CPT 86677 | $84.60 | $141.00 | not published | 0 |
| Hematocrit CPT 85014 | $35.40 | $59.00 | not published | 0 |
| Hemodialysis one evaluation CPT 90935 | $940.20 | $1,567.00 | not published | 0 |
| Hemoglobin CPT 85018 | $34.20 | $57.00 | not published | 0 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $105.60 | $176.00 | not published | 0 |
| Hemoglobin plasma CPT 83051 | $64.80 | $108.00 | not published | 0 |
| Hemophilus influenza antibdy CPT 86684 | $145.20 | $242.00 | not published | 0 |
| Heparin assay CPT 85520 | $109.80 | $183.00 | not published | 0 |
| Heparin bolus from bag HCPCS J1644 | $91.49 | $152.48 | not published | 0 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $24.00 | $40.00 | not published | 0 |
| Hepatitis a antibody igm CPT 86709 | $129.00 | $215.00 | not published | 0 |
| Hepatitis b core antibody igm CPT 86705 | $128.40 | $214.00 | not published | 0 |
| Hepatitis b core antibody total CPT 86704 | $102.00 | $170.00 | not published | 0 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $1,990.13 | $3,316.88 | 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.