LEWISGALE HOSPITAL-PULASKI
2400 Lee Hwy, PULASKI, VA · HCA Virginia · · NPI 1205882396
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | not published | not published | $22.48 – $31.33 | 18 |
| 17-hydroxypregnenolone CPT 84143 | not published | not published | $17.51 – $24.41 | 18 |
| 17-ketosteroids CPT 83586 | $320.00 | $320.00 | $9.82 – $13.70 | 18 |
| 2019-ncov diagnostic p HCPCS U0001 | not published | not published | $27.58 – $38.43 | 18 |
| 3d anat seg imaging preop HCPCS C8001 | not published | not published | $198.11 – $198.11 | 1 |
| 3d bn img algor drvd fr MRI HCPCS G0566 | not published | not published | $352.04 – $352.04 | 1 |
| 3-d radiotherapy plan CPT 77295 | not published | not published | $790.54 – $790.54 | 1 |
| 3d recon without postprocess indpndt CPT 76376 | not published | not published | $32.66 – $32.66 | 1 |
| 5' nucleotidase - sendout CPT 83915 | $544.00 | $544.00 | $8.56 – $11.93 | 18 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $235.00 | $235.00 | $19.19 – $82.33 | 2 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | not published | not published | $44.21 – $53.06 | 3 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | not published | not published | $47.40 – $56.88 | 3 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | not published | not published | $50.28 – $60.34 | 3 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | not published | not published | $40.36 – $48.43 | 3 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | not published | not published | $44.21 – $53.06 | 3 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | not published | not published | $44.21 – $53.06 | 3 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | not published | not published | $50.28 – $60.34 | 3 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | not published | not published | $59.37 – $71.24 | 3 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $2,418.00 | $2,418.00 | $32.54 – $118.64 | 4 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | not published | not published | $9.23 – $12.85 | 18 |
| Abciximab injection HCPCS J0130 | not published | not published | $1,528.60 – $1,528.60 | 1 |
| Abd aorta w/runoff s&i CPT 75630 | not published | not published | $234.89 – $6,438.74 | 2 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $13,012.00 | $13,012.00 | $223.86 – $401.74 | 2 |
| Abdominal CT scan (with contrast) CPT 74160 | $11,060.00 | $11,060.00 | $203.91 – $401.74 | 2 |
| Abdominal CT scan (without contrast) CPT 74150 | $10,047.00 | $10,047.00 | $190.96 – $245.18 | 2 |
| Abdominal MRI (with and without contrast) CPT 74183 | $13,505.00 | $13,505.00 | $353.94 – $828.27 | 2 |
| Abdominal MRI (with contrast) CPT 74182 | $8,600.00 | $8,600.00 | $276.23 – $828.27 | 2 |
| Abdominal MRI (without contrast) CPT 74181 | $5,553.00 | $5,553.00 | $232.10 – $517.79 | 2 |
| Abdominal Ultrasound (complete) CPT 76700 | $3,822.00 | $3,822.00 | $130.66 – $245.18 | 2 |
| Abdominal Ultrasound (limited) CPT 76705 | $3,294.00 | $3,294.00 | $95.64 – $245.18 | 2 |
| Abl1 gene CPT 81170 | not published | not published | $300.00 – $321.00 | 15 |
| Abobotulinumtoxina HCPCS J0586 | not published | not published | $6.78 – $23.32 | 4 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | not published | not published | $0.04 – $0.16 | 4 |
| Acetaminophen level CPT 80143 | $513.00 | $513.00 | $14.31 – $19.94 | 18 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $260.00 | $260.00 | $14.29 – $67.81 | 4 |
| Acetone qualitative CPT 82009 | $261.00 | $261.00 | $3.47 – $4.84 | 18 |
| Acetylcholine receptor modulating antibody CPT 86043 | $34.00 | $34.00 | $9.25 – $12.89 | 18 |
| Acetylcholinesterase assay CPT 82013 | $341.00 | $341.00 | $9.44 – $13.15 | 18 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | not published | not published | $0.34 – $0.98 | 4 |
| Acetylcysteine non-comp unit HCPCS J7608 | $93.00 | $93.00 | $6.33 – $22.42 | 4 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $100.85 – $192.60 | 18 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $79.43 – $151.96 | 18 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $26.00 | $26.00 | $12.23 – $15.84 | 18 |
| Acth stimulation panel CPT 80402 | not published | not published | $66.77 – $93.05 | 18 |
| Acth stimulation panel CPT 80406 | not published | not published | $60.09 – $83.74 | 18 |
| Acute hepatitis panel CPT 80074 | $945.00 | $945.00 | $36.57 – $50.96 | 18 |
| Acute venous thrombus image CPT 78456 | not published | not published | $160.37 – $2,938.37 | 2 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $178.00 | $178.00 | $0.03 – $0.32 | 4 |
| #acylcarnitineprfl CPT 82017 | $703.00 | $703.00 | $12.95 – $18.05 | 18 |
| Acylcarnitines qual CPT 82016 | not published | not published | $12.66 – $17.64 | 18 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $144.00 | $144.00 | $0.29 – $1.40 | 4 |
| Adenovirus ag ia CPT 87301 | $39.00 | $39.00 | $9.20 – $12.82 | 18 |
| Adenovirus antibody,serum - quest CPT 86603 | not published | not published | $9.88 – $13.77 | 18 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $16.71 – $23.28 | 18 |
| Adh-sendout CPT 84588 | $848.00 | $848.00 | $26.06 – $36.32 | 18 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | not published | not published | $1.40 – $1.40 | 1 |
| Admin ecg contrast agent CPT 93352 | not published | not published | $21.28 – $25.53 | 3 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $14.04 – $16.85 | 3 |
| Administration vaccine influenza virus HCPCS G0008 | not published | not published | $21.00 – $21.00 | 1 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $11.98 – $14.38 | 3 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $30.83 – $111.80 | 4 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $118.89 – $2,938.37 | 2 |
| Adrenalin epinephrine inject HCPCS J0171 | not published | not published | $0.55 – $0.66 | 3 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $80.96 – $86.63 | 15 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $7,800.06 – $7,800.06 | 1 |
| Afamitresgene autoleucel HCPCS Q2057 | not published | not published | $2,042,143.00 – $2,042,143.00 | 1 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $15.40 – $21.45 | 18 |
| #afb mycobacteria suscep. #1 CPT 87190 | $164.00 | $164.00 | $5.61 – $7.82 | 18 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $769.00 | $769.00 | $88.58 – $123.44 | 18 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $137.00 – $146.59 | 15 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $274.83 – $294.07 | 15 |
| Aflibercept injection HCPCS J0178 | not published | not published | $596.89 – $2,024.34 | 4 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | not published | not published | $68.21 – $68.21 | 1 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | not published | not published | $167.13 – $610.35 | 4 |
| Albumin body fluid quantitative each specimen CPT 82042 | $272.00 | $272.00 | $5.98 – $8.32 | 18 |
| Albumin (human), 25%, 50ml HCPCS P9047 | not published | not published | $39.81 – $140.66 | 4 |
| Albumin, human 25 % intravenous solution HCPCS P9046 | not published | not published | $15.92 – $56.26 | 4 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | not published | not published | $39.81 – $140.66 | 4 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | not published | not published | $7.96 – $28.14 | 4 |
| Albumin ischemia modified CPT 82045 | not published | not published | $26.06 – $36.32 | 18 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $225.00 | $225.00 | $4.44 – $6.18 | 18 |
| Albumin serum plasma or whole blood CPT 82040 | $228.00 | $228.00 | $3.80 – $5.30 | 18 |
| Albuterol ipratrop non-comp HCPCS J7620 | $25.00 | $25.00 | $0.14 – $0.53 | 4 |
| Albuterol non-comp con HCPCS J7611 | $25.00 | $25.00 | $0.14 – $0.69 | 4 |
| Albuterol non-comp unit HCPCS J7613 | not published | not published | $0.06 – $0.19 | 4 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $513.00 | $513.00 | $17.27 – $18.48 | 15 |
| Aldesleukin injection HCPCS J9015 | not published | not published | $8,848.01 – $8,848.01 | 1 |
| Aldosterone suppression eval CPT 80408 | not published | not published | $96.37 – $134.28 | 18 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | not published | not published | $1,831.12 – $6,484.82 | 4 |
| Alkaline phosphatase CPT 84075 | $296.00 | $296.00 | $3.97 – $5.54 | 18 |
| Allergen alpha lactalbumin ige CPT 86008 | not published | not published | $13.77 – $19.19 | 18 |
| Allergen egg white ige CPT 86003 | not published | not published | $4.00 – $5.59 | 18 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $376.00 | $376.00 | $6.12 – $8.53 | 18 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | not published | not published | $62.07 – $336.92 | 4 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | not published | not published | $76.64 – $336.92 | 4 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | not published | not published | $336.92 – $336.92 | 1 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | not published | not published | $18.35 – $336.92 | 4 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | not published | not published | $118.75 – $336.92 | 4 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | not published | not published | $336.92 – $336.92 | 1 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | not published | not published | $96.32 – $336.92 | 4 |
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.