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 |
|---|---|---|---|---|
| Ghs semen analysis fert CPT 89320 | $573.00 | $573.00 | $9.45 – $13.17 | 18 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $7.55 – $10.53 | 18 |
| Ghs sensitivity (per antimicro) CPT 87184 | $252.00 | $252.00 | $5.75 – $8.00 | 18 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $35.29 – $51.45 | 18 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $74.91 – $110.73 | 18 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $52.84 – $77.11 | 18 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $5.60 – $7.81 | 18 |
| Ghs urine, hydroxproline total CPT 83505 | $1,010.00 | $1,010.00 | $18.66 – $26.00 | 18 |
| Ghs urine, porphyrins quant CPT 84120 | $676.00 | $676.00 | $11.29 – $15.74 | 18 |
| Giardia ag if CPT 87269 | not published | not published | $10.45 – $14.56 | 18 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $11.30 – $15.75 | 18 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $150.51 – $517.79 | 2 |
| Gi inhouse confirmation CPT 87045 | $382.00 | $382.00 | $7.25 – $10.10 | 18 |
| Gi protein loss CPT 78282 | not published | not published | $52.40 – $848.52 | 2 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $108.20 | 15 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $65.83 | 15 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $37.45 | 15 |
| Glassia injection HCPCS J0257 | not published | not published | $4.09 – $15.08 | 4 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $1,981.00 | $1,981.00 | $143.07 – $436.88 | 4 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $112.83 – $379.61 | 4 |
| Glucagon plasma - sendout CPT 82943 | $734.00 | $734.00 | $10.97 – $15.29 | 18 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $35.38 – $49.29 | 18 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $38.78 – $54.04 | 18 |
| Glucagon tolerance test CPT 82946 | not published | not published | $13.64 – $19.01 | 18 |
| Glucose 1 hr post dose CPT 82950 | not published | not published | $3.65 – $5.08 | 18 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $4.64 – $6.47 | 18 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $2.52 – $3.51 | 18 |
| Glucose blood quantitative CPT 82947 | $269.00 | $269.00 | $3.01 – $4.21 | 18 |
| Glucose body fluid CPT 82945 | not published | not published | $3.01 – $4.21 | 18 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | not published | not published | $9.88 – $13.77 | 18 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $146.00 | $146.00 | $3.01 – $4.19 | 18 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.38 – $1.01 | 4 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $36.28 – $36.28 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $8.08 – $30.82 | 4 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $643.00 | $643.00 | $14.27 – $19.88 | 18 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $113.95 – $158.80 | 18 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $584.00 | $584.00 | $14.22 – $19.82 | 18 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $528.86 – $2,060.38 | 4 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $22.77 – $336.92 | 4 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $336.92 – $950.37 | 4 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $47.71 – $336.92 | 4 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $336.92 – $336.92 | 1 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $5,293.38 – $5,293.38 | 1 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $49.06 – $336.92 | 4 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | not published | not published | $79.09 – $336.92 | 4 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $102.28 – $336.92 | 4 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $38.84 – $336.92 | 4 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $336.92 – $336.92 | 1 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | not published | not published | $336.92 – $336.92 | 1 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | not published | not published | $336.92 – $336.92 | 1 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $28.13 – $336.92 | 4 |
| Granisetron 1 mg tab HCPCS Q0166 | not published | not published | $156.48 – $156.48 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.20 – $0.40 | 4 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $14.80 – $15.84 | 15 |
| Group train without patient HCPCS G0543 | not published | not published | $6.53 – $7.84 | 3 |
| Growth hormone antibody CPT 86277 | not published | not published | $12.08 – $16.84 | 18 |
| Growth hormone panel CPT 80428 | not published | not published | $51.22 – $71.37 | 18 |
| Growth hormone panel CPT 80430 | not published | not published | $99.31 – $138.38 | 18 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $75.60 – $80.89 | 15 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $138.22 – $4,034.23 | 2 |
| Hair analysis HCPCS P2031 | not published | not published | $4.95 – $5.30 | 15 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $265.00 | $265.00 | $3.46 – $10.44 | 4 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $124.00 | $124.00 | $0.58 – $1.93 | 4 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $5.58 – $23.94 | 2 |
| Hand X-ray CPT 73130 | not published | not published | $30.39 – $182.03 | 2 |
| Haptoglobin quantitative CPT 83010 | $553.00 | $553.00 | $9.66 – $13.46 | 18 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $642.00 | 15 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $216.57 | 15 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $401.52 | 15 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $347.30 | 15 |
| Hbb gene com variants CPT 81361 | not published | not published | $174.81 – $187.05 | 15 |
| Hbb gene dup/del variants CPT 81363 | not published | not published | $202.40 – $216.57 | 15 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $401.52 | 15 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $7.46 – $10.39 | 18 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $187.43 – $401.74 | 2 |
| Hcg free betachain test CPT 84704 | not published | not published | $11.74 – $16.36 | 18 |
| Hcg qualitative CPT 84703 | not published | not published | $5.78 – $8.05 | 18 |
| Hcg quantitative CPT 84702 | not published | not published | $11.56 – $16.10 | 18 |
| Hc hearing aid exam both ears CPT 92591 | not published | not published | $315.09 – $378.11 | 3 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | not published | not published | $258.45 – $258.45 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $155.94 – $1,101.15 | 2 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $848.52 – $848.52 | 1 |
| Hc nm kidney imaging with flow CPT 78701 | $1,963.00 | $1,963.00 | $80.36 – $848.52 | 2 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $148.31 – $1,101.15 | 2 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $247.42 – $2,938.37 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $358.61 – $358.61 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $701.26 – $701.26 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $987.79 – $987.79 | 1 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $192.75 – $192.75 | 1 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $259.58 – $259.58 | 1 |
| Head CT scan (with and without contrast) CPT 70470 | $11,678.00 | $11,678.00 | $203.91 – $401.74 | 2 |
| Head CT scan (with contrast) CPT 70460 | $9,304.00 | $9,304.00 | $181.56 – $401.74 | 2 |
| Head CT scan (without contrast) CPT 70450 | $7,951.00 | $7,951.00 | $137.43 – $245.18 | 2 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $679.57 – $727.14 | 15 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $1,625.00 – $1,738.75 | 15 |
| Heart first pass add-on CPT 78496 | not published | not published | $70.47 – $70.47 | 1 |
| Heart first pass multiple CPT 78483 | not published | not published | $235.16 – $1,101.15 | 2 |
| Heart image spect CPT 78494 | not published | not published | $190.38 – $848.52 | 2 |
| Heart infarct image CPT 78466 | not published | not published | $109.75 – $848.52 | 2 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $128.60 – $1,101.15 | 2 |
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.