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 |
|---|---|---|---|---|
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $209.00 | $209.00 | $60.76 – $209.06 | 4 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $36.05 – $125.58 | 4 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $316.60 – $316.60 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $773.00 | $773.00 | $15.98 – $22.27 | 18 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $645.00 | $645.00 | $15.98 – $22.27 | 18 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $19.63 – $27.36 | 18 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | not published | not published | $9.20 – $12.82 | 18 |
| Immunodiffusion nes CPT 86329 | not published | not published | $10.79 – $15.03 | 18 |
| Immunofixation electrophoresis serum CPT 86334 | $744.00 | $744.00 | $17.15 – $23.90 | 18 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | not published | not published | $81.30 – $348.78 | 2 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | not published | not published | $291.26 – $1,249.51 | 2 |
| Immunoglobulin assay CPT 86023 | $945.00 | $945.00 | $9.57 – $13.33 | 18 |
| Immunotherapy 2/> injections CPT 95125 | not published | not published | $63.02 – $75.62 | 3 |
| Imported lipodox inj HCPCS Q2049 | $4,839.00 | $4,839.00 | $791.66 – $791.66 | 1 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $32.36 – $114.56 | 4 |
| In-111 autologous plt stdy dx HCPCS A9571 | not published | not published | $12,713.03 – $12,713.03 | 1 |
| In-111 autol wbc diag per dose HCPCS A9570 | not published | not published | $2,923.45 – $2,923.45 | 1 |
| In-111 capromab pendet HCPCS A9507 | not published | not published | $4,585.27 – $4,585.27 | 1 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $10,893.22 – $10,893.22 | 1 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $3,614.00 | $3,614.00 | $2,203.37 – $2,203.37 | 1 |
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $3,614.00 | $3,614.00 | $1,975.89 – $1,975.89 | 1 |
| In-111 pentetreotide HCPCS A9572 | $10,030.00 | $10,030.00 | $5,302.49 – $5,302.49 | 1 |
| In-111 satumomab pend HCPCS A4642 | not published | not published | $4,442.43 – $4,442.43 | 1 |
| Inactivated je vacc im CPT 90738 | not published | not published | $810.13 – $810.13 | 1 |
| Incobotulinumtoxin a HCPCS J0588 | not published | not published | $4.00 – $13.91 | 4 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | not published | not published | $24.65 – $24.65 | 1 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $70.20 – $75.11 | 15 |
| Infect ag drug suscept pheno predict CPT 87900 | $388.00 | $388.00 | $100.09 – $139.47 | 18 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $11.52 – $16.05 | 18 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $10.85 – $15.12 | 18 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $197.69 – $275.47 | 18 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $197.69 – $275.47 | 18 |
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $98.84 – $137.74 | 18 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | not published | not published | $197.69 – $275.47 | 18 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $239.00 | $239.00 | $25.16 – $35.06 | 18 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $27.10 – $37.76 | 18 |
| Infect ag ia optc obs influenza CPT 87804 | not published | not published | $12.71 – $17.71 | 18 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $9.20 – $12.82 | 18 |
| Infect ag if hep delta agent CPT 87380 | $947.00 | $947.00 | $14.10 – $19.65 | 18 |
| Infect ag if influenza a CPT 87276 | not published | not published | $12.34 – $17.19 | 18 |
| Infect ag if influenza b CPT 87275 | not published | not published | $9.40 – $13.11 | 18 |
| Infect ag if legionella pneumophila CPT 87278 | $632.00 | $632.00 | $11.98 – $16.69 | 18 |
| Infect ag if nos ea CPT 87299 | not published | not published | $12.36 – $17.23 | 18 |
| Infect ag if pneumocystis carinii CPT 87281 | $36.00 | $36.00 | $9.20 – $12.82 | 18 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $10.30 – $14.36 | 18 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $41.05 – $57.21 | 18 |
| Infect ag na hep b amp CPT 87516 | not published | not published | $26.95 – $37.55 | 18 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $32.89 – $45.84 | 18 |
| Infect ag na hpv high-risk types CPT 87624 | $349.00 | $349.00 | $26.95 – $37.55 | 18 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $630.00 | $630.00 | $73.56 – $102.51 | 18 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $39.40 – $54.90 | 18 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $114.00 | $114.00 | $50.26 – $60.31 | 18 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $1,706.00 | $1,706.00 | $320.02 – $445.95 | 18 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $375.22 – $522.87 | 18 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $20.02 – $27.89 | 18 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $41.38 – $141.47 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | not published | not published | $9.20 – $12.82 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $10.30 – $14.36 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $577.00 | $577.00 | $10.61 – $14.79 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $384.00 | $384.00 | $9.20 – $12.82 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $976.00 | $976.00 | $11.04 – $15.39 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $166.00 | $166.00 | $7.94 – $11.05 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $162.00 | $162.00 | $7.94 – $11.05 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | not published | not published | $18.49 – $25.77 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | not published | not published | $9.20 – $12.82 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $492.00 | $492.00 | $9.20 – $12.82 | 18 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $252.00 | $252.00 | $9.20 – $12.82 | 18 |
| Infectious agent nucleic acid amplified probe CPT 87798 | not published | not published | $26.95 – $37.55 | 18 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $438.00 | $438.00 | $26.95 – $37.55 | 18 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | not published | not published | $28.62 – $39.88 | 18 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,051.00 | $1,051.00 | $320.02 – $445.95 | 18 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $1,176.00 | $1,176.00 | $26.95 – $37.55 | 18 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $364.00 | $364.00 | $26.95 – $37.55 | 18 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $1,142.00 | $1,142.00 | $32.00 – $44.60 | 18 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $438.00 | $438.00 | $26.95 – $37.55 | 18 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | not published | not published | $39.40 – $54.90 | 18 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | not published | not published | $109.52 – $152.61 | 18 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $109.52 – $152.61 | 18 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $26.95 – $37.55 | 18 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $105.00 | $105.00 | $26.95 – $37.55 | 18 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $211.00 | $211.00 | $70.18 – $75.09 | 15 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $230.00 | $230.00 | $76.77 – $82.14 | 15 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $679.77 – $727.35 | 15 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,189.00 | $1,189.00 | $320.02 – $445.95 | 18 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $98.50 – $137.27 | 18 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $201.94 – $281.40 | 18 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | not published | not published | $32.89 – $45.84 | 18 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $1,282.00 | $1,282.00 | $32.89 – $45.84 | 18 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $1,301.00 | $1,301.00 | $32.89 – $45.84 | 18 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $1,461.00 | $1,461.00 | $65.35 – $91.06 | 18 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | $718.00 | $718.00 | $109.52 – $152.61 | 18 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $22.89 – $85.91 | 4 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $14.81 – $63.10 | 4 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $11.93 – $64.18 | 4 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $22.44 – $31.27 | 18 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $62.62 – $260.12 | 4 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $21.65 – $78.73 | 4 |
| Infuse radioactive materials CPT 77750 | not published | not published | $484.09 – $484.09 | 1 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $28.23 – $33.88 | 3 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $36.62 – $43.94 | 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.