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 |
|---|---|---|---|---|
| Mayo sirolimus therapeutic drug level CPT 80195 | $810.00 | $810.00 | $10.54 – $14.69 | 18 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $15.00 | $15.00 | $92.03 – $98.47 | 15 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | not published | not published | $3.28 – $4.57 | 18 |
| Mayo tau phosphorylated 217 each CPT 84393 | not published | not published | $128.92 – $137.94 | 15 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | not published | not published | $208.92 – $223.54 | 15 |
| Mayo tgrp testosterone free CPT 84402 | $789.00 | $789.00 | $19.56 – $27.25 | 18 |
| Mayo tgrp testosterone total CPT 84403 | $701.00 | $701.00 | $19.82 – $27.62 | 18 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $541.00 | $541.00 | $17.02 – $23.72 | 18 |
| Mayo thyroglobulin CPT 84432 | $443.00 | $443.00 | $12.33 – $17.18 | 18 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | not published | not published | $7.81 – $10.89 | 18 |
| Mayo ticks babesia microti antibody igg CPT 86753 | not published | not published | $9.51 – $13.26 | 18 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | not published | not published | $39.38 – $54.87 | 18 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | not published | not published | $10.88 – $15.15 | 18 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | not published | not published | $10.39 – $14.49 | 18 |
| Mayo vasoactive intestinal peptide CPT 84586 | $1,324.00 | $1,324.00 | $27.13 – $37.80 | 18 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $472.00 | $472.00 | $15.54 – $21.66 | 18 |
| Mayo vitamin b3 (niacin) CPT 84591 | not published | not published | $13.10 – $18.25 | 18 |
| Mayo vitamin k CPT 84597 | not published | not published | $10.54 – $14.68 | 18 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $676.00 | $676.00 | $10.18 – $14.18 | 18 |
| Mcoln1 gene CPT 81290 | not published | not published | $39.31 – $42.06 | 15 |
| Md inr test revie inter mgmt HCPCS G0250 | not published | not published | $5.29 – $6.35 | 3 |
| Md service required for pmd HCPCS G0372 | not published | not published | $5.29 – $6.35 | 3 |
| Mecasermin injection HCPCS J2170 | not published | not published | $1,226.92 – $1,226.92 | 1 |
| Mechlorethamine hcl inj HCPCS J9230 | not published | not published | $346.96 – $346.96 | 1 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $150.00 – $160.50 | 15 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $527.87 – $564.82 | 15 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $120.00 – $128.40 | 15 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $285.46 – $285.46 | 1 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $169.00 | $169.00 | $1.27 – $1.27 | 1 |
| Melphalan oral 2 mg HCPCS J8600 | not published | not published | $12.40 – $12.40 | 1 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | not published | not published | $197.20 – $336.92 | 4 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | not published | not published | $102.36 – $336.92 | 4 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | not published | not published | $19.73 – $90.37 | 4 |
| Membrane amniotic barrier 4x4cm-q4163-cost per sq cm HCPCS Q4163 | not published | not published | $136.63 – $336.92 | 4 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | $99,999.00 | $99,999.00 | $221,874.56 – $221,874.56 | 1 |
| Membrane placenta tiss biodfence g3 2x2cm-4sqcm-q4116-cost per sq cm HCPCS Q4140 | not published | not published | $126.69 – $336.92 | 4 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | not published | not published | $53.86 – $336.92 | 4 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | not published | not published | $47.47 – $336.92 | 4 |
| Menacwy-tt menb-fhbp vacc im CPT 90623 | not published | not published | $183.45 – $800.51 | 4 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $157.00 | $157.00 | $7.61 – $21.60 | 4 |
| Meperidine/promethazine inj HCPCS J2180 | not published | not published | $20.35 – $20.35 | 1 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | not published | not published | $22.91 – $84.51 | 4 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | not published | not published | $0.32 – $1.01 | 4 |
| Mesh ez derm 7x18 xenograft porcine -cost per sq cm HCPCS Q4136 | not published | not published | $336.92 – $336.92 | 1 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $25.00 | $25.00 | $1.02 – $4.51 | 4 |
| Metabolic Blood Panel (Basic) CPT 80048 | $778.00 | $778.00 | $6.50 – $9.05 | 18 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | $1,135.00 | $1,135.00 | $8.11 – $11.30 | 18 |
| Metabolic panel ionized ca CPT 80047 | $684.00 | $684.00 | $10.54 – $14.69 | 18 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | not published | not published | $1.22 – $5.04 | 4 |
| Methadone injection HCPCS J1230 | not published | not published | $15.68 – $46.91 | 4 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | $333.00 | $333.00 | $4.77 – $12.03 | 4 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $39.00 | $39.00 | $0.15 – $0.40 | 4 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | not published | not published | $1.94 – $6.84 | 4 |
| Methotrexate therapeutic drug level CPT 80204 | not published | not published | $29.62 – $41.27 | 18 |
| Methyldopate hcl injection HCPCS J0210 | not published | not published | $25.68 – $25.68 | 1 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | not published | not published | $26.00 – $26.00 | 1 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $124.00 | $124.00 | $15.97 – $56.60 | 4 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | not published | not published | $5.57 – $5.57 | 1 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | $25.00 | $25.00 | $0.18 – $0.37 | 4 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | not published | not published | $0.08 – $0.32 | 4 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | not published | not published | $0.19 – $0.69 | 4 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $124.00 | $124.00 | $0.85 – $2.86 | 4 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $244.00 | $244.00 | $0.32 – $0.32 | 1 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | $180.00 | $180.00 | $0.02 – $0.08 | 4 |
| Metyrapone panel CPT 80436 | not published | not published | $70.00 – $97.54 | 18 |
| Mgmt promoter methylation analysis CPT 81287 | not published | not published | $124.64 – $133.36 | 15 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | not published | not published | $0.21 – $0.66 | 4 |
| Microalbumin urine screen CPT 82044 | not published | not published | $4.79 – $6.67 | 18 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $30.85 – $42.98 | 18 |
| Microdissection laser CPT 88380 | not published | not published | $78.86 – $338.31 | 2 |
| Microdissection manual CPT 88381 | $1,490.00 | $1,490.00 | $180.05 – $772.41 | 2 |
| Microfluid analy tears CPT 83861 | not published | not published | $17.27 – $24.05 | 18 |
| Microsatellite instability CPT 81301 | not published | not published | $348.56 – $372.96 | 15 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | not published | not published | $0.10 – $0.37 | 4 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $263.39 | $263.39 | $0.13 – $0.48 | 4 |
| Middle cerebral artery echo CPT 76821 | not published | not published | $117.00 – $245.18 | 2 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | not published | not published | $1.18 – $3.58 | 4 |
| Minocycline hydrochloride HCPCS J2265 | not published | not published | $7.08 – $7.08 | 1 |
| Miroderm HCPCS Q4175 | not published | not published | $51.42 – $336.92 | 4 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | not published | not published | $51.05 – $188.60 | 4 |
| Mitochondrial gene CPT 81440 | not published | not published | $3,324.00 – $3,556.68 | 15 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | not published | not published | $19.20 – $69.17 | 4 |
| Mitomycin instillation HCPCS J9281 | not published | not published | $234.75 – $858.36 | 4 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | not published | not published | $20.77 – $81.83 | 4 |
| Mlh1 gene CPT 81288 | not published | not published | $192.32 – $205.78 | 15 |
| Mlh1 gene dup/delete variant CPT 81294 | not published | not published | $202.40 – $216.57 | 15 |
| Mlh1 gene full seq CPT 81292 | not published | not published | $675.40 – $722.68 | 15 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $331.00 – $354.17 | 15 |
| Mlt fam grp bhv train 1st 60 CPT 96202 | not published | not published | $17.32 – $21.81 | 18 |
| Mlt fam grp bhv train ea add CPT 96203 | not published | not published | $4.35 – $6.02 | 18 |
| Mnl appl strs jt radiography CPT 77071 | not published | not published | $182.03 – $208.92 | 2 |
| Mnt subs tx for change dx HCPCS G0270 | not published | not published | $27.38 – $29.30 | 15 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | not published | not published | $12.05 – $40.37 | 18 |
| Molecular pathology interpr HCPCS G0452 | not published | not published | $3.14 – $13.47 | 2 |
| Mometasone sinus sinuva HCPCS J7402 | not published | not published | $8.51 – $30.08 | 4 |
| Monovisc inj per dose HCPCS J7327 | not published | not published | $497.73 – $1,496.64 | 4 |
| Mopath procedure level 1 CPT 81400 | $816.00 | $816.00 | $63.96 – $68.44 | 15 |
| Mopath procedure level 3 CPT 81402 | $1,484.00 | $1,484.00 | $150.33 – $160.85 | 15 |
| Mopath procedure level 5 CPT 81404 | not published | not published | $274.83 – $294.07 | 15 |
| Mopath procedure level 6 CPT 81405 | $3,277.00 | $3,277.00 | $301.35 – $322.44 | 15 |
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.