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 |
|---|---|---|---|---|
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $1,255.00 | $1,255.00 | $2.33 – $2.33 | 1 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,345.31 – $1,439.48 | 15 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,195.83 – $1,279.54 | 15 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,288.51 – $3,518.71 | 15 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,046.35 – $1,119.59 | 15 |
| Somatropin injection HCPCS J2941 | not published | not published | $436.99 – $436.99 | 1 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $2,989.55 – $3,198.82 | 15 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $896.87 – $959.65 | 15 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $66.49 – $66.49 | 1 |
| Special radiation dosimetry CPT 77331 | not published | not published | $70.47 – $70.47 | 1 |
| Special radiation treatment CPT 77470 | not published | not published | $140.93 – $140.93 | 1 |
| Special teletx port plan CPT 77321 | not published | not published | $163.22 – $163.22 | 1 |
| Specific gravity body fluid CPT 84315 | $83.00 | $83.00 | $2.52 – $3.51 | 18 |
| Specimen fat stain CPT 89125 | $384.00 | $384.00 | $4.51 – $6.29 | 18 |
| Speech evaluation complex CPT 70371 | not published | not published | $143.92 – $517.79 | 2 |
| Sperm antibody test CPT 89325 | not published | not published | $8.19 – $11.42 | 18 |
| Sperm evaluation test CPT 89329 | not published | not published | $15.04 – $20.96 | 18 |
| Sperm identification CPT 89257 | not published | not published | $49.76 – $213.47 | 2 |
| Sperm isolation complex CPT 89261 | not published | not published | $49.76 – $213.47 | 2 |
| Sperm isolation simple CPT 89260 | not published | not published | $49.76 – $213.47 | 2 |
| Spleen imaging CPT 78185 | not published | not published | $54.70 – $848.52 | 2 |
| Split blood or products CPT 86985 | not published | not published | $149.16 – $639.90 | 2 |
| Sputum specimen collection CPT 89220 | not published | not published | $149.16 – $639.90 | 2 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $10,987.80 – $10,987.80 | 1 |
| Srs cranial lesion complex CPT 61798 | not published | not published | $827.98 – $993.57 | 3 |
| Srs cran les complex addl CPT 61799 | not published | not published | $177.59 – $213.10 | 3 |
| Srs cran les simple addl CPT 61797 | not published | not published | $128.66 – $154.40 | 3 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $175.40 – $187.68 | 15 |
| St analysis behavior qualitative voice/resonance CPT 92524 | not published | not published | $79.34 – $118.71 | 18 |
| Staph a dna amp probe CPT 87640 | not published | not published | $26.95 – $37.55 | 18 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $56.88 – $81.15 | 18 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $56.88 – $81.15 | 18 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | $461.00 | $461.00 | $74.00 – $111.86 | 18 |
| Stem cells total count CPT 86367 | not published | not published | $59.72 – $83.22 | 18 |
| Stereotactic radiation trmt CPT 77432 | not published | not published | $261.31 – $1,484.07 | 4 |
| St evaluate speech sound production CPT 92522 | $714.00 | $714.00 | $80.71 – $121.53 | 18 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $714.00 | $714.00 | $166.07 – $243.96 | 18 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $753.00 | $753.00 | $65.95 – $100.01 | 18 |
| St evaluation swallow function CPT 92610 | $753.00 | $753.00 | $61.94 – $91.63 | 18 |
| Storage/year embryo(s) CPT 89342 | not published | not published | $149.16 – $639.90 | 2 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $291.26 – $1,249.51 | 2 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $149.16 – $639.90 | 2 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $149.16 – $639.90 | 2 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $12.63 – $18.02 | 18 |
| Strep a ag ia CPT 87430 | $536.00 | $536.00 | $12.91 – $17.99 | 18 |
| Strep a dna dir probe CPT 87650 | not published | not published | $15.40 – $21.45 | 18 |
| Strep a dna quant CPT 87652 | not published | not published | $32.06 – $44.68 | 18 |
| Strep b assay w/optic CPT 87802 | $286.00 | $286.00 | $9.77 – $13.62 | 18 |
| Strep b dna amp probe CPT 87653 | not published | not published | $26.95 – $37.55 | 18 |
| Streptokinase antibody CPT 86590 | not published | not published | $9.72 – $13.55 | 18 |
| Streptomycin injection HCPCS J3000 | not published | not published | $19.19 – $89.78 | 4 |
| Streptozocin injection HCPCS J9320 | not published | not published | $464.68 – $464.68 | 1 |
| Str markers spec anal addl CPT 81266 | not published | not published | $304.81 – $326.15 | 15 |
| Str markers specimen anal CPT 81265 | not published | not published | $233.07 – $249.38 | 15 |
| St treatment speech individual CPT 92507 | $550.00 | $550.00 | $55.78 – $82.23 | 18 |
| St treatment swallow dysfunction/oral CPT 92526 | $550.00 | $550.00 | $61.53 – $90.90 | 18 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | not published | not published | $4.11 – $4.11 | 1 |
| Sugars multiple quant CPT 84379 | not published | not published | $8.85 – $12.34 | 18 |
| Sugars single quant CPT 84378 | $200.00 | $200.00 | $8.85 – $12.34 | 18 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $162.00 | $162.00 | $0.04 – $0.11 | 4 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | not published | not published | $502.18 – $502.18 | 1 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $2.70 – $3.85 | 18 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $21.80 – $31.10 | 18 |
| Supprelin la implant HCPCS J9226 | not published | not published | $33,909.00 – $114,441.15 | 4 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $44.21 – $53.06 | 3 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $38.30 – $45.95 | 3 |
| Surgical pathology level 1 gross examination only CPT 88300 | $919.00 | $919.00 | $24.67 – $105.83 | 2 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $1,129.00 | $1,129.00 | $24.67 – $105.83 | 2 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $1,129.00 | $1,129.00 | $49.76 – $213.47 | 2 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $1,129.00 | $1,129.00 | $49.76 – $213.47 | 2 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $3,450.00 | $3,450.00 | $291.26 – $1,249.51 | 2 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $4,510.00 | $4,510.00 | $656.15 – $2,814.88 | 2 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $336.92 – $336.92 | 1 |
| Susceptibility agar dilution per agent CPT 87181 | not published | not published | $3.65 – $5.08 | 18 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $117.00 | $117.00 | $3.65 – $5.08 | 18 |
| Susceptibility mic per plate CPT 87186 | not published | not published | $6.64 – $9.26 | 18 |
| Suscept studies macrobroth dilution ea CPT 87188 | $20.00 | $20.00 | $5.10 – $7.10 | 18 |
| Svc venogram s&i CPT 75827 | not published | not published | $181.66 – $3,163.82 | 2 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $49.76 – $213.47 | 2 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $6.32 – $8.27 | 4 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $6.94 – $20.03 | 4 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | not published | not published | $3.38 – $4.71 | 18 |
| T3 (triiodothyronine) free CPT 84481 | $725.00 | $725.00 | $13.00 – $18.13 | 18 |
| T3 (triiodothyronine) total CPT 84480 | $181.00 | $181.00 | $10.89 – $15.17 | 18 |
| T4 (thyroxine) free CPT 84439 | $272.00 | $272.00 | $6.92 – $9.65 | 18 |
| T4 (thyroxine) total CPT 84436 | $324.00 | $324.00 | $5.27 – $7.35 | 18 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.43 – $1.56 | 4 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.36 – $4.96 | 4 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.14 – $0.53 | 4 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | not published | not published | $191.30 – $695.49 | 4 |
| Tacrolimus therapeutic drug level CPT 80197 | $897.00 | $897.00 | $10.54 – $14.69 | 18 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $10.45 – $37.74 | 4 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $52.78 – $195.94 | 4 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $52.50 – $198.54 | 4 |
| Talymed HCPCS Q4127 | not published | not published | $51.37 – $336.92 | 4 |
| Target gsa panel hmtlmph neop CPT 81450 | not published | not published | $759.53 – $812.70 | 15 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $1,171.00 | $1,171.00 | $2,919.60 – $3,123.97 | 15 |
| Target gsa panel organ neop CPT 81445 | $1,368.00 | $1,368.00 | $597.91 – $639.76 | 15 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,178.08 – $4,151.46 | 4 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.28 – $0.66 | 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.