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 |
|---|---|---|---|---|
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $1,673.00 | $1,673.00 | $107.21 – $245.18 | 2 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $1,709.00 | $1,709.00 | $123.69 – $245.18 | 2 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $111.40 – $245.18 | 2 |
| Ultrasound retroperitoneal limited CPT 76775 | $3,437.00 | $3,437.00 | $94.47 – $245.18 | 2 |
| Ultrasound scrotum and contents CPT 76870 | $2,956.00 | $2,956.00 | $103.60 – $245.18 | 2 |
| Ultrasound spinal canal and contents CPT 76800 | not published | not published | $221.49 – $245.18 | 2 |
| Ultrasound transabd ea addl gest CPT 76812 | not published | not published | $299.44 – $299.44 | 1 |
| Ultrasound transvaginal non obstetric CPT 76830 | $3,669.00 | $3,669.00 | $113.08 – $245.18 | 2 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $260.13 – $401.74 | 2 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $137.43 – $137.43 | 1 |
| Ultraviolet therapy CPT 97028 | not published | not published | $5.95 – $9.30 | 18 |
| Unlisted CT procedure CPT 76497 | not published | not published | $182.03 – $182.03 | 1 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $49.76 – $213.47 | 2 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $49.76 – $213.47 | 2 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $182.03 – $182.03 | 1 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted misc path test CPT 89240 | not published | not published | $49.76 – $213.47 | 2 |
| Unlisted mr procedure CPT 76498 | not published | not published | $182.03 – $182.03 | 1 |
| Unlisted muscskel px dx nuc CPT 78399 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted nrvs sys px dx nuc CPT 78699 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $49.76 – $213.47 | 2 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted surgical path px CPT 88399 | not published | not published | $49.76 – $213.47 | 2 |
| Unlisted transfusion med px CPT 86999 | not published | not published | $24.67 – $105.83 | 2 |
| Unlisted ultrasound procedure CPT 76999 | not published | not published | $182.03 – $182.03 | 1 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $848.52 – $848.52 | 1 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $13,226.00 | $13,226.00 | $368.12 – $828.27 | 2 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | not published | not published | $286.91 – $828.27 | 2 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $11,071.00 | $11,071.00 | $237.77 – $517.79 | 2 |
| Urea nitrogen CPT 84520 | $252.00 | $252.00 | $3.03 – $4.23 | 18 |
| Urea nitrogen 24 hour urine CPT 84540 | $216.00 | $216.00 | $4.27 – $5.95 | 18 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $5.53 – $7.70 | 18 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $3.94 – $5.49 | 18 |
| Ureteral reflux study CPT 78740 | not published | not published | $94.85 – $848.52 | 2 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $53.57 – $517.79 | 2 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $54.81 – $517.79 | 2 |
| Uric acid blood CPT 84550 | $279.00 | $279.00 | $3.47 – $4.84 | 18 |
| Uric acid urine CPT 84560 | not published | not published | $3.90 – $5.44 | 18 |
| Urinalysis glass test CPT 81020 | not published | not published | $3.61 – $5.03 | 18 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $2.34 – $3.26 | 18 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | $87.00 | $87.00 | $1.67 – $2.32 | 18 |
| Urinalysis (with microscopy) CPT 81001 | $177.00 | $177.00 | $2.44 – $3.39 | 18 |
| Urinalysis (without microscopy) CPT 81003 | not published | not published | $1.72 – $2.41 | 18 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $27.16 – $27.16 | 1 |
| Urine Culture Test CPT 87086 | $117.00 | $117.00 | $6.20 – $8.63 | 18 |
| Urine pregnancy test CPT 81025 | $349.00 | $349.00 | $6.61 – $9.21 | 18 |
| Urine screen for bacteria CPT 81007 | not published | not published | $23.02 – $32.08 | 18 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $3.00 – $9.99 | 15 |
| Urography, antegrade CPT 74425 | not published | not published | $82.69 – $828.27 | 2 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $80.70 – $401.74 | 2 |
| Use 1st target lesion CPT 76982 | not published | not published | $98.08 – $245.18 | 2 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | $3,121.00 | $3,121.00 | $9.61 – $33.10 | 4 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $1,080.43 – $1,080.43 | 1 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $121.24 – $428.37 | 4 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $110.30 – $389.71 | 4 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $116.93 – $446.18 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $65.84 – $251.22 | 4 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $49.16 – $173.50 | 4 |
| Vaccine dtap < 7 years im CPT 90700 | $50.00 | $50.00 | $23.84 – $98.16 | 4 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $82.38 – $351.66 | 4 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $50.87 – $208.53 | 4 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $124.57 – $529.81 | 4 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $95.45 – $374.37 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $24.31 – $99.69 | 4 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $10.56 – $43.25 | 4 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | $355.00 | $355.00 | $54.12 – $194.88 | 4 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $105.28 – $449.49 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $31.00 – $113.98 | 4 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $83.21 – $83.21 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $56.36 – $199.15 | 4 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | $443.00 | $443.00 | $52.78 – $199.15 | 4 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $133.17 – $470.53 | 4 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $308.00 | $308.00 | $23.75 – $87.98 | 4 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | $497.00 | $497.00 | $244.55 – $1,046.11 | 4 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $300.06 – $300.06 | 1 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $217.00 | $217.00 | $62.62 – $260.12 | 4 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $62.62 – $260.12 | 4 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $16.39 – $58.49 | 4 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $89.00 | $89.00 | $16.76 – $61.53 | 4 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $27.64 – $131.18 | 4 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $8.20 – $29.23 | 4 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $188.51 – $798.76 | 4 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $151.26 – $717.99 | 4 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $562.81 – $562.81 | 1 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $134.64 – $561.54 | 4 |
| Vaccine mmr live subcutaneous CPT 90707 | $575.00 | $575.00 | $75.68 – $310.42 | 4 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $221.14 – $917.96 | 4 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $100.10 – $353.70 | 4 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $193.49 – $683.30 | 4 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $195.86 – $713.67 | 4 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $234.67 – $829.19 | 4 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $33.90 – $151.63 | 4 |
| Vaccine rabies im CPT 90675 | $4,071.00 | $4,071.00 | $238.25 – $847.34 | 4 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $234.52 – $1,014.63 | 4 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $413.21 – $1,892.29 | 4 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $413.21 – $1,892.29 | 4 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $233.73 – $974.19 | 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.