St Mary's Hospital
5801 Bremo Rd., Richmond, VA · Bonsecours · · NPI 1962464016
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 |
|---|---|---|---|---|
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $481.80 | $803.00 | not published | 0 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,496.40 | $2,494.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $100,510.60 | $167,517.67 | $407.84 – $416.00 | 3 |
| Debride nail1-5 11720 CPT 11720 | $89.40 | $149.00 | not published | 0 |
| Debride nail6 or more 11721 CPT 11721 | $229.80 | $383.00 | not published | 0 |
| Debride skin bone at fx site CPT 11012 | $2,153.40 | $3,589.00 | not published | 0 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $6,255.00 | $10,425.00 | $407.84 – $416.00 | 3 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $3,228.00 | $5,380.00 | $741.49 – $756.32 | 3 |
| Decalcification CPT 88311 | $79.20 | $132.00 | not published | 0 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $492.00 | $820.00 | not published | 0 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $606.00 | $1,010.00 | not published | 0 |
| Decompression of lower leg CPT 27600 | $49,993.03 | $83,321.72 | $7,279.94 – $7,425.54 | 3 |
| Decompression of tibia nerve CPT 28035 | $81,817.10 | $136,361.83 | $3,282.70 – $3,282.70 | 2 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $368.33 | $613.88 | not published | 0 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $3,749.48 | $6,249.14 | not published | 0 |
| Delayed breast prosthesis 19342 CPT 19342 | $45,363.09 | $75,605.15 | $8,200.11 – $8,364.11 | 3 |
| Delay flap eye/nos/ear/lip CPT 15630 | $12,629.71 | $21,049.52 | $2,070.03 – $2,111.43 | 2 |
| Delay flap trunk 15600 CPT 15600 | $22,468.71 | $37,447.85 | $3,928.24 – $4,006.80 | 3 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $185.40 | $309.00 | not published | 0 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $16,351.77 | $27,252.95 | not published | 0 |
| Dentoalveolar/drain abs/cyst/hema 41800 CPT 41800 | $97.20 | $162.00 | not published | 0 |
| Dermapure 1 square cm HCPCS Q4152 | $10,434.85 | $17,391.41 | not published | 0 |
| Design mlc device for imrt CPT 77338 | $664.80 | $1,108.00 | not published | 0 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $84.93 | $141.55 | not published | 0 |
| Desoxycorticosterone CPT 82633 | $166.20 | $277.00 | not published | 0 |
| Destroy internal hemorrhoids destroy 46930 CPT 46930 | $11,107.04 | $18,511.73 | $1,925.18 – $1,963.69 | 3 |
| Destruction anal lesion(s) CPT 46910 | $13,664.20 | $22,773.67 | $2,784.74 – $2,840.43 | 3 |
| Destruction benign lesions < 14 lesions CPT 17110 | $9,218.82 | $15,364.70 | $133.57 – $136.24 | 3 |
| Destruction vag lesions simple 57061 CPT 57061 | $8,710.05 | $14,516.75 | $3,247.71 – $3,312.66 | 3 |
| Developmental screen/score/document 96110 CPT 96110 | $17.40 | $29.00 | not published | 0 |
| Device ablt adv novasure HCPCS C1886 | $25,367.93 | $42,279.88 | not published | 0 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $13,076.25 | $21,793.75 | not published | 0 |
| Device sut capio slim opn HCPCS C2631 | $5,983.69 | $9,972.82 | not published | 0 |
| Device tiss remov myosure reach HCPCS C1782 | $4,844.75 | $8,074.58 | not published | 0 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $147.60 | $246.00 | not published | 0 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $9.31 | $15.51 | not published | 0 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $564.11 | $940.19 | not published | 0 |
| Dextran 40 infusion HCPCS J7100 | $594.51 | $990.85 | not published | 0 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $201.60 | $336.00 | not published | 0 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $193.20 | $322.00 | not published | 0 |
| Dextrose 5 % IV bolus HCPCS J7070 | $235.20 | $392.00 | not published | 0 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $167.40 | $279.00 | not published | 0 |
| Diabetes (HbA1c) Test CPT 83036 | $117.00 | $195.00 | not published | 0 |
| Diag laparo separate proc 49320 CPT 49320 | $15,263.10 | $25,438.50 | $6,065.29 – $6,186.60 | 3 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $97.20 | $162.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $149.40 | $249.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $433.80 | $723.00 | not published | 0 |
| Diagnostic Mammogram (one breast) CPT 77065 | $340.80 | $568.00 | not published | 0 |
| Diagnostic radio unlisted proc CPT 76499 | $181.20 | $302.00 | not published | 0 |
| Dialysis one evaluation CPT 90945 | $2,635.20 | $4,392.00 | not published | 0 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $414.00 | $690.00 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $75.23 | $125.39 | not published | 0 |
| Diffusing capacity CPT 94729 | $642.60 | $1,071.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $45.00 | $75.00 | not published | 0 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $23,576.76 | $39,294.60 | not published | 0 |
| Digoxin total therapeutic drug level CPT 80162 | $74.40 | $124.00 | not published | 0 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $469.35 | $782.25 | not published | 0 |
| Dilate biliary duct/ampulla CPT 47542 | $2,772.60 | $4,621.00 | not published | 0 |
| Dilate esophagus 1/mult pass CPT 43450 | $4,203.81 | $7,006.35 | $909.95 – $928.15 | 3 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $869.40 | $1,449.00 | not published | 0 |
| Dilation of cervical canal 57800 CPT 57800 | $9,186.46 | $15,310.77 | $3,247.71 – $3,312.66 | 3 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $521.40 | $869.00 | not published | 0 |
| Dilator fascial 10fx20cm HCPCS C2627 | $1,660.16 | $2,766.93 | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $45.00 | $75.00 | not published | 0 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $45.00 | $75.00 | not published | 0 |
| Disability dlco CPT 94727 | $103.20 | $172.00 | not published | 0 |
| Disaccharidases CPT 82657 | $114.60 | $191.00 | not published | 0 |
| Dmpk gene detc abnor allele CPT 81234 | $431.40 | $719.00 | not published | 0 |
| Dna antibody native/double stranded CPT 86225 | $70.20 | $117.00 | not published | 0 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $357.60 | $596.00 | not published | 0 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $984.00 | $1,640.00 | not published | 0 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $176.57 | $294.28 | not published | 0 |
| Doppler echo complete CPT 93320 | $1,312.80 | $2,188.00 | not published | 0 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $4,588.20 | $7,647.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $428.40 | $714.00 | not published | 0 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $640.80 | $1,068.00 | not published | 0 |
| Dornase alfa non-comp unit HCPCS J7639 | $1,195.95 | $1,993.25 | not published | 0 |
| Dornhoffer fixed part w/window HCPCS L8614 | $134,685.38 | $224,475.63 | not published | 0 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $1,294.11 | $2,156.85 | not published | 0 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,214.00 | $3,690.00 | not published | 0 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $235.39 | $392.32 | not published | 0 |
| Dpyd gene common variants CPT 81232 | $669.60 | $1,116.00 | not published | 0 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $541.20 | $902.00 | not published | 0 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $541.20 | $902.00 | not published | 0 |
| Drainage external ear complex 69005 CPT 69005 | $1,456.80 | $2,428.00 | not published | 0 |
| Drainage external ear simple 69000 CPT 69000 | $541.20 | $902.00 | not published | 0 |
| Drainage mouth roof lesion CPT 42000 | $174.00 | $290.00 | not published | 0 |
| Drainage of arm bursa 23931 CPT 23931 | $1,250.40 | $2,084.00 | not published | 0 |
| Drainage of kidney lesion CPT 50390 | $1,351.80 | $2,253.00 | not published | 0 |
| Drainage of mouth lesion CPT 41009 | $962.40 | $1,604.00 | not published | 0 |
| Drainage of rectal abscess CPT 45005 | $1,122.00 | $1,870.00 | not published | 0 |
| Drain blood from under nail 11740 CPT 11740 | $272.40 | $454.00 | not published | 0 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $3,124.80 | $5,208.00 | not published | 0 |
| Drain cath image guided visceral pq CPT 49405 | $3,176.40 | $5,294.00 | not published | 0 |
| Drain finger abscess;simple 26010 CPT 26010 | $603.60 | $1,006.00 | not published | 0 |
| Drain neck/chest lesion 21501 CPT 21501 | $8,074.69 | $13,457.82 | $2,914.21 – $2,972.50 | 3 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $392.40 | $654.00 | not published | 0 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $286.20 | $477.00 | not published | 0 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $795.00 | $1,325.00 | not published | 0 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | $64,891.52 | $108,152.53 | not published | 0 |
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.