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 |
|---|---|---|---|---|
| Drng of eyelid abscess 67700 CPT 67700 | $221.40 | $369.00 | not published | 0 |
| Drng of finger abscess comp 26011 CPT 26011 | $2,401.20 | $4,002.00 | not published | 0 |
| Drng of scrotum abscess 55100 CPT 55100 | $3,495.60 | $5,826.00 | not published | 0 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $19.36 | $32.26 | not published | 0 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $45.00 | $75.00 | not published | 0 |
| Drop lock knee HCPCS L2182 | $408.50 | $680.84 | not published | 0 |
| Drop lock retainer each HCPCS L2785 | $139.76 | $232.93 | not published | 0 |
| Drsg interceed 3x4in adh wnd barr absorb HCPCS C1765 | $13,599.30 | $22,665.50 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $9,016.07 | $15,026.79 | not published | 0 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $36,482.74 | $60,804.56 | not published | 0 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $8,526.08 | $14,210.14 | not published | 0 |
| Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm HCPCS A2008 | $51,002.60 | $85,004.34 | not published | 0 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $72,642.86 | $121,071.43 | not published | 0 |
| Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm HCPCS A2007 | $51,206.60 | $85,344.33 | not published | 0 |
| Drug admin & hemodynmic meas CPT 93463 | $674.40 | $1,124.00 | not published | 0 |
| Drug assay caffeine CPT 80155 | $90.60 | $151.00 | not published | 0 |
| Drug assay rufinamide CPT 80210 | $62.40 | $104.00 | not published | 0 |
| Drug assay vedolizumab CPT 80280 | $460.20 | $767.00 | not published | 0 |
| Drug assay voriconazole CPT 80285 | $90.60 | $151.00 | not published | 0 |
| Drug asy hydroxychloroquine CPT 80220 | $127.80 | $213.00 | not published | 0 |
| Drug test def 1-7 classes HCPCS G0480 | $600.60 | $1,001.00 | not published | 0 |
| Drug test prsmv instrmnt CPT 80306 | $11.40 | $19.00 | not published | 0 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $660.60 | $1,101.00 | not published | 0 |
| Drvvt confirm - quest CPT 85597 | $118.80 | $198.00 | not published | 0 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $372.60 | $621.00 | not published | 0 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $1,314.00 | $2,190.00 | not published | 0 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $508.20 | $847.00 | not published | 0 |
| Duragen 1x1 5ea/bx HCPCS C9354 | $37,630.94 | $62,718.23 | not published | 0 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $21,129.73 | $35,216.22 | not published | 0 |
| Dx bronchoscope/brush 31623 CPT 31623 | $28,595.56 | $47,659.27 | $7,080.53 – $7,222.14 | 3 |
| Dx bronchoscope/lavage 31624 CPT 31624 | $28,095.44 | $46,825.73 | $7,080.53 – $7,222.14 | 3 |
| Dx bronchoscope/wash 31622 CPT 31622 | $3,331.20 | $5,552.00 | not published | 0 |
| Ear cartilage graft CPT 21235 | $25,103.21 | $41,838.68 | $5,939.19 – $6,057.97 | 3 |
| Ear irrigation 69209 CPT 69209 | $48.00 | $80.00 | not published | 0 |
| Ecg 12 lead tracing only CPT 93005 | $226.20 | $377.00 | not published | 0 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | $190.80 | $318.00 | not published | 0 |
| Ecg < 30 days transmission & analysis CPT 93271 | $393.60 | $656.00 | not published | 0 |
| Ecg external < 48 hours recording CPT 93225 | $525.00 | $875.00 | not published | 0 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $78.60 | $131.00 | not published | 0 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $128.40 | $214.00 | not published | 0 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $3,630.60 | $6,051.00 | not published | 0 |
| Echocardiography doppler color flow mapping CPT 93325 | $672.60 | $1,121.00 | not published | 0 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $2,967.60 | $4,946.00 | not published | 0 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $1,197.00 | $1,995.00 | not published | 0 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $402.00 | $670.00 | not published | 0 |
| Echo exam of fetal heart CPT 76825 | $1,419.60 | $2,366.00 | not published | 0 |
| Echo exam of fetal heart CPT 76826 | $405.60 | $676.00 | not published | 0 |
| Echo exam of fetal heart CPT 76827 | $70.20 | $117.00 | not published | 0 |
| Echo exam of fetal heart CPT 76828 | $70.20 | $117.00 | not published | 0 |
| Echo exam uterus 76831- CPT 76831 | $190.80 | $318.00 | not published | 0 |
| Echo guide for amniocentesis CPT 76946 | $1,315.20 | $2,192.00 | not published | 0 |
| Echo guide villus sampling CPT 76945 | $372.60 | $621.00 | not published | 0 |
| Echo stress CPT 93350 | $1,653.60 | $2,756.00 | not published | 0 |
| Echo tee guidance CPT 93355 | $4,576.20 | $7,627.00 | not published | 0 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $2,698.20 | $4,497.00 | not published | 0 |
| Echo transesophageal CPT 93313 | $2,446.20 | $4,077.00 | not published | 0 |
| Echo transesophageal intraop CPT 93318 | $1,939.20 | $3,232.00 | not published | 0 |
| Echo transthoracic CPT 93303 | $2,373.00 | $3,955.00 | not published | 0 |
| Ecmo/ecls daily mgmt artery 33949 CPT 33949 | $442.20 | $737.00 | not published | 0 |
| Ecmo/ecls daily mgmt-venous 33948 CPT 33948 | $442.20 | $737.00 | not published | 0 |
| Ecmo/ecls initiation artery 33947 CPT 33947 | $1,162.80 | $1,938.00 | not published | 0 |
| Ecmo/ecls initiation venous 33946 CPT 33946 | $10,070.40 | $16,784.00 | not published | 0 |
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | $30,918.98 | $51,531.63 | not published | 0 |
| Edu/train/pt/nonmd/in person/30 min98960 CPT 98960 | $105.60 | $176.00 | not published | 0 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | $336.60 | $561.00 | not published | 0 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | $1,007.40 | $1,679.00 | not published | 0 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | $2,401.80 | $4,003.00 | not published | 0 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | $1,426.80 | $2,378.00 | not published | 0 |
| Eeg recording awake and asleep CPT 95819 | $3,283.20 | $5,472.00 | not published | 0 |
| Eeg without vid 2-12hr cont mntr CPT 95707 | $588.60 | $981.00 | not published | 0 |
| Eeg without vid 2-12 hr unmntr CPT 95705 | $588.60 | $981.00 | not published | 0 |
| Eeg without vid ea 12-26hr cont CPT 95710 | $1,003.20 | $1,672.00 | not published | 0 |
| Eeg wo vid 2-12hr intmt mntr CPT 95706 | $611.40 | $1,019.00 | not published | 0 |
| E equine encephalitis igg CPT 86652 | $130.20 | $217.00 | not published | 0 |
| Egd control bleeding any CPT 43255 | $10,462.60 | $17,437.67 | $1,925.18 – $1,963.69 | 3 |
| Egd dilate stricture CPT 43245 | $5,292.50 | $8,820.83 | $1,925.18 – $1,963.69 | 3 |
| Egd endo mucosal resection CPT 43254 | $8,525.48 | $14,209.13 | $3,868.08 – $3,945.44 | 3 |
| Egd esophagogastrc fndoplsty CPT 43210 | $57,149.97 | $95,249.95 | $10,664.59 – $10,877.88 | 3 |
| Egd guide wire insertion CPT 43248 | $4,940.79 | $8,234.65 | $909.95 – $928.15 | 3 |
| Egd lesion ablation CPT 43270 | $17,465.03 | $29,108.38 | $1,925.18 – $1,963.69 | 3 |
| Egd remove foreign body CPT 43247 | $4,331.85 | $7,219.75 | $909.95 – $928.15 | 3 |
| Egd remove lesion snare CPT 43251 | $5,938.80 | $9,898.00 | $1,925.18 – $1,963.69 | 3 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | $4,127.28 | $6,878.80 | $1,925.18 – $1,963.69 | 3 |
| Egd Ultrasound fine needle bx/aspir CPT 43238 | $7,930.70 | $13,217.83 | $1,925.18 – $1,963.69 | 3 |
| Egd Ultrasound fine needle bx/aspir CPT 43242 | $7,595.55 | $12,659.25 | $1,925.18 – $1,963.69 | 3 |
| Egd Ultrasound transmural injxn/mark CPT 43253 | $39,805.76 | $66,342.93 | $1,925.18 – $1,963.69 | 3 |
| Egd varices ligation CPT 43244 | $5,187.86 | $8,646.43 | $1,925.18 – $1,963.69 | 3 |
| Egfr gene com variants CPT 81235 | $1,096.80 | $1,828.00 | not published | 0 |
| Ehrlicha chaffeensis amp prb CPT 87484 | $115.80 | $193.00 | not published | 0 |
| Electrd sq emblem s-icd HCPCS C1896 | $28,192.40 | $46,987.33 | not published | 0 |
| Electrolyte panel CPT 80051 | $54.00 | $90.00 | not published | 0 |
| Electron microscopy diagnostic CPT 88348 | $1,083.60 | $1,806.00 | not published | 0 |
| Electrophysiology evaluation CPT 93620 | $12,438.00 | $20,730.00 | not published | 0 |
| Electrophysiology evaluation CPT 93621 | $7,083.60 | $11,806.00 | not published | 0 |
| Electrophysiology evaluation CPT 93622 | $6,839.40 | $11,399.00 | not published | 0 |
| Electrophysiology evaluation CPT 93641 | $2,047.80 | $3,413.00 | not published | 0 |
| Electrophysiology evaluation CPT 93642 | $2,452.80 | $4,088.00 | not published | 0 |
| Electrophys map 3d add-on CPT 93613 | $5,762.40 | $9,604.00 | not published | 0 |
| Embolization s&i CPT 75894 | $4,879.80 | $8,133.00 | not published | 0 |
| Embo or occlude vascular arterial s&i CPT 37242 | $87,943.52 | $146,572.53 | $18,391.57 – $18,759.41 | 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.