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 |
|---|---|---|---|---|
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $197.40 | $329.00 | not published | 0 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $197.40 | $329.00 | not published | 0 |
| Ghs myocardial strain img spckl track CPT 93356 | $712.80 | $1,188.00 | not published | 0 |
| Ghs nailbed repair/nail removal CPT 11760 | $14,157.10 | $23,595.17 | $741.49 – $756.32 | 3 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $1,217.40 | $2,029.00 | not published | 0 |
| Ghs nerve blk intercostal, single level CPT 64420 | $952.80 | $1,588.00 | not published | 0 |
| Ghs nerve block axillary nerve CPT 64417 | $1,793.40 | $2,989.00 | not published | 0 |
| Ghs nerve block brachial plexus CPT 64415 | $2,104.80 | $3,508.00 | not published | 0 |
| Ghs nerve block celiac plexus CPT 64530 | $653.40 | $1,089.00 | not published | 0 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $950.40 | $1,584.00 | not published | 0 |
| Ghs nerve block sciatic nerve CPT 64445 | $2,112.00 | $3,520.00 | not published | 0 |
| Ghs nerve block suprascapular CPT 64418 | $501.00 | $835.00 | not published | 0 |
| Ghs ng placement w fluoro guidance CPT 43752 | $544.20 | $907.00 | not published | 0 |
| Ghs ob unlisted IV or art inj or infusion CPT 96379 | $88.20 | $147.00 | not published | 0 |
| Ghs opcc repair cvp without subq port CPT 36575 | $483.00 | $805.00 | not published | 0 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $57.00 | $95.00 | not published | 0 |
| Ghs ot group caregiver training CPT 97552 | $40.80 | $68.00 | not published | 0 |
| Ghs pacing - transcutaneous CPT 92953 | $490.20 | $817.00 | not published | 0 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $307.20 | $512.00 | not published | 0 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $1,076.40 | $1,794.00 | not published | 0 |
| Ghs peritonsillar abscess i andd CPT 42700 | $1,132.80 | $1,888.00 | not published | 0 |
| Ghs phenylketonurid CPT 84030 | $19.80 | $33.00 | not published | 0 |
| Ghs picc line insert < 5 CPT 36568 | $2,572.20 | $4,287.00 | not published | 0 |
| Ghs plngl fx pm cl CPT 26725 | $172.80 | $288.00 | not published | 0 |
| Ghs polysom <6 yrs 4/> parameters CPT 95782 | $2,275.80 | $3,793.00 | not published | 0 |
| Ghs ppd (tb intradermal) CPT 86580 | $16.20 | $27.00 | not published | 0 |
| Ghs protoporphyrins fract CPT 84202 | $118.20 | $197.00 | not published | 0 |
| Ghs pr without cont pulse ox CPT 94625 | $126.60 | $211.00 | not published | 0 |
| Ghs pseudocholinesterase,dibucain-inhibi CPT 82638 | $70.20 | $117.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $46.20 | $77.00 | not published | 0 |
| Ghs removal intranasal foreign body CPT 30300 | $278.40 | $464.00 | not published | 0 |
| Ghs removal pharyngeal foreign body CPT 42809 | $427.20 | $712.00 | not published | 0 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $10.20 | $17.00 | not published | 0 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $44.40 | $74.00 | not published | 0 |
| Ghs sensitivity (per antimicro) CPT 87184 | $108.60 | $181.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $941.40 | $1,569.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $941.40 | $1,569.00 | not published | 0 |
| Ghs sleep study unattended CPT 95800 | $783.00 | $1,305.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $226.80 | $378.00 | not published | 0 |
| Ghs strapping shoulder - 29240 CPT 29240 | $477.60 | $796.00 | not published | 0 |
| Ghs st - re-eval for alt comm CPT 92597 | $279.60 | $466.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $485.40 | $809.00 | not published | 0 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $1,156.80 | $1,928.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $172.80 | $288.00 | not published | 0 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | $172.80 | $288.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $126.60 | $211.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $4,052.40 | $6,754.00 | not published | 0 |
| Ghs windowing of cast CPT 29730 | $237.00 | $395.00 | not published | 0 |
| Giardia lamblia antibody CPT 86674 | $57.60 | $96.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $30.60 | $51.00 | not published | 0 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $6,966.51 | $11,610.85 | $1,925.18 – $1,963.69 | 3 |
| Glassia injection HCPCS J0257 | $3,128.40 | $5,214.00 | not published | 0 |
| Glove finger flexion right lg xl HCPCS L3912 | $452.18 | $753.63 | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $2,503.20 | $4,172.00 | not published | 0 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $2,258.96 | $3,764.94 | not published | 0 |
| Glucagon plasma - sendout CPT 82943 | $129.00 | $215.00 | not published | 0 |
| Glucose 1 hr post dose CPT 82950 | $49.20 | $82.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $46.20 | $77.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $39.60 | $66.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $242.40 | $404.00 | not published | 0 |
| Glucose monitoring continual min 72hr pt CPT 95249 | $115.80 | $193.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $69.60 | $116.00 | not published | 0 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $28.20 | $47.00 | not published | 0 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $45.00 | $75.00 | not published | 0 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $9,476.17 | $15,793.62 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $154.80 | $258.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $147.00 | $245.00 | not published | 0 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $15,214.12 | $25,356.86 | not published | 0 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $8,912.77 | $14,854.62 | not published | 0 |
| Graft axiofill 1000mg HCPCS J3590 | $12,092.69 | $20,154.48 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $120,118.43 | $200,197.39 | not published | 0 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $86,580.47 | $144,300.78 | not published | 0 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | $7,776.60 | $12,961.00 | not published | 0 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $221,197.85 | $368,663.08 | not published | 0 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $167,376.00 | $278,960.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $73,227.00 | $122,045.00 | not published | 0 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $26,832.47 | $44,720.78 | not published | 0 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $45,505.35 | $75,842.25 | not published | 0 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $17,675.43 | $29,459.05 | not published | 0 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | $7,845.75 | $13,076.25 | not published | 0 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $164,938.59 | $274,897.65 | not published | 0 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $13,860.83 | $23,101.38 | not published | 0 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $165,231.50 | $275,385.83 | not published | 0 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $78,261.35 | $130,435.59 | not published | 0 |
| Granisetron hcl injection HCPCS J1626 | $94.80 | $158.00 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $172.80 | $288.00 | not published | 0 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | $30,710.87 | $51,184.78 | $1,657.00 – $1,657.00 | 2 |
| Grfg autol fat lipo ea addl CPT 15772 | $22,844.89 | $38,074.82 | $2,914.21 – $2,972.50 | 3 |
| Grfg autol soft tiss dir exc CPT 15769 | $23,371.00 | $38,951.67 | $3,282.70 – $3,348.35 | 3 |
| Guided cath fluid drainage 10030 CPT 10030 | $2,856.60 | $4,761.00 | not published | 0 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | $27,114.91 | $45,191.52 | not published | 0 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $41,739.39 | $69,565.65 | not published | 0 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $3,661.35 | $6,102.25 | 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.