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 |
|---|---|---|---|---|
| Lefort i-1 piece without graft CPT 21141 | $85,650.52 | $142,750.87 | $5,939.19 – $6,057.97 | 3 |
| Lefort i-2 piece without graft CPT 21142 | $54,751.24 | $91,252.07 | $5,939.19 – $6,057.97 | 3 |
| Lefort i-3/> piece without graft CPT 21143 | $236,927.35 | $394,878.92 | $5,939.19 – $6,057.97 | 3 |
| Legg perthes orthosis trilat HCPCS L1720 | $6,956.93 | $11,594.89 | not published | 0 |
| Legg perthes orth scottish r HCPCS L1730 | $5,873.23 | $9,788.71 | not published | 0 |
| Legg perthes patten bottom t HCPCS L1755 | $8,444.02 | $14,073.36 | not published | 0 |
| Leg perthes orth toronto typ HCPCS L1700 | $7,337.29 | $12,228.82 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $2,194.80 | $3,658.00 | not published | 0 |
| Lengthening of thigh bone CPT 27466 | $27,119.19 | $45,198.65 | $7,279.94 – $7,425.54 | 3 |
| Lens, intraocular (new tech) HCPCS C1780 | $444.59 | $740.99 | not published | 0 |
| Lens iol 23.0 d 1.5 cyl eyhance toric HCPCS V2787 | $5,230.50 | $8,717.50 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $6,250.45 | $10,417.41 | not published | 0 |
| Lens iol ant chamb 10.5 HCPCS V2630 | $1,569.15 | $2,615.25 | not published | 0 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $189.60 | $316.00 | not published | 0 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $6,732.61 | $11,221.02 | not published | 0 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $26,584.58 | $44,307.64 | not published | 0 |
| Leuprolide acetate injeciton HCPCS J9218 | $6,372.43 | $10,620.72 | not published | 0 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $135.89 | $226.48 | not published | 0 |
| Levetiracetam therapeutic drug level CPT 80177 | $118.20 | $197.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $54.53 | $90.89 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $161,805.52 | $269,675.86 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $129.63 | $216.05 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $53.64 | $89.40 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $162.00 | $270.00 | not published | 0 |
| Lift heel adj small gl60404sm HCPCS L3332 | $347.83 | $579.71 | not published | 0 |
| Lift heel adjustable med HCPCS L3334 | $179.83 | $299.71 | not published | 0 |
| Lifts elevation metal extens HCPCS L3330 | $2,668.97 | $4,448.28 | not published | 0 |
| Ligation internal/common carotid artery 37605 CPT 37605 | $2,483.40 | $4,139.00 | not published | 0 |
| Ligation/major artery/extremity 37618 CPT 37618 | $5,023.20 | $8,372.00 | not published | 0 |
| Lig/band angioaccess av fistula CPT 37607 | $10,563.32 | $17,605.53 | $3,167.80 – $3,231.16 | 3 |
| Liletta, 52 mg HCPCS J7297 | $8,329.67 | $13,882.78 | not published | 0 |
| Limited ankle motion ea jnt HCPCS L2200 | $195.41 | $325.69 | not published | 0 |
| Limited motion knee joint HCPCS L2184 | $546.28 | $910.46 | not published | 0 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $75.10 | $125.16 | not published | 0 |
| Lipase CPT 83690 | $228.00 | $380.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $168.60 | $281.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $45.60 | $76.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $101.40 | $169.00 | not published | 0 |
| Lip surgery procedure CPT 40799 | $174.00 | $290.00 | not published | 0 |
| Listeria monocytogenes CPT 86723 | $143.40 | $239.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $40.20 | $67.00 | not published | 0 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $9,229.80 | $15,383.00 | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $528.60 | $881.00 | not published | 0 |
| Liver elastography 91200 CPT 91200 | $98.40 | $164.00 | not published | 0 |
| Liver Function Test CPT 80076 | $208.20 | $347.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $205.20 | $342.00 | not published | 0 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $39,445.17 | $65,741.95 | $3,282.70 – $3,348.35 | 3 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $300.38 | $500.63 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $45.00 | $75.00 | not published | 0 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | $813.55 | $1,355.92 | not published | 0 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | $334.33 | $557.22 | not published | 0 |
| Low back disk surgery CPT 63030 | $28,446.47 | $47,410.78 | $7,279.94 – $7,425.54 | 3 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,975.40 | $4,959.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,447.80 | $2,413.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,340.20 | $5,567.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,557.00 | $2,595.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,954.80 | $3,258.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $1,279.80 | $2,133.00 | not published | 0 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $34,554.75 | $57,591.25 | $10,664.59 – $10,877.88 | 3 |
| Lso corset front HCPCS L0972 | $496.37 | $827.29 | not published | 0 |
| Lso flex no ri stays pre ots HCPCS L0628 | $517.82 | $863.03 | not published | 0 |
| Lso full corset HCPCS L0976 | $705.13 | $1,175.21 | not published | 0 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $800.27 | $1,333.78 | not published | 0 |
| Lso sag-coronal panel custom HCPCS L0638 | $7,913.75 | $13,189.58 | not published | 0 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | $6,109.64 | $10,182.74 | not published | 0 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | $763.86 | $1,273.10 | not published | 0 |
| Lso sagit rigid panel prefab HCPCS L0635 | $4,712.36 | $7,853.94 | not published | 0 |
| Lso sagittal rigid panel cus HCPCS L0636 | $6,393.92 | $10,656.53 | not published | 0 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $1,230.16 | $2,050.27 | not published | 0 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | $1,352.35 | $2,253.91 | not published | 0 |
| Lso s/c shell/panel custom HCPCS L0640 | $4,488.92 | $7,481.53 | not published | 0 |
| Lumbar bolster pad HCPCS L1030 | $369.28 | $615.46 | not published | 0 |
| Lumbar derotation pad HCPCS L1240 | $428.90 | $714.84 | not published | 0 |
| Lumbar or lumbar rib pad HCPCS L1040 | $418.13 | $696.88 | not published | 0 |
| Lumbar sling HCPCS L1090 | $474.56 | $790.94 | not published | 0 |
| Lumbar Spinal Fusion (single level) CPT 22612 | $103,738.76 | $172,897.93 | $17,591.15 – $17,591.15 | 1 |
| Lung Function Test (Spirometry) CPT 94010 | $698.40 | $1,164.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,385.40 | $2,309.00 | not published | 0 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $40,590.00 | $67,650.00 | not published | 0 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $128,110.27 | $213,517.12 | not published | 0 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,569.15 | $2,615.25 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $2,111.40 | $3,519.00 | not published | 0 |
| Lymph vessel x-ray arms/legs CPT 75803 | $2,935.80 | $4,893.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75807 | $6,207.60 | $10,346.00 | not published | 0 |
| Lysis penil circumic lesion CPT 54162 | $11,190.60 | $18,651.00 | $3,536.51 – $3,607.24 | 3 |
| Macroscopic exam arthropod CPT 87168 | $70.20 | $117.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $24.00 | $40.00 | not published | 0 |
| Magnesium CPT 83735 | $126.00 | $210.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $141.25 | $235.42 | not published | 0 |
| Mammosite ced HCPCS C1728 | $15,822.26 | $26,370.44 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $149.40 | $249.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $190.80 | $318.00 | not published | 0 |
| Man's shoe oxford brace HCPCS L3225 | $348.09 | $580.15 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $23,167.79 | $38,612.98 | $6,661.88 – $6,795.12 | 3 |
| Marker biop eviva buckle ss HCPCS A4648 | $29,552.33 | $49,253.88 | not published | 0 |
| Marsupialization liver lesion 47300 CPT 47300 | $23,031.01 | $38,385.02 | $1.44 – $1,279.11 | 3 |
| Mastectomy partial CPT 19301 | $44,927.66 | $74,879.43 | $3,928.24 – $4,006.80 | 3 |
| Mast mod rad CPT 19307 | $31,316.87 | $52,194.78 | $6,661.88 – $6,795.12 | 3 |
| Mastoidectomy complete 69502 CPT 69502 | $32,245.04 | $53,741.73 | $5,939.19 – $6,057.97 | 3 |
| Mastopexy CPT 19316 | $35,384.41 | $58,974.02 | $6,661.88 – $6,795.12 | 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.