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 |
|---|---|---|---|---|
| Surgical pathology level 1 gross examination only CPT 88300 | $87.60 | $146.00 | not published | 0 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $154.80 | $258.00 | not published | 0 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $172.80 | $288.00 | not published | 0 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $259.80 | $433.00 | not published | 0 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $337.20 | $562.00 | not published | 0 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $811.20 | $1,352.00 | not published | 0 |
| Susceptibility agar dilution per agent CPT 87181 | $43.20 | $72.00 | not published | 0 |
| Susceptibility mic per plate CPT 87186 | $202.80 | $338.00 | not published | 0 |
| Suscept studies macrobroth dilution ea CPT 87188 | $360.60 | $601.00 | not published | 0 |
| Suspension sleeve lower ext HCPCS L2397 | $501.03 | $835.05 | not published | 0 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $27.60 | $46.00 | not published | 0 |
| System cardiomems hosp electronics HCPCS C2624 | $99,379.50 | $165,632.50 | not published | 0 |
| System pacing micra av HCPCS C1786 | $87,349.35 | $145,582.25 | not published | 0 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $42,204.91 | $70,341.51 | not published | 0 |
| System recell skin grafting/harvesting HCPCS C1832 | $35,959.69 | $59,932.81 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $205.20 | $342.00 | not published | 0 |
| T3 (triiodothyronine) total CPT 84480 | $186.60 | $311.00 | not published | 0 |
| T4 (thyroxine) free CPT 84439 | $85.20 | $142.00 | not published | 0 |
| T4 (thyroxine) total CPT 84436 | $42.00 | $70.00 | not published | 0 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $66.43 | $110.71 | not published | 0 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $17.06 | $28.44 | not published | 0 |
| Tacrolimus therapeutic drug level CPT 80197 | $301.20 | $502.00 | not published | 0 |
| Talymed HCPCS Q4127 | $6,799.65 | $11,332.75 | not published | 0 |
| Tap block bilat cont infusion 64489 CPT 64489 | $1,407.60 | $2,346.00 | not published | 0 |
| Tap block uni by cont infusion 64487 CPT 64487 | $756.00 | $1,260.00 | not published | 0 |
| Target gsa panel hmtlmph neop CPT 81450 | $4,625.40 | $7,709.00 | not published | 0 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $9,196.80 | $15,328.00 | not published | 0 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | $2,233.78 | $3,722.96 | not published | 0 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $330.60 | $551.00 | not published | 0 |
| Tc-99m bicisate HCPCS A9557 | $726.00 | $1,210.00 | not published | 0 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $2,385.60 | $3,976.00 | not published | 0 |
| Tc-99m labeled rbc HCPCS A9560 | $276.60 | $461.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $822.00 | $1,370.00 | not published | 0 |
| Tc-99m mebrofenin HCPCS A9537 | $121.20 | $202.00 | not published | 0 |
| Tc-99m medronate HCPCS A9503 | $60.60 | $101.00 | not published | 0 |
| Tc-99m mertiatide HCPCS A9562 | $438.01 | $730.01 | not published | 0 |
| Tc-99m oxidronate HCPCS A9561 | $1,031.10 | $1,718.50 | not published | 0 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $35.70 | $59.50 | not published | 0 |
| Tc-99m pyroph diag per dose up to 25 mci HCPCS A9538 | $36.00 | $60.00 | not published | 0 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $888.60 | $1,481.00 | not published | 0 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $358.20 | $597.00 | not published | 0 |
| Tc-99m sulfur colloid HCPCS A9541 | $52.80 | $88.00 | not published | 0 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $155.40 | $259.00 | not published | 0 |
| Tc-99m tilmanocept diag HCPCS A9520 | $1,480.80 | $2,468.00 | not published | 0 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $160.20 | $267.00 | not published | 0 |
| T cells absolute cd 4 count CPT 86361 | $126.60 | $211.00 | not published | 0 |
| T cells total count CPT 86359 | $158.40 | $264.00 | not published | 0 |
| Telethx isodose plan cplx CPT 77307 | $1,242.00 | $2,070.00 | not published | 0 |
| Telethx isodose plan simple CPT 77306 | $698.40 | $1,164.00 | not published | 0 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $39,329.02 | $65,548.36 | not published | 0 |
| Tenodesis biceps tdn at elbw CPT 24340 | $78,688.82 | $131,148.03 | $17,591.15 – $17,942.97 | 3 |
| Tenosynovectomy radic 26145 CPT 26145 | $13,073.77 | $21,789.62 | $1,613.25 – $1,645.51 | 3 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $47,062.09 | $78,436.82 | $12,880.66 – $13,138.27 | 3 |
| Tension based scoliosis orth HCPCS L1005 | $15,094.28 | $25,157.14 | not published | 0 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $45.00 | $75.00 | not published | 0 |
| Test socket below knee HCPCS L5620 | $1,217.24 | $2,028.74 | not published | 0 |
| Test stress cardiovascular tracing only CPT 93017 | $1,669.80 | $2,783.00 | not published | 0 |
| Tetanus immune globulin inj HCPCS J1670 | $3,077.07 | $5,128.45 | not published | 0 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $20,708.87 | $34,514.79 | not published | 0 |
| Tgsap so neo 5-50 rna alys CPT 81449 | $2,929.80 | $4,883.00 | not published | 0 |
| Theophylline therapeutic drug level CPT 80198 | $74.40 | $124.00 | not published | 0 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | $126.60 | $211.00 | not published | 0 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | $140.40 | $234.00 | not published | 0 |
| Ther nma rdctj intus/obstrcj CPT 74283 | $1,147.80 | $1,913.00 | not published | 0 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $1,334.30 | $2,223.83 | not published | 0 |
| Thigh/wght bear high roll cu HCPCS L2550 | $1,604.61 | $2,674.35 | not published | 0 |
| Thigh/wght bear lacer molded HCPCS L2540 | $2,140.16 | $3,566.94 | not published | 0 |
| Thigh/wght bear lacer non-mo HCPCS L2530 | $1,130.99 | $1,884.99 | not published | 0 |
| Thi/glut/ischia wgt bearing HCPCS L2500 | $1,475.78 | $2,459.64 | not published | 0 |
| Thorac cont lat support upri HCPCS L2680 | $690.06 | $1,150.10 | not published | 0 |
| Thorac cont paraspinal uprig HCPCS L2670 | $752.20 | $1,253.66 | not published | 0 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $1,321.80 | $2,203.00 | not published | 0 |
| Thoracic control thoracic ba HCPCS L2660 | $844.99 | $1,408.31 | not published | 0 |
| Thoracic pad HCPCS L1060 | $510.76 | $851.26 | not published | 0 |
| Thor rib belt custom fabrica HCPCS L0220 | $5,421.73 | $9,036.21 | not published | 0 |
| Thrombectmy crnry perq mechanical CPT 92973 | $1,732.80 | $2,888.00 | not published | 0 |
| Thrombin time CPT 85670 | $58.20 | $97.00 | not published | 0 |
| Thromboplastin inhibition CPT 85705 | $55.20 | $92.00 | not published | 0 |
| Thromboplastin time partial (ptt) substitution fractions each CPT 85732 | $55.80 | $93.00 | not published | 0 |
| Th/wght bear nar m-l brim cu HCPCS L2526 | $3,020.41 | $5,034.01 | not published | 0 |
| Th/wght bear nar m-l brim mo HCPCS L2525 | $5,375.28 | $8,958.80 | not published | 0 |
| Th/wght bear quad-lat brim c HCPCS L2520 | $2,534.86 | $4,224.76 | not published | 0 |
| Th/wght bear quad-lat brim m HCPCS L2510 | $3,803.51 | $6,339.19 | not published | 0 |
| Thyroglobulin antibody CPT 86800 | $84.00 | $140.00 | not published | 0 |
| Thyroid imaging CPT 78013 | $537.00 | $895.00 | not published | 0 |
| Thyroid mets imag whole body CPT 78018 | $492.00 | $820.00 | not published | 0 |
| Thyroid (TSH) Test CPT 84443 | $250.20 | $417.00 | not published | 0 |
| Thyroid Ultrasound CPT 76536 | $945.60 | $1,576.00 | not published | 0 |
| Thyroid uptake measurement CPT 78012 | $305.40 | $509.00 | not published | 0 |
| Thyrotropin alfa 0.9 mg intramuscular solution HCPCS J3240 | $1,772.81 | $2,954.68 | not published | 0 |
| Thyroxine binding globulin (tbg) CPT 84442 | $135.00 | $225.00 | not published | 0 |
| Tib/per revasc stent & ather 37231 CPT 37231 | $125,264.16 | $208,773.60 | $675.50 – $689.01 | 3 |
| Tilt table study CPT 93660 | $2,149.20 | $3,582.00 | not published | 0 |
| Tissue amnio epifix inj 100mg HCPCS Q4145 | $15,171.07 | $25,285.11 | not published | 0 |
| Tissue culture skin/biopsy CPT 88233 | $300.00 | $500.00 | not published | 0 |
| Tissue exam koh skin/hair/nails CPT 87220 | $70.20 | $117.00 | not published | 0 |
| Tissue matrix 1.8x1.8cm collagen dermacell porous 4sq cm cost per sq cm HCPCS Q4122 | $66,523.91 | $110,873.18 | not published | 0 |
| Tissue transglutaminase iga CPT 86364 | $40.20 | $67.00 | not published | 0 |
| Tlh uterus 250 g or less CPT 58570 | $24,036.71 | $40,061.18 | $10,664.59 – $10,877.88 | 3 |
| Tlh w/t/o 250 g or less CPT 58571 | $23,757.98 | $39,596.63 | $10,664.59 – $10,877.88 | 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.