LEWISGALE MEDICAL CENTER
1423 W RURITAN RD, ROANOKE, VA · HCA Virginia · · NPI 1619914785
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 |
|---|---|---|---|---|
| Creatine kinase isoenzymes CPT 82552 | $228.00 | $228.00 | $11.65 – $19.42 | 19 |
| Creatine kinase mb CPT 82553 | $342.00 | $342.00 | $10.05 – $16.75 | 19 |
| Creatine - sendout CPT 82540 | $146.00 | $146.00 | $4.04 – $6.73 | 19 |
| Creatinine CPT 82565 | not published | not published | $4.45 – $7.42 | 19 |
| Creatinine 24 hour urine CPT 82570 | not published | not published | $4.50 – $7.51 | 19 |
| Creatinine clearance urine CPT 82575 | $443.00 | $443.00 | $8.24 – $13.72 | 19 |
| #creutz-prot.,western blot CPT 84182 | not published | not published | $25.42 – $42.35 | 19 |
| Crh stimulation panel CPT 80412 | not published | not published | $697.60 – $1,162.35 | 19 |
| Crizanlizumab-tmca 10 mg/ml intravenous solution HCPCS J0791 | not published | not published | $110.08 – $388.77 | 4 |
| Cromolyn sodium noncomp unit HCPCS J7631 | not published | not published | $0.25 – $2.73 | 4 |
| Crotalidae poly immune fab HCPCS J0840 | $18,422.00 | $18,422.00 | $1,492.44 – $5,479.56 | 4 |
| Crutches underarm other than wood adjustable or e0114 HCPCS E0114 | not published | not published | $50.23 – $63.23 | 18 |
| Cryofibrinogen qualitative - sendout CPT 82585 | $139.00 | $139.00 | $12.31 – $20.50 | 19 |
| Cryopreservation embryo(s) CPT 89258 | not published | not published | $656.15 – $3,683.63 | 2 |
| Cryopreservation oocyte(s) CPT 89337 | not published | not published | $149.16 – $837.38 | 2 |
| Cryopreservation sperm CPT 89259 | not published | not published | $149.16 – $837.38 | 2 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $49.76 – $279.35 | 2 |
| Cryptococcus abs qn - sendout CPT 86641 | not published | not published | $12.54 – $20.89 | 19 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $10.43 – $17.37 | 19 |
| Crystal identification light microscopy CPT 89060 | $307.00 | $307.00 | $6.38 – $10.63 | 19 |
| Csf leakage imaging CPT 78650 | $1,935.00 | $1,935.00 | $108.33 – $2,938.37 | 2 |
| Csf ventriculography CPT 78635 | not published | not published | $128.23 – $1,101.15 | 2 |
| Cstb gene detc abnor allele CPT 81188 | not published | not published | $137.00 – $198.65 | 16 |
| Cstb gene full gene sequence CPT 81189 | not published | not published | $274.83 – $398.50 | 16 |
| Cstb gene known famil vrnt CPT 81190 | not published | not published | $185.20 – $268.54 | 16 |
| CT 3d report other modality w/workstation CPT 76377 | not published | not published | $169.12 – $169.12 | 1 |
| Cta abdomen without & /or w/contrast CPT 74175 | $9,622.00 | $9,622.00 | $379.12 – $401.74 | 2 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $4,142.00 | $4,142.00 | $401.74 – $499.08 | 2 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | not published | not published | $395.61 – $401.74 | 2 |
| Cta neck without &/or w/contrast CPT 70498 | $9,622.00 | $9,622.00 | $366.04 – $401.74 | 2 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $19,237.00 | $19,237.00 | $459.90 – $828.27 | 2 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $9,622.00 | $9,622.00 | $380.69 – $401.74 | 2 |
| CT Angiogram of the Head CPT 70496 | $7,038.00 | $7,038.00 | $366.04 – $401.74 | 2 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $401.74 – $505.15 | 2 |
| CT angio pelvis CPT 72191 | $9,622.00 | $9,622.00 | $375.97 – $401.74 | 2 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $3,861.00 | $3,861.00 | $375.97 – $401.74 | 2 |
| CT bone density axial CPT 77078 | not published | not published | $51.98 – $182.03 | 2 |
| CT cerebral perf w cont & prcssng CPT 70473 | $3,563.00 | $3,563.00 | $216.38 – $403.20 | 2 |
| CT colonography dx CPT 74261 | not published | not published | $245.18 – $505.91 | 2 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $401.74 – $527.48 | 2 |
| CT colonography screening CPT 74263 | not published | not published | $1,486.98 – $1,486.98 | 1 |
| CT guidance for needle placement CPT 77012 | not published | not published | $266.21 – $266.21 | 1 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | not published | not published | $247.83 – $247.83 | 1 |
| CT guid parench tis ablat CPT 77013 | not published | not published | $804.47 – $804.47 | 1 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $850.00 | $850.00 | $122.03 – $182.03 | 2 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $9,877.00 | $9,877.00 | $401.74 – $540.28 | 2 |
| CT hrt w/3d image CPT 75572 | $9,877.00 | $9,877.00 | $366.90 – $401.74 | 2 |
| CT limited or localized follow-up study CPT 76380 | $3,641.00 | $3,641.00 | $182.03 – $203.49 | 2 |
| CT lower extremity w/contrast (both sides) CPT 73701 | not published | not published | $243.70 – $401.74 | 2 |
| CT lower extremity without contrast (both sides) CPT 73700 | not published | not published | $211.76 – $245.18 | 2 |
| Ctlso a-p-l control molded HCPCS L0700 | not published | not published | $1,996.77 – $2,513.58 | 18 |
| Ctlso a-p-l control with inter HCPCS L0710 | not published | not published | $2,039.95 – $2,567.94 | 18 |
| Ctlso axilla sling HCPCS L1010 | not published | not published | $65.55 – $82.52 | 18 |
| Ctlso milwauke initial model HCPCS L1000 | not published | not published | $2,003.36 – $2,521.87 | 18 |
| CT lwr extremity w/o&w/dye CPT 73702 | not published | not published | $254.39 – $401.74 | 2 |
| CT neck soft tissue w/contrast CPT 70491 | $7,971.00 | $7,971.00 | $289.89 – $401.74 | 2 |
| CT neck soft tissue without contrast CPT 70490 | $6,673.00 | $6,673.00 | $245.18 – $269.89 | 2 |
| CT neck soft tissue without & w/contrast CPT 70492 | $10,127.00 | $10,127.00 | $337.15 – $401.74 | 2 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $10,127.00 | $10,127.00 | $265.18 – $401.74 | 2 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $7,971.00 | $7,971.00 | $237.54 – $401.74 | 2 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $6,673.00 | $6,673.00 | $245.18 – $269.89 | 2 |
| CT scan for localization CPT 77011 | not published | not published | $275.24 – $275.24 | 1 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $21,334.00 | $21,334.00 | $423.51 – $828.27 | 2 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $17,025.00 | $17,025.00 | $382.31 – $828.27 | 2 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $12,973.00 | $12,973.00 | $364.52 – $517.79 | 2 |
| CT thoracic spine w/contrast CPT 72129 | $8,396.00 | $8,396.00 | $256.01 – $401.74 | 2 |
| CT thoracic spine without contrast CPT 72128 | $6,673.00 | $6,673.00 | $211.76 – $245.18 | 2 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $545.00 | $545.00 | $182.03 – $225.59 | 2 |
| CT t-spine w /wo contrast CPT 72130 | $10,549.00 | $10,549.00 | $266.79 – $401.74 | 2 |
| CT upper extremity w/contrast (both sides) CPT 73201 | not published | not published | $243.70 – $828.27 | 2 |
| CT upper extremity without contrast (both sides) CPT 73200 | not published | not published | $211.76 – $245.18 | 2 |
| CT uppr extremity w/o&w/dye CPT 73202 | not published | not published | $254.39 – $401.74 | 2 |
| Cuffs adj lock with active con HCPCS L3740 | not published | not published | $1,021.51 – $1,285.90 | 18 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $149.16 – $837.38 | 2 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $149.16 – $837.38 | 2 |
| Culture aerobic additional method definitive id each CPT 87077 | not published | not published | $7.03 – $11.72 | 19 |
| Culture afb any source CPT 87116 | $784.00 | $784.00 | $9.40 – $15.66 | 19 |
| Culture anaerobic additional method definitive id each CPT 87076 | $489.00 | $489.00 | $7.03 – $11.72 | 19 |
| Culture anaerobic except blood CPT 87075 | $839.00 | $839.00 | $8.24 – $13.73 | 19 |
| Culture bacteria anaerobic CPT 87073 | not published | not published | $8.41 – $14.01 | 19 |
| Culture bacterial urine HCPCS P7001 | not published | not published | $18.84 – $105.77 | 2 |
| Culture bact stool aero addl path ea CPT 87046 | $664.00 | $664.00 | $8.21 – $13.69 | 19 |
| Culture body fluid CPT 87070 | not published | not published | $7.51 – $12.50 | 19 |
| Culture fungi definitive id mold CPT 87107 | $445.00 | $445.00 | $8.98 – $14.96 | 19 |
| Culture fungi definitive id yeast CPT 87106 | $601.00 | $601.00 | $8.98 – $14.96 | 19 |
| Culture fungi other (except blood) CPT 87102 | not published | not published | $7.32 – $12.19 | 19 |
| Culture fungi skin/hair/nail CPT 87101 | $168.00 | $168.00 | $6.71 – $11.18 | 19 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $157.00 | $157.00 | $12.72 – $21.18 | 19 |
| Culture mycoplasma any source CPT 87109 | $238.00 | $238.00 | $13.40 – $22.32 | 19 |
| Culture of specimen by kit CPT 87084 | not published | not published | $23.55 – $39.25 | 19 |
| Culture quantitative aerobic other source CPT 87071 | $343.00 | $343.00 | $8.61 – $14.34 | 19 |
| Culture screening strep group a CPT 87081 | not published | not published | $5.77 – $9.61 | 19 |
| Culture type pulse field gel CPT 87152 | not published | not published | $6.73 – $11.22 | 19 |
| Culture typing added method CPT 87158 | $23.00 | $23.00 | $6.73 – $11.22 | 19 |
| Culture typing glc/hplc CPT 87143 | not published | not published | $10.90 – $18.15 | 19 |
| Culture typing immunologic CPT 87147 | $318.00 | $318.00 | $4.50 – $7.51 | 19 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | not published | not published | $189.76 – $316.19 | 19 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | not published | not published | $30.54 – $50.88 | 19 |
| Culture urine each isolate CPT 87088 | $419.00 | $419.00 | $7.04 – $11.73 | 19 |
| Culture virus isolation CPT 87250 | not published | not published | $17.03 – $28.36 | 19 |
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.