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 |
|---|---|---|---|---|
| Cus elbo skt in for con/atyp HCPCS L6696 | not published | not published | $1,343.77 – $1,691.56 | 18 |
| Cus elbo skt in not con/atyp HCPCS L6697 | not published | not published | $1,343.77 – $1,691.56 | 18 |
| Custom glove for term device HCPCS L6895 | not published | not published | $644.20 – $810.93 | 18 |
| Custom shape cover ak HCPCS L5705 | not published | not published | $1,120.69 – $1,410.75 | 18 |
| Custom shape cover bk HCPCS L5704 | not published | not published | $611.26 – $769.47 | 18 |
| Custom shape cvr hip disart HCPCS L5707 | not published | not published | $1,468.55 – $1,848.65 | 18 |
| Custom shape cvr knee disart HCPCS L5706 | not published | not published | $1,093.09 – $1,376.01 | 18 |
| Cyanocobalamin unsat binding capacity CPT 82608 | not published | not published | $12.46 – $20.76 | 19 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $357.00 | $357.00 | $0.57 – $1.92 | 4 |
| Cyclic citrullinated peptide antibody CPT 86200 | $617.00 | $617.00 | $11.27 – $18.78 | 19 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | not published | not published | $0.68 – $1.77 | 4 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | not published | not published | $0.97 – $5.46 | 4 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $1,300.00 | $1,300.00 | $60.69 – $221.04 | 4 |
| Cyclosporine 2 hour CPT 80158 | $357.00 | $357.00 | $15.71 – $26.17 | 19 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $47.00 | $47.00 | $0.63 – $1.59 | 4 |
| Cyclosporine oral 100 mg HCPCS J7502 | not published | not published | $1.72 – $5.43 | 4 |
| Cygnus matrix, per sq cm HCPCS Q4199 | not published | not published | $282.56 – $381.42 | 4 |
| Cygnus, per sq cm HCPCS Q4170 | not published | not published | $378.03 – $431.40 | 4 |
| Cyp2c19 gene com variants CPT 81225 | $779.00 | $779.00 | $291.36 – $422.47 | 16 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $174.81 – $253.47 | 16 |
| Cyp2d6 gene com variants CPT 81226 | $1,063.00 | $1,063.00 | $450.91 – $653.82 | 16 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $174.81 – $253.47 | 16 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $174.81 – $253.47 | 16 |
| Cystatin c CPT 82610 | $213.00 | $213.00 | $16.12 – $26.85 | 19 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $499.00 – $1,737.56 | 19 |
| Cystine urine quantitative CPT 82131 | not published | not published | $20.00 – $33.32 | 19 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $2,061.00 | $2,061.00 | $68.56 – $828.27 | 2 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | not published | not published | $0.69 – $2.52 | 4 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $1,042.48 – $1,737.01 | 19 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $36.88 – $61.45 | 19 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $35.42 – $59.02 | 19 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,160.00 – $1,682.00 | 16 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $900.00 – $1,305.00 | 16 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,263.53 – $1,993.65 | 15 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $10.43 – $17.37 | 19 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | not published | not published | $12.52 – $20.87 | 19 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $641.00 | $641.00 | $14.66 – $24.43 | 19 |
| Cytomegalovirus dfa CPT 87271 | $610.00 | $610.00 | $11.68 – $19.46 | 19 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $1,540.21 – $5,424.99 | 4 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $26.13 – $43.54 | 19 |
| Cyto/molecular report CPT 88291 | not published | not published | $27.73 – $190.03 | 5 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $22.07 – $36.79 | 19 |
| Cytopath c/v automated CPT 88147 | not published | not published | $44.00 – $73.31 | 19 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $24.05 – $40.08 | 19 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $15.83 – $25.75 | 19 |
| Cytopath c/v index add-on CPT 88155 | $178.00 | $178.00 | $12.75 – $21.24 | 19 |
| Cytopath c/v manual CPT 88150 | $170.00 | $170.00 | $15.15 – $25.75 | 19 |
| Cytopath c/v redo CPT 88153 | not published | not published | $20.91 – $34.84 | 19 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $20.05 – $33.41 | 19 |
| Cytopath fl nongyn filter CPT 88106 | $141.00 | $141.00 | $24.67 – $138.50 | 2 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $1,930.00 | $1,930.00 | $49.76 – $279.35 | 2 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $230.00 | $230.00 | $23.15 – $38.58 | 19 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $394.00 | $394.00 | $17.63 – $29.38 | 19 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $637.00 | $637.00 | $33.84 – $189.98 | 2 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $303.00 | $303.00 | $33.84 – $189.98 | 2 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $382.00 | $382.00 | $7.33 – $41.15 | 2 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $567.00 | $567.00 | $149.16 – $837.38 | 2 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $567.00 | $567.00 | $49.76 – $279.35 | 2 |
| Cytopath smear other source CPT 88160 | $291.00 | $291.00 | $24.67 – $138.50 | 2 |
| Cytopath smear other source CPT 88162 | $439.00 | $439.00 | $49.76 – $279.35 | 2 |
| Cytopath smear oth prep screen & interp CPT 88161 | $410.00 | $410.00 | $24.67 – $138.50 | 2 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $15.15 – $25.75 | 19 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $15.15 – $25.75 | 19 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $36.74 – $61.22 | 19 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $15.15 – $25.75 | 19 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $68.44 – $114.04 | 19 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $25.83 – $43.04 | 19 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $2,260.00 | $2,260.00 | $291.26 – $1,635.13 | 2 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $927.00 | $927.00 | $3.82 – $12.36 | 4 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $14,506.00 | $14,506.00 | $245.48 – $923.97 | 4 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $7,179.00 | $7,179.00 | $13.23 – $46.77 | 4 |
| Dalteparin sodium HCPCS J1645 | $928.00 | $928.00 | $13.63 – $44.70 | 4 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | not published | not published | $0.03 – $0.09 | 4 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.04 – $0.18 | 4 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $45.04 – $165.18 | 4 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $79.00 | $79.00 | $2.48 – $9.06 | 4 |
| Darbepoetin alfa, esrd use HCPCS J0882 | not published | not published | $2.48 – $9.06 | 4 |
| Dark field exam spec collj CPT 87164 | not published | not published | $9.35 – $15.57 | 19 |
| Dark field exam without collj CPT 87166 | $767.00 | $767.00 | $9.83 – $16.39 | 19 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | not published | not published | $211.67 – $781.47 | 4 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | not published | not published | $22.44 – $78.99 | 4 |
| Dch glucoscan CPT 82948 | not published | not published | $4.39 – $7.31 | 19 |
| Dch validity tests CPT 81002 | not published | not published | $3.03 – $5.05 | 19 |
| Deamidated gliadin antibody iga CPT 86258 | not published | not published | $10.49 – $17.47 | 19 |
| Debridement (>20 cm) charge pt CPT 97598 | $283.00 | $283.00 | $49.76 – $53.24 | 15 |
| Decalcification CPT 88311 | $250.00 | $250.00 | $8.72 – $48.95 | 2 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | not published | not published | $1.50 – $1.95 | 4 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $988.00 | $988.00 | $6.98 – $25.41 | 4 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | not published | not published | $3.71 – $13.35 | 4 |
| Dengue vacc quad 3 dose subq CPT 90587 | not published | not published | $59.47 – $237.60 | 4 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | not published | not published | $23.64 – $88.38 | 4 |
| Deodorant ostmy adapt lube 8ml HCPCS A4394 | not published | not published | $3.14 – $3.95 | 18 |
| Depo-estradiol cypionate inj HCPCS J1000 | not published | not published | $35.97 – $155.46 | 4 |
| Derma-gide, 1 sq cm HCPCS Q4203 | not published | not published | $255.15 – $381.42 | 4 |
| Dermapure 1 square cm HCPCS Q4152 | not published | not published | $46.43 – $381.42 | 4 |
| Dermavest, plurivest sq cm HCPCS Q4153 | not published | not published | $108.87 – $381.42 | 4 |
| Derm-maxx, per sq cm HCPCS Q4238 | not published | not published | $381.42 – $1,595.64 | 4 |
| Design mlc device for imrt CPT 77338 | not published | not published | $1,035.95 – $1,035.95 | 1 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | not published | not published | $3.82 – $10.23 | 4 |
| Desoxycorticosterone CPT 82633 | not published | not published | $26.96 – $44.92 | 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.