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 |
|---|---|---|---|---|
| #flow interp 9 - 15 markers CPT 88188 | not published | not published | $62.81 – $352.62 | 2 |
| Floxuridine injection HCPCS J9200 | $6,600.00 | $6,600.00 | $3,390.08 – $12,764.76 | 4 |
| Flt3 gene CPT 81245 | not published | not published | $165.51 – $239.99 | 16 |
| Flt3 gene analysis CPT 81246 | $448.00 | $448.00 | $83.00 – $120.35 | 16 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | not published | not published | $3.04 – $13.44 | 4 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | $4,409.00 | $4,409.00 | $50.60 – $244.23 | 4 |
| Fluidotherapy charges pt CPT 97022 | not published | not published | $13.01 – $15.15 | 18 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $417.15 – $1,522.32 | 4 |
| Fluocinolone acetonide implt HCPCS J7311 | not published | not published | $289.03 – $1,016.82 | 4 |
| Fluorescent antibody titer dna CPT 86256 | not published | not published | $10.49 – $17.47 | 19 |
| Fluorodopa f-18 diag per mci HCPCS A9602 | not published | not published | $2,566.65 – $2,566.65 | 1 |
| Fluoroestradiol f 18 HCPCS A9591 | not published | not published | $1,381.26 – $1,381.26 | 1 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $3,294.00 | $3,294.00 | $129.40 – $129.40 | 1 |
| Fluoroguide needle placement CPT 77002 | not published | not published | $123.92 – $123.92 | 1 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $16.46 – $27.42 | 19 |
| Fluoroscopy up to 1 hour CPT 76000 | not published | not published | $69.82 – $517.79 | 2 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | not published | not published | $1.88 – $5.82 | 4 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | $255.00 | $255.00 | $7.51 – $18.60 | 4 |
| Flurpiridaz f18, diag, 1 mci HCPCS A9611 | not published | not published | $1,590.00 – $1,590.00 | 1 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | $18,628.00 | $18,628.00 | $5,832.03 – $5,832.03 | 1 |
| Fluvirin vacc, 3 yrs & >, im HCPCS Q2037 | not published | not published | $37.08 – $37.08 | 1 |
| Fluzone vacc, 3 yrs & >, im HCPCS Q2038 | not published | not published | $167.82 – $167.82 | 1 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $517.79 – $521.64 | 2 |
| Fmri brain by tech CPT 70554 | not published | not published | $446.24 – $517.79 | 2 |
| Foam drg >16<=48 sq in without b HCPCS A6210 | not published | not published | $24.14 – $30.39 | 18 |
| Foam drg <=16 sq in w/border HCPCS A6212 | not published | not published | $11.76 – $14.81 | 18 |
| Foam drg > 48 sq in w/border HCPCS A6214 | not published | not published | $12.48 – $15.71 | 18 |
| Foam drg > 48 sq in without brdr HCPCS A6211 | not published | not published | $35.58 – $44.79 | 18 |
| Foam drsg <=16 sq in without bdr HCPCS A6209 | not published | not published | $9.05 – $11.40 | 18 |
| Foam/fabric leg strap HCPCS A5114 | not published | not published | $9.21 – $11.60 | 18 |
| Foam stability fetal lung CPT 83662 | not published | not published | $16.46 – $27.42 | 19 |
| Folic acid CPT 82746 | $332.00 | $332.00 | $12.79 – $21.31 | 19 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $5.00 | $5.00 | $0.05 – $0.15 | 4 |
| Follow-up angiography CPT 75898 | $1,494.00 | $1,494.00 | $476.30 – $6,438.74 | 2 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | not published | not published | $19.29 – $19.29 | 1 |
| Fondaparinux sodium HCPCS J1652 | not published | not published | $0.73 – $2.64 | 4 |
| Fo nontorsion joint cf HCPCS L3935 | not published | not published | $204.98 – $258.03 | 18 |
| Foot arch support remov prem HCPCS L3030 | not published | not published | $77.82 – $97.96 | 18 |
| Foot arch supp premold metat HCPCS L3050 | not published | not published | $47.98 – $60.40 | 18 |
| Foot drp splt w/exp heel lg HCPCS L4398 | not published | not published | $78.77 – $99.16 | 18 |
| Foot external keel sach foot HCPCS L5970 | not published | not published | $228.45 – $287.57 | 18 |
| Foot insert plastazote or eq HCPCS L3002 | not published | not published | $164.67 – $207.29 | 18 |
| Foot insert remov molded spe HCPCS L3001 | not published | not published | $134.86 – $169.77 | 18 |
| Foot insert silicone gel eac HCPCS L3003 | not published | not published | $177.68 – $223.67 | 18 |
| Foot lamin/prepreg composite HCPCS L3031 | not published | not published | $124.88 – $157.20 | 18 |
| Foot longitudinal arch suppo HCPCS L3010 | not published | not published | $177.68 – $223.67 | 18 |
| Foot longitud/metatarsal sup HCPCS L3020 | not published | not published | $202.27 – $254.63 | 18 |
| Foot plas heel stabi pre ots HCPCS L3170 | not published | not published | $51.88 – $65.31 | 18 |
| Foot plate molded stirrup at HCPCS L2250 | not published | not published | $376.09 – $473.43 | 18 |
| Foot single axis ankle/foot HCPCS L5974 | not published | not published | $309.42 – $389.50 | 18 |
| Foot X-ray CPT 73630 | not published | not published | $36.57 – $182.03 | 2 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | not published | not published | $861.61 – $1,084.62 | 18 |
| Forearm/arm cuffs free motio HCPCS L3720 | not published | not published | $666.45 – $838.94 | 18 |
| Forensic autopsy (necropsy) CPT 88040 | not published | not published | $584.46 – $3,281.16 | 2 |
| Forensic cytopathology CPT 88125 | $132.00 | $132.00 | $49.76 – $279.35 | 2 |
| Formoterol fumarate, inh HCPCS J7606 | $122.00 | $122.00 | $1.44 – $6.60 | 4 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $6,407.00 | $6,407.00 | $0.10 – $0.33 | 4 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $18.39 – $20.98 | 4 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | not published | not published | $4.02 – $4.02 | 1 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $24.80 – $41.32 | 19 |
| Fracture assessment via dxa CPT 77086 | not published | not published | $36.57 – $182.03 | 2 |
| _fragile x methylation-sendout CPT 81244 | $112.00 | $112.00 | $44.89 – $65.09 | 16 |
| Frame typ sock above elb/dis HCPCS L6688 | not published | not published | $580.63 – $730.91 | 18 |
| Frame typ socket bel elbow/w HCPCS L6687 | not published | not published | $600.24 – $755.59 | 18 |
| Frame typ socket shoulder di HCPCS L6689 | not published | not published | $701.16 – $882.64 | 18 |
| Frame typ sock interscap-tho HCPCS L6690 | not published | not published | $759.33 – $955.86 | 18 |
| Fresh frozen plasma thawing ea un CPT 86927 | not published | not published | $149.16 – $837.38 | 2 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $33.84 – $189.98 | 2 |
| Frozen blood prep CPT 86930 | not published | not published | $291.26 – $1,635.13 | 2 |
| Frozen blood thaw CPT 86931 | not published | not published | $291.26 – $1,635.13 | 2 |
| Frozen cell preparation CPT 88241 | not published | not published | $10.52 – $17.53 | 19 |
| Fructosamine glycated protein CPT 82985 | $211.00 | $211.00 | $14.59 – $24.30 | 19 |
| Ft arch suprt premold longit HCPCS L3040 | not published | not published | $47.98 – $60.40 | 18 |
| Ft insert ucb berkeley shell HCPCS L3000 | not published | not published | $320.28 – $403.18 | 18 |
| Ftl cgen abnor 3 proteins CPT 81509 | not published | not published | $1,294.35 – $2,156.69 | 19 |
| Ftl cgen abnor five anal CPT 81512 | not published | not published | $60.49 – $100.80 | 19 |
| Ftl cgen abnor four anal CPT 81511 | not published | not published | $133.58 – $222.57 | 19 |
| Ftl cgen abnor three anal CPT 81510 | not published | not published | $48.33 – $80.53 | 19 |
| Ftl cgen abnor two proteins CPT 81508 | not published | not published | $49.09 – $78.73 | 19 |
| Ft prosth multiaxial ankl/ft HCPCS L5978 | not published | not published | $303.68 – $382.28 | 18 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $51.80 – $517.79 | 2 |
| Full sole/heel wedge btween HCPCS L3420 | not published | not published | $55.78 – $70.21 | 18 |
| Furnsh initial orthosis only HCPCS L1200 | not published | not published | $1,530.40 – $1,926.50 | 18 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | not published | not published | $0.02 – $0.06 | 4 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $274.83 – $398.50 | 16 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $137.00 – $198.65 | 16 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $274.83 – $398.50 | 16 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $185.20 – $268.54 | 16 |
| G6pc gene CPT 81250 | not published | not published | $58.49 – $84.81 | 16 |
| G6pd full gene sequence CPT 81249 | not published | not published | $600.00 – $870.00 | 16 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $253.47 | 16 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $544.11 | 16 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | $154.00 | $154.00 | $68.13 – $68.13 | 1 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $395.00 | $395.00 | $148.89 – $148.89 | 1 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $603.00 | $603.00 | $0.22 – $0.84 | 4 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $1.27 – $4.38 | 4 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.10 – $0.30 | 4 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $977.00 | $977.00 | $12.50 – $44.25 | 4 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | $1,980.00 | $1,980.00 | $18.33 – $30.55 | 19 |
| Galactokinase - sendout CPT 82759 | not published | not published | $18.69 – $31.15 | 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.