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 |
|---|---|---|---|---|
| Ghs sensitivity (per antimicro) CPT 87184 | not published | not published | $6.51 – $10.85 | 19 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $39.99 – $51.45 | 18 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $84.90 – $110.73 | 18 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $59.89 – $77.11 | 18 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $6.35 – $10.58 | 19 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $21.15 – $35.23 | 19 |
| Ghs urine, porphyrins quant CPT 84120 | $235.00 | $235.00 | $12.80 – $21.33 | 19 |
| Giardia ag if CPT 87269 | not published | not published | $11.84 – $19.73 | 19 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $12.81 – $21.34 | 19 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $196.93 – $517.79 | 2 |
| Gi inhouse confirmation CPT 87045 | $669.00 | $669.00 | $8.21 – $13.69 | 19 |
| Gi protein loss CPT 78282 | not published | not published | $68.56 – $848.52 | 2 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $101.12 – $146.62 | 16 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $61.52 – $89.20 | 16 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $35.00 – $50.75 | 16 |
| Glassia injection HCPCS J0257 | not published | not published | $4.63 – $17.07 | 4 |
| Glove finger flexion right lg xl HCPCS L3912 | not published | not published | $111.38 – $140.21 | 18 |
| Glucagon 1 mg solution for injection HCPCS J1610 | not published | not published | $162.15 – $494.58 | 4 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | not published | not published | $127.87 – $429.75 | 4 |
| Glucagon plasma - sendout CPT 82943 | $899.00 | $899.00 | $12.44 – $20.72 | 19 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $40.09 – $66.80 | 19 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $43.95 – $73.22 | 19 |
| Glucagon tolerance test CPT 82946 | not published | not published | $15.46 – $25.77 | 19 |
| Glucose 1 hr post dose CPT 82950 | not published | not published | $4.13 – $6.89 | 19 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.26 – $8.77 | 19 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $2.86 – $4.76 | 19 |
| Glucose blood quantitative CPT 82947 | $428.00 | $428.00 | $3.42 – $5.70 | 19 |
| Glucose body fluid CPT 82945 | not published | not published | $3.42 – $5.70 | 19 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $1,290.00 | $1,290.00 | $11.20 – $18.66 | 19 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $273.00 | $273.00 | $3.41 – $5.68 | 19 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | not published | not published | $0.43 – $1.14 | 4 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $41.07 – $41.07 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | not published | not published | $9.15 – $34.89 | 4 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $1,248.00 | $1,248.00 | $16.17 – $26.94 | 19 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $129.15 – $215.19 | 19 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $255.00 | $255.00 | $16.12 – $26.85 | 19 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | not published | not published | $599.37 – $2,332.50 | 4 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $25.81 – $381.42 | 4 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $381.42 – $1,024.29 | 4 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $54.08 – $381.42 | 4 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | not published | not published | $381.42 – $381.42 | 1 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $5,992.50 – $5,992.50 | 1 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $55.60 – $381.42 | 4 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | not published | not published | $89.64 – $381.42 | 4 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | not published | not published | $115.91 – $381.42 | 4 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $44.02 – $381.42 | 4 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $381.42 – $381.42 | 1 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | not published | not published | $381.42 – $381.42 | 1 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | not published | not published | $381.42 – $381.42 | 1 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $31.88 – $381.42 | 4 |
| Granisetron 1 mg tab HCPCS Q0166 | $555.00 | $555.00 | $177.15 – $177.15 | 1 |
| Granisetron hcl injection HCPCS J1626 | not published | not published | $0.22 – $0.45 | 4 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $14.80 – $15.84 | 15 |
| Group train without patient HCPCS G0543 | not published | not published | $7.40 – $8.45 | 3 |
| Growth hormone antibody CPT 86277 | not published | not published | $13.69 – $22.82 | 19 |
| Growth hormone panel CPT 80428 | not published | not published | $58.05 – $96.72 | 19 |
| Growth hormone panel CPT 80430 | not published | not published | $112.55 – $187.53 | 19 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $75.60 – $109.62 | 16 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $180.84 – $4,034.23 | 2 |
| Guide endoanchr sg-64 aaa 62cm HCPCS L8670 | not published | not published | $579.27 – $729.19 | 18 |
| Hair analysis HCPCS P2031 | not published | not published | $4.95 – $7.18 | 16 |
| Hallus-valgus nt dyn pre ots HCPCS L3100 | not published | not published | $44.08 – $55.49 | 18 |
| Halo cervical into body jack HCPCS L0820 | not published | not published | $2,289.87 – $2,882.55 | 18 |
| Halo cervical into jckt vest HCPCS L0810 | not published | not published | $2,551.22 – $3,211.53 | 18 |
| Halo cerv into milwaukee typ HCPCS L0830 | not published | not published | $3,227.12 – $4,062.37 | 18 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $561.00 | $561.00 | $3.92 – $11.82 | 4 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $429.00 | $429.00 | $0.66 – $2.19 | 4 |
| Halo repl liner/interface HCPCS L0861 | not published | not published | $219.75 – $276.63 | 18 |
| Hand-held pefr meter a4614 HCPCS A4614 | not published | not published | $28.81 – $36.26 | 18 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $5.58 – $31.33 | 2 |
| Hand orthosis metacarpal fracture orthosis prefa l3918 HCPCS L3918 | not published | not published | $98.06 – $123.45 | 18 |
| Hand restoration multiple fi HCPCS L6905 | not published | not published | $1,641.32 – $2,066.14 | 18 |
| Hand restoration no fingers HCPCS L6910 | not published | not published | $1,684.93 – $2,121.03 | 18 |
| Hand restoration replacmnt g HCPCS L6915 | not published | not published | $651.45 – $820.06 | 18 |
| Hand restorat thumb/1 finger HCPCS L6900 | not published | not published | $1,671.89 – $2,104.62 | 18 |
| Hand X-ray CPT 73130 | not published | not published | $39.76 – $182.03 | 2 |
| Haptoglobin quantitative CPT 83010 | $375.00 | $375.00 | $10.95 – $18.24 | 19 |
| Harness chest/shlder saddle HCPCS L6672 | not published | not published | $175.47 – $220.88 | 18 |
| Harness figure of 8 dual con HCPCS L6676 | not published | not published | $126.20 – $158.86 | 18 |
| Harness figure of 8 sing con HCPCS L6675 | not published | not published | $124.97 – $157.31 | 18 |
| Hba1/hba2 full gene sequence CPT 81259 | not published | not published | $600.00 – $870.00 | 16 |
| Hba1/hba2 gene dup/del vrnts CPT 81269 | not published | not published | $202.40 – $293.48 | 16 |
| Hba1/hba2 gene fam vrnt CPT 81258 | not published | not published | $375.25 – $544.11 | 16 |
| Hbb full gene sequence CPT 81364 | not published | not published | $324.58 – $470.64 | 16 |
| Hbb gene com variants CPT 81361 | $1,512.00 | $1,512.00 | $174.81 – $253.47 | 16 |
| Hbb gene dup/del variants CPT 81363 | $631.00 | $631.00 | $202.40 – $293.48 | 16 |
| Hbb gene known fam variant CPT 81362 | not published | not published | $375.25 – $544.11 | 16 |
| Hb glycosylated a1c home dev CPT 83037 | not published | not published | $8.45 – $14.08 | 19 |
| Hc fl sm bowel enteroclss tube w kub double contrast CPT 74251 | not published | not published | $245.23 – $401.74 | 2 |
| Hcg free betachain test CPT 84704 | not published | not published | $13.30 – $22.17 | 19 |
| Hcg qualitative CPT 84703 | not published | not published | $6.54 – $10.90 | 19 |
| Hcg quantitative CPT 84702 | not published | not published | $13.10 – $21.82 | 19 |
| Hc hearing aid exam both ears CPT 92591 | not published | not published | $357.10 – $407.52 | 3 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $113.00 | $113.00 | $292.59 – $292.59 | 1 |
| Hc nm cardiac blood pool planar 1 stdy wal motn eject fract CPT 78481 | not published | not published | $204.03 – $1,101.15 | 2 |
| Hc nm fusion spect CT unlisted CPT 78999 | not published | not published | $848.52 – $848.52 | 1 |
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $105.14 – $848.52 | 2 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $194.05 – $1,101.15 | 2 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $9,975.00 | $9,975.00 | $323.72 – $2,938.37 | 2 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $469.20 – $469.20 | 1 |
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.