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 |
|---|---|---|---|---|
| Hydrogel drg > 48 sq in w/b HCPCS A6247 | not published | not published | $28.81 – $36.26 | 18 |
| Hydrogel drsg gel filler HCPCS A6248 | not published | not published | $19.68 – $24.77 | 18 |
| Hydrogel dsg>16<=48 sq in HCPCS A6232 | not published | not published | $8.31 – $10.46 | 18 |
| Hydrogel dsg<=16 sq in HCPCS A6231 | not published | not published | $5.66 – $7.13 | 18 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | not published | not published | $0.12 – $0.42 | 4 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.01 – $0.03 | 4 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $357.00 | $357.00 | $15.10 – $39.00 | 4 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | not published | not published | $6.00 – $6.00 | 1 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | not published | not published | $15.58 – $25.95 | 19 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $14.88 – $52.92 | 4 |
| Hyoscyamine sulfate inj HCPCS J1980 | not published | not published | $28.05 – $28.05 | 1 |
| #hypersens-actinomyces ab CPT 86602 | not published | not published | $8.86 – $14.76 | 19 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $468.93 – $468.93 | 1 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $322.78 – $322.78 | 1 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $391.21 – $506.83 | 4 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $316.80 – $316.80 | 1 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $442.92 – $442.92 | 1 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $14.93 – $54.99 | 4 |
| Hysterosalpingography s&i CPT 74740 | $2,087.00 | $2,087.00 | $80.87 – $517.79 | 2 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | not published | not published | $194.17 – $221.59 | 3 |
| I-123 iobenguane diag HCPCS A9582 | $11,228.00 | $11,228.00 | $6,952.50 – $6,952.50 | 1 |
| I-123 ioflupane diag HCPCS A9584 | $11,767.00 | $11,767.00 | $4,163.22 – $4,163.22 | 1 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $316.00 | $316.00 | $362.73 – $362.73 | 1 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $1,948.92 – $1,948.92 | 1 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $1,407.18 – $1,407.18 | 1 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | $9,949.00 | $9,949.00 | $2,859.03 – $2,859.03 | 1 |
| I131 iodide cap, rx HCPCS A9517 | $120.00 | $120.00 | $72.21 – $72.21 | 1 |
| I131 iodide sol, rx HCPCS A9530 | $60.00 | $60.00 | $62.31 – $62.31 | 1 |
| I131 max 100uci HCPCS A9531 | $181.00 | $181.00 | $13.02 – $13.02 | 1 |
| I131 serum albumin, dx HCPCS A9524 | not published | not published | $2,103.24 – $2,103.24 | 1 |
| Iaadi respiratory synctial virus CPT 87280 | $194.00 | $194.00 | $11.68 – $19.46 | 19 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $473.00 | $473.00 | $30.54 – $50.88 | 19 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | not published | not published | $15.74 – $26.23 | 19 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | $67.00 | $67.00 | $39.41 – $65.66 | 19 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $6,758.00 | $6,758.00 | $18.89 – $39.42 | 4 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $2,448.56 – $3,550.41 | 16 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $2.53 – $9.54 | 4 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | $11,639.00 | $11,639.00 | $595.53 – $595.53 | 1 |
| Icatibant injection HCPCS J1744 | not published | not published | $106.52 – $942.51 | 4 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $36.98 – $120.15 | 4 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $448,478.70 – $1,674,245.19 | 4 |
| Identify sperm tissue CPT 89264 | not published | not published | $49.76 – $279.35 | 2 |
| Idh1 common variants CPT 81120 | $446.00 | $446.00 | $193.25 – $280.21 | 16 |
| Idh2 common variants CPT 81121 | $683.00 | $683.00 | $295.79 – $428.90 | 16 |
| Iduc valve sply repl HCPCS A4342 | not published | not published | $746.35 – $939.52 | 18 |
| Idursulfase injection HCPCS J1743 | not published | not published | $461.18 – $1,674.30 | 4 |
| Ifnl3 gene CPT 81283 | not published | not published | $73.37 – $106.39 | 16 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $20.93 – $74.52 | 4 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $207.31 – $300.60 | 16 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $68.55 – $99.40 | 16 |
| Igh gene rearrange amp meth CPT 81261 | $2,414.00 | $2,414.00 | $197.99 – $287.09 | 16 |
| Igh@ var region somatic mutation analy CPT 81263 | $2,651.00 | $2,651.00 | $294.52 – $427.05 | 16 |
| Igk rearrangeabn clonal pop CPT 81264 | not published | not published | $172.73 – $250.46 | 16 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | not published | not published | $65.25 – $366.31 | 2 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | not published | not published | $291.26 – $1,635.13 | 2 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | not published | not published | $149.16 – $837.38 | 2 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | not published | not published | $40.14 – $40.14 | 1 |
| Ikbkap gene CPT 81260 | $607.00 | $607.00 | $39.31 – $57.00 | 16 |
| Iliac/fem angio cath insert HCPCS G0278 | not published | not published | $51.44 – $51.44 | 1 |
| Iloprost non-comp unit dose HCPCS Q4074 | $2,618.00 | $2,618.00 | $126.45 – $476.76 | 4 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $47.18 – $174.90 | 4 |
| Immntx 1 sting insect CPT 95130 | not published | not published | $57.14 – $65.20 | 3 |
| Immntx 4 sting insects CPT 95133 | not published | not published | $142.91 – $163.09 | 3 |
| Immntx 5 sting insects CPT 95134 | not published | not published | $166.32 – $189.80 | 3 |
| Immob elbow child sm HCPCS L3762 | not published | not published | $99.77 – $125.60 | 18 |
| Immobilizer shldr cntor adlt HCPCS L3670 | not published | not published | $129.82 – $163.42 | 18 |
| Immobilizer shldr dlx str 24-36in med HCPCS L1830 | not published | not published | $65.65 – $82.64 | 18 |
| Immobilizer shldr sling med HCPCS L3660 | not published | not published | $98.23 – $123.66 | 18 |
| Immune complex assay CPT 86332 | $902.00 | $902.00 | $21.21 – $35.34 | 19 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | not published | not published | $38.36 – $141.87 | 4 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | $1,038.00 | $1,038.00 | $68.86 – $236.67 | 4 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $40.85 – $142.17 | 4 |
| Immune globulin ig human im use 90281 CPT 90281 | not published | not published | $358.41 – $358.41 | 1 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $1,152.00 | $1,152.00 | $18.11 – $30.17 | 19 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $882.00 | $882.00 | $18.11 – $30.17 | 19 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $22.25 – $37.08 | 19 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | not published | not published | $10.43 – $17.37 | 19 |
| Immunodiffusion nes CPT 86329 | $307.00 | $307.00 | $12.22 – $20.37 | 19 |
| Immunoelectrophoresis assay CPT 86327 | not published | not published | $43.38 – $43.38 | 1 |
| Immunofixation electrophoresis serum CPT 86334 | $228.00 | $228.00 | $19.44 – $32.39 | 19 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | not published | not published | $81.30 – $456.42 | 2 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | not published | not published | $291.26 – $1,635.13 | 2 |
| Immunoglobulin assay CPT 86023 | not published | not published | $10.85 – $18.07 | 19 |
| Immunotherapy 2/> injections CPT 95125 | not published | not published | $71.42 – $81.50 | 3 |
| Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster HCPCS L8612 | not published | not published | $642.95 – $809.36 | 18 |
| Implant 11 volt lithium-ion backup battery for controller pocket HCPCS Q0506 | not published | not published | $872.56 – $1,098.40 | 18 |
| Implant cochlear osia osi300 HCPCS L8690 | not published | not published | $4,859.77 – $6,117.60 | 18 |
| Implant power module patient cable cable 14 volt HCPCS Q0477 | not published | not published | $792.53 – $997.66 | 18 |
| Implant ureth bulk agent HCPCS L8606 | not published | not published | $226.83 – $285.54 | 18 |
| Impl ear abutment ba300 9mm HCPCS L8693 | not published | not published | $1,549.02 – $1,949.95 | 18 |
| Impl eye bio-eye 16mm HCPCS L8042 | not published | not published | $3,526.31 – $4,439.00 | 18 |
| Imp neurosti pls gn any type HCPCS L8679 | not published | not published | $8,559.41 – $10,774.79 | 18 |
| Imported lipodox inj HCPCS Q2049 | $18,422.00 | $18,422.00 | $896.22 – $896.22 | 1 |
| Impreg gauze no h20/sal/yard HCPCS A6266 | not published | not published | $2.31 – $2.91 | 18 |
| Imuglucerase injection HCPCS J1786 | not published | not published | $36.67 – $129.69 | 4 |
| In-111 autologous plt stdy dx HCPCS A9571 | not published | not published | $14,392.11 – $14,392.11 | 1 |
| In-111 autol wbc diag per dose HCPCS A9570 | $4,733.00 | $4,733.00 | $3,309.57 – $3,309.57 | 1 |
| In-111 capromab pendet HCPCS A9507 | $18,126.00 | $18,126.00 | $5,190.87 – $5,190.87 | 1 |
| In-111 ibritumomab tiux dx HCPCS A9542 | not published | not published | $12,331.95 – $12,331.95 | 1 |
| In-111 oxyquinolin per 0.5 mci HCPCS A9547 | $5,928.00 | $5,928.00 | $2,494.38 – $2,494.38 | 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.