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 |
|---|---|---|---|---|
| In-111 pentetate dtpa / 0.5 mci HCPCS A9548 | $4,733.00 | $4,733.00 | $2,236.86 – $2,236.86 | 1 |
| In-111 pentetreotide HCPCS A9572 | $4,817.00 | $4,817.00 | $6,002.82 – $6,002.82 | 1 |
| In-111 satumomab pend HCPCS A4642 | $12,591.00 | $12,591.00 | $5,029.17 – $5,029.17 | 1 |
| Inactivated je vacc im CPT 90738 | not published | not published | $917.13 – $917.13 | 1 |
| Incobotulinumtoxin a HCPCS J0588 | not published | not published | $4.53 – $15.75 | 4 |
| Indigotindisulfonate 8 mg/ml soln 5 ml ampule HCPCS J9220 | not published | not published | $27.90 – $27.90 | 1 |
| Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s) CPT 87626 | not published | not published | $70.20 – $75.11 | 15 |
| Infect ag drug suscept pheno predict CPT 87900 | not published | not published | $113.43 – $189.01 | 19 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $13.06 – $21.75 | 19 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $12.30 – $20.49 | 19 |
| Infect ag genotype na cytomegalovirus CPT 87910 | not published | not published | $224.04 – $373.30 | 19 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $224.04 – $373.30 | 19 |
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $112.02 – $186.66 | 19 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $3,150.00 | $3,150.00 | $224.04 – $373.30 | 19 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | not published | not published | $28.52 – $47.52 | 19 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $30.71 – $51.17 | 19 |
| Infect ag ia optc obs influenza CPT 87804 | not published | not published | $14.40 – $24.00 | 19 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | not published | not published | $10.43 – $17.37 | 19 |
| Infect ag if hep delta agent CPT 87380 | $617.00 | $617.00 | $15.98 – $26.62 | 19 |
| Infect ag if influenza a CPT 87276 | $232.00 | $232.00 | $13.98 – $23.30 | 19 |
| Infect ag if influenza b CPT 87275 | $185.00 | $185.00 | $10.66 – $17.76 | 19 |
| Infect ag if legionella pneumophila CPT 87278 | $523.00 | $523.00 | $13.57 – $22.62 | 19 |
| Infect ag if nos ea CPT 87299 | $232.00 | $232.00 | $14.01 – $23.35 | 19 |
| Infect ag if pneumocystis carinii CPT 87281 | $533.00 | $533.00 | $10.43 – $17.37 | 19 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $11.68 – $19.46 | 19 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $46.53 – $77.53 | 19 |
| Infect ag na hep b amp CPT 87516 | $596.00 | $596.00 | $30.54 – $50.88 | 19 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $37.28 – $62.12 | 19 |
| Infect ag na hpv high-risk types CPT 87624 | $305.00 | $305.00 | $30.54 – $50.88 | 19 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $630.00 | $630.00 | $83.37 – $138.91 | 19 |
| Infect ag na influenza revr/amp ea type CPT 87501 | not published | not published | $44.65 – $74.40 | 19 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | $113.00 | $113.00 | $51.17 – $65.00 | 18 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $1,299.00 | $1,299.00 | $362.69 – $604.33 | 19 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | $3,877.00 | $3,877.00 | $425.25 – $708.56 | 19 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | $935.00 | $935.00 | $22.69 – $37.80 | 19 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $41.38 – $152.47 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $416.00 | $416.00 | $10.43 – $17.37 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $11.68 – $19.46 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $365.00 | $365.00 | $12.03 – $20.04 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $737.00 | $737.00 | $10.43 – $17.37 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $1,127.00 | $1,127.00 | $12.51 – $20.85 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $580.00 | $580.00 | $8.99 – $14.98 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | not published | not published | $8.99 – $14.98 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | not published | not published | $20.95 – $34.92 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | not published | not published | $10.43 – $17.37 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $169.00 | $169.00 | $10.43 – $17.37 | 19 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $241.00 | $241.00 | $10.43 – $17.37 | 19 |
| Infectious agent nucleic acid amplified probe CPT 87798 | not published | not published | $30.54 – $50.88 | 19 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $459.00 | $459.00 | $30.54 – $50.88 | 19 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | not published | not published | $32.44 – $54.04 | 19 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | $1,115.00 | $1,115.00 | $362.69 – $604.33 | 19 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | not published | not published | $30.54 – $50.88 | 19 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $439.00 | $439.00 | $30.54 – $50.88 | 19 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | not published | not published | $36.27 – $60.44 | 19 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $459.00 | $459.00 | $30.54 – $50.88 | 19 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $76.00 | $76.00 | $44.65 – $74.40 | 19 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | not published | not published | $124.12 – $206.81 | 19 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | $111.00 | $111.00 | $124.12 – $206.81 | 19 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $30.54 – $50.88 | 19 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $389.00 | $389.00 | $30.54 – $50.88 | 19 |
| Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae CPT 87494 | $176.00 | $176.00 | $70.18 – $75.09 | 15 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $205.00 | $205.00 | $76.77 – $82.14 | 15 |
| Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets CPT 87627 | not published | not published | $679.77 – $727.35 | 15 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $561.00 | $561.00 | $362.69 – $604.33 | 19 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $111.64 – $186.02 | 19 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $228.86 – $381.34 | 19 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | not published | not published | $37.28 – $62.12 | 19 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $956.00 | $956.00 | $37.28 – $62.12 | 19 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | not published | not published | $37.28 – $62.12 | 19 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | not published | not published | $74.06 – $123.39 | 19 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | not published | not published | $124.12 – $206.81 | 19 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $25.94 – $97.26 | 4 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $16.79 – $71.43 | 4 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $13.52 – $72.66 | 4 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $25.43 – $42.37 | 19 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $70.97 – $294.48 | 4 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $24.54 – $89.13 | 4 |
| Infuse radioactive materials CPT 77750 | not published | not published | $633.38 – $633.38 | 1 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $1,809.95 – $2,278.40 | 18 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $1,336.48 – $1,682.39 | 18 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $31.99 – $36.51 | 3 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $1,343.77 – $1,691.56 | 18 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $41.50 – $47.36 | 3 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $83.90 – $95.75 | 3 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $4.99 – $18.06 | 4 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $5.98 – $21.84 | 4 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.19 – $0.27 | 4 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.04 – $0.15 | 4 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.04 – $0.18 | 4 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.03 – $0.15 | 4 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $3,309.42 – $12,517.59 | 4 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $489.54 – $489.54 | 1 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $79.02 – $79.02 | 1 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $53,750.26 – $192,824.37 | 4 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $5.08 – $5.80 | 3 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $29.34 – $106.44 | 4 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $676.48 – $2,598.60 | 4 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $273.00 – $920.97 | 4 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $1.28 – $4.74 | 4 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $3.78 – $13.20 | 4 |
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.