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 |
|---|---|---|---|---|
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | not published | not published | $0.12 – $0.45 | 4 |
| Io radiation tx management CPT 77469 | not published | not published | $1,211.72 – $1,211.72 | 1 |
| Io rad tx delivery by x-ray CPT 77424 | not published | not published | $11,229.00 – $11,229.00 | 1 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | not published | not published | $153.19 – $560.73 | 4 |
| Ipratropium bromide non-comp HCPCS J7644 | $31.00 | $31.00 | $0.31 – $1.20 | 4 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | not published | not published | $1.39 – $5.37 | 4 |
| Irinotecan liposomal 4.3 mg/ml intravenous HCPCS J9205 | not published | not published | $55.49 – $197.88 | 4 |
| Iron CPT 83540 | not published | not published | $5.63 – $9.38 | 19 |
| Iron binding capacity CPT 83550 | $125.00 | $125.00 | $7.61 – $12.67 | 19 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | not published | not published | $14.65 – $54.24 | 4 |
| Iron stain peripheral blood CPT 85536 | not published | not published | $5.98 – $9.98 | 19 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | not published | not published | $0.20 – $0.72 | 4 |
| Irradiation of blood product each unit reference CPT 86945 | not published | not published | $33.84 – $189.98 | 2 |
| Irrigation syringe HCPCS A4322 | not published | not published | $3.42 – $4.30 | 18 |
| Irrigation tray HCPCS A4320 | not published | not published | $6.47 – $8.14 | 18 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $67.03 – $252.90 | 4 |
| Ivc venogram s&i CPT 75825 | not published | not published | $234.89 – $6,438.74 | 2 |
| IV inj ra drug dx study CPT 78808 | $831.00 | $831.00 | $193.74 – $848.52 | 2 |
| Ivp w/nephrotomography CPT 74415 | not published | not published | $103.56 – $401.74 | 2 |
| Ivp w/wo kub w/wo tomography CPT 74400 | not published | not published | $103.56 – $401.74 | 2 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $115.78 – $419.94 | 4 |
| Jak2 targeted sequence analysis CPT 81279 | $800.00 | $800.00 | $185.20 – $268.54 | 16 |
| John cunningham antibody CPT 86711 | $1,753.00 | $1,753.00 | $14.70 – $24.49 | 19 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | not published | not published | $1,211.59 – $1,525.18 | 18 |
| Kafo dbl solid stirrup without j HCPCS L2030 | not published | not published | $1,099.85 – $1,384.52 | 18 |
| Kafo fem fx cast molded to p HCPCS L2128 | not published | not published | $1,818.20 – $2,288.79 | 18 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | not published | not published | $1,051.89 – $1,324.15 | 18 |
| Kafo fem fx cast thermoplas HCPCS L2126 | not published | not published | $1,283.98 – $1,616.31 | 18 |
| Kafo femoral fx cast rigid HCPCS L2136 | not published | not published | $1,255.50 – $1,580.45 | 18 |
| Kafo femoral fx cast soft HCPCS L2132 | not published | not published | $985.77 – $1,240.91 | 18 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | not published | not published | $2,077.39 – $2,615.07 | 18 |
| Kafo plas sing free knee mol HCPCS L2037 | not published | not published | $1,752.03 – $2,205.49 | 18 |
| Kafo plastic pediatric size HCPCS L2035 | not published | not published | $178.41 – $224.58 | 18 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | not published | not published | $1,031.49 – $1,298.47 | 18 |
| Kafo sng/dbl mechanical act HCPCS L2005 | not published | not published | $4,177.93 – $5,259.27 | 18 |
| Kafo sng solid stirrup without j HCPCS L2010 | not published | not published | $962.25 – $1,211.30 | 18 |
| Kafo without joint multi-axis an HCPCS L2038 | not published | not published | $1,779.78 – $2,240.43 | 18 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $381.42 – $381.42 | 1 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $13.46 – $22.43 | 19 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | not published | not published | $7.11 – $11.85 | 19 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | not published | not published | $0.42 – $0.99 | 4 |
| Kidney function study CPT 78725 | not published | not published | $77.68 – $848.52 | 2 |
| Kidney imaging morphology CPT 78700 | not published | not published | $91.52 – $848.52 | 2 |
| Kidney imag w/bld flow multi CPT 78709 | $1,234.00 | $1,234.00 | $288.14 – $1,101.15 | 2 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $5,518.00 | $5,518.00 | $198.10 – $1,101.15 | 2 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $3,140.00 | $3,140.00 | $155.55 – $245.18 | 2 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | not published | not published | $44.61 – $56.15 | 18 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | not published | not published | $8.47 – $10.67 | 18 |
| Kit gene analys d816 variant CPT 81273 | not published | not published | $124.87 – $181.06 | 16 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | not published | not published | $14.76 – $18.58 | 18 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $19.76 – $381.42 | 4 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | not published | not published | $1,759.27 – $2,214.61 | 18 |
| Kit trach suct cls 30.5cm HCPCS A4605 | not published | not published | $19.87 – $25.02 | 18 |
| Knee cap medial or lateral p HCPCS L2800 | not published | not published | $129.58 – $163.12 | 18 |
| Knee control condylar pad HCPCS L2810 | not published | not published | $101.72 – $128.05 | 18 |
| Knee control full kneecap HCPCS L2795 | not published | not published | $84.30 – $106.12 | 18 |
| Knee disart expand wall sock HCPCS L5653 | not published | not published | $605.63 – $762.39 | 18 |
| Knee disarticulat leather so HCPCS L5640 | not published | not published | $723.33 – $910.55 | 18 |
| Knee disc/dial lock/adj flex HCPCS L2425 | not published | not published | $146.14 – $183.97 | 18 |
| Knee jnt ratchet lock ea jnt HCPCS L2430 | not published | not published | $146.14 – $183.97 | 18 |
| Knee joint cam lock each joi HCPCS L2415 | not published | not published | $123.84 – $155.89 | 18 |
| Knee joint drop lock ea jnt HCPCS L2405 | not published | not published | $88.88 – $111.89 | 18 |
| Knee lift loop drop lock rin HCPCS L2492 | not published | not published | $132.69 – $167.04 | 18 |
| Knee MRI (with and without contrast) CPT 73723 | not published | not published | $452.76 – $828.27 | 2 |
| Knee MRI (with contrast) CPT 73722 | not published | not published | $343.53 – $1,609.16 | 2 |
| Knee MRI (without contrast) CPT 73721 | not published | not published | $286.92 – $517.79 | 2 |
| Knee orth pos locking joint HCPCS L1831 | not published | not published | $300.08 – $377.75 | 18 |
| Knee-shin exo fluid swing ph HCPCS L5724 | not published | not published | $1,570.72 – $1,977.25 | 18 |
| Knee-shin exo frct swg & sta HCPCS L5718 | not published | not published | $947.97 – $1,193.33 | 18 |
| Knee-shin exo frict swg & st HCPCS L5712 | not published | not published | $448.39 – $564.45 | 18 |
| Knee-shin exo mech stance ph HCPCS L5716 | not published | not published | $758.44 – $954.74 | 18 |
| Knee-shin exo mnl lock ultra HCPCS L5711 | not published | not published | $567.76 – $714.71 | 18 |
| Knee-shin exo variable frict HCPCS L5714 | not published | not published | $462.41 – $582.09 | 18 |
| Knee-shin ext jnts fld swg e HCPCS L5726 | not published | not published | $2,062.52 – $2,596.34 | 18 |
| Knee-shin fluid swg & stance HCPCS L5728 | not published | not published | $2,569.62 – $3,234.70 | 18 |
| Knee-shin pneum/hydra pneum HCPCS L5780 | not published | not published | $1,238.94 – $1,559.61 | 18 |
| Knee-shin pneum swg frct exo HCPCS L5722 | not published | not published | $989.24 – $1,245.28 | 18 |
| Knee-shin pro flex/ext cont HCPCS L5859 | not published | not published | $14,822.22 – $18,658.55 | 18 |
| Knee-shin sys hydraul stance HCPCS L5848 | not published | not published | $1,098.52 – $1,382.85 | 18 |
| Knee-shin sys stance flexion HCPCS L5845 | not published | not published | $1,831.03 – $2,304.94 | 18 |
| Knee X-ray CPT 73564 | not published | not published | $50.64 – $245.18 | 2 |
| Kne-shin exo sng axi mnl loc HCPCS L5710 | not published | not published | $374.26 – $471.13 | 18 |
| Kne sing axis fric shin sach HCPCS L5200 | not published | not published | $3,462.31 – $4,358.44 | 18 |
| Ko dbl upright w/air pre cst HCPCS L1847 | not published | not published | $586.43 – $738.21 | 18 |
| Ko dbl upright w/air pre ots HCPCS L1848 | not published | not published | $586.43 – $738.21 | 18 |
| Ko derot ant cruciate custom HCPCS L1840 | not published | not published | $1,009.97 – $1,271.37 | 18 |
| Ko elastic w/joints pre ots HCPCS L1812 | not published | not published | $72.85 – $91.71 | 18 |
| Ko rigid without joints pre ots HCPCS L1836 | not published | not published | $92.82 – $116.84 | 18 |
| Ko single upright pre cst HCPCS L1843 | not published | not published | $914.82 – $1,151.60 | 18 |
| Ko single upright prefab ots HCPCS L1851 | not published | not published | $624.14 – $785.68 | 18 |
| Ko supracondylar socket mold HCPCS L1860 | not published | not published | $1,048.11 – $1,319.38 | 18 |
| Ko swedish type pre ots HCPCS L1850 | not published | not published | $213.78 – $269.11 | 18 |
| Ko w/0 joint rigid molded to HCPCS L1834 | not published | not published | $758.22 – $954.46 | 18 |
| Ko w adj flex/ext rotat mold HCPCS L1846 | not published | not published | $1,163.96 – $1,465.23 | 18 |
| Ko w/adj jt rot cntrl molded HCPCS L1844 | not published | not published | $1,585.68 – $1,996.10 | 18 |
| Kras gene addl variants CPT 81276 | not published | not published | $168.17 – $280.21 | 19 |
| Kras gene variants exon 2 CPT 81275 | not published | not published | $168.17 – $280.21 | 19 |
| Kyleena, 19.5 mg HCPCS J7296 | $2,950.00 | $2,950.00 | $4,580.79 – $4,580.79 | 1 |
| Kyphosis pad HCPCS L1020 | not published | not published | $84.43 – $106.28 | 18 |
| Kyphosis pad floating HCPCS L1025 | not published | not published | $161.16 – $202.87 | 18 |
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.