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 |
|---|---|---|---|---|
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | not published | not published | $165.12 – $207.86 | 18 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,344.72 – $1,692.76 | 18 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $784.34 – $987.34 | 18 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $106.94 – $134.62 | 18 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $934.94 – $1,176.93 | 18 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,384.06 – $1,742.29 | 18 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | not published | not published | $292.37 – $368.05 | 18 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $189.35 – $238.36 | 18 |
| Lso s/c shell/panel custom HCPCS L0640 | not published | not published | $1,066.91 – $1,343.05 | 18 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,095.31 – $1,378.80 | 18 |
| L/s ratio fetal lung CPT 83661 | $899.00 | $899.00 | $19.13 – $31.89 | 19 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $1.93 – $2.43 | 18 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $62.13 – $78.22 | 18 |
| Lumbar derotation pad HCPCS L1240 | not published | not published | $84.60 – $106.50 | 18 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $185.20 – $3,947.38 | 2 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $81.33 – $102.38 | 18 |
| Lumbar sling HCPCS L1090 | not published | not published | $115.57 – $145.48 | 18 |
| Lumizyme injection HCPCS J0221 | not published | not published | $171.33 – $622.17 | 4 |
| Lung perfusion imaging CPT 78580 | $4,577.00 | $4,577.00 | $153.98 – $848.52 | 2 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $174.28 – $632.34 | 4 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $35.05 – $128.31 | 4 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $962.31 – $962.31 | 1 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $777.96 – $777.96 | 1 |
| Lvad shower bag heartmate HCPCS Q0501 | not published | not published | $521.69 – $656.71 | 18 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | not published | not published | $288.48 – $363.15 | 18 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $17.45 – $29.07 | 19 |
| Lymphatics/lymph node imaging CPT 78195 | $4,605.00 | $4,605.00 | $243.79 – $1,101.15 | 2 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $31.82 – $53.01 | 19 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $42.67 – $71.09 | 19 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $164.92 – $274.79 | 19 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $41.41 – $69.01 | 19 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $197.92 – $1,218.65 | 2 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $246.80 – $3,163.82 | 2 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $172.13 – $6,438.74 | 2 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $232.02 – $6,438.74 | 2 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $13.03 – $45.30 | 4 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $8.03 – $45.08 | 2 |
| Macroscopic exam arthropod CPT 87168 | $387.00 | $387.00 | $3.71 – $6.19 | 19 |
| Macroscopic exam parasite CPT 87169 | $387.00 | $387.00 | $3.75 – $6.25 | 19 |
| Magnesium CPT 83735 | not published | not published | $5.83 – $9.71 | 19 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | not published | not published | $0.42 – $1.23 | 4 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $335.72 – $517.79 | 2 |
| Malaria antibody CPT 86750 | not published | not published | $11.47 – $19.13 | 19 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $1.92 – $2.19 | 3 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $3.54 – $3.54 | 1 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $66.72 – $83.98 | 18 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $4.41 – $7.35 | 19 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $41.25 – $161.25 | 4 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $3,762.00 – $3,762.00 | 1 |
| Mask full face lg af531 HCPCS A7030 | not published | not published | $93.97 – $118.29 | 18 |
| Mastectomy form HCPCS L8020 | not published | not published | $260.36 – $327.74 | 18 |
| Mastoids complete CPT 70130 | not published | not published | $73.24 – $245.18 | 2 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $73.40 – $381.42 | 4 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $7,700.01 – $7,700.01 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $18.27 – $381.42 | 4 |
| M.avium-intra dna amp prob CPT 87561 | $494.00 | $494.00 | $30.54 – $50.88 | 19 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $23.75 – $39.57 | 19 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $37.28 – $62.12 | 19 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $406.00 | $406.00 | $12.58 – $20.97 | 19 |
| Mayo aathr protein s free CPT 85306 | not published | not published | $13.33 – $22.21 | 19 |
| Mayo activated protein c resistance assay CPT 85307 | $837.00 | $837.00 | $13.33 – $22.21 | 19 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $456.00 | $456.00 | $33.57 – $55.93 | 19 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $742.00 | $742.00 | $12.86 – $21.43 | 19 |
| Mayo alpha 1 antitrypsin CPT 82103 | $189.00 | $189.00 | $11.70 – $19.49 | 19 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | not published | not published | $13.12 – $21.87 | 19 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | not published | not published | $121.63 – $176.36 | 16 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | not published | not published | $91.66 – $132.91 | 16 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $2,136.00 | $2,136.00 | $137.00 – $198.65 | 16 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | not published | not published | $1,160.00 – $1,682.00 | 16 |
| Mayo androstenedione CPT 82157 | $622.00 | $622.00 | $25.48 – $42.46 | 19 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | not published | not published | $12.71 – $21.17 | 19 |
| Mayo antithrombin iii antigen CPT 85301 | $693.00 | $693.00 | $9.41 – $15.67 | 19 |
| Mayo aspergillus fumigatus antibody CPT 86606 | not published | not published | $13.10 – $21.82 | 19 |
| Mayo avwpr vw factor activity CPT 85397 | $842.00 | $842.00 | $26.85 – $44.75 | 19 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | not published | not published | $30.54 – $50.88 | 19 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | not published | not published | $8.86 – $14.76 | 19 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $647.00 | $647.00 | $144.84 – $210.02 | 16 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | not published | not published | $214.62 – $311.20 | 16 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $246.00 | $246.00 | $11.23 – $18.70 | 19 |
| Mayo bordetella pertussis antibody igg CPT 86615 | not published | not published | $11.47 – $19.13 | 19 |
| Mayo brcmg brucella antibody igm CPT 86622 | not published | not published | $7.77 – $12.95 | 19 |
| Mayo c1 esterase inhibitor CPT 83883 | $189.00 | $189.00 | $11.83 – $19.72 | 19 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $491.00 | $491.00 | $14.68 – $24.46 | 19 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $682.00 | $682.00 | $23.31 – $38.83 | 19 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | not published | not published | $106.36 – $177.22 | 19 |
| Mayo ceruloplasmin CPT 82390 | $386.00 | $386.00 | $9.35 – $15.57 | 19 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | not published | not published | $12.29 – $20.47 | 19 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | not published | not published | $11.21 – $18.68 | 19 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | not published | not published | $10.29 – $17.14 | 19 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | not published | not published | $11.03 – $18.39 | 19 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | not published | not published | $101.37 – $168.91 | 19 |
| Mayo chromium CPT 82495 | $356.00 | $356.00 | $17.65 – $29.41 | 19 |
| Mayo coccidioides antibody CPT 86635 | $705.00 | $705.00 | $9.98 – $16.63 | 19 |
| Mayo cocou cortisone urine CPT 82542 | not published | not published | $20.96 – $34.93 | 19 |
| Mayo cortisol free CPT 82530 | not published | not published | $14.54 – $24.23 | 19 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $62.00 | $62.00 | $36.66 – $61.09 | 19 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | not published | not published | $10.55 – $17.57 | 19 |
| Mayo cyanide CPT 82600 | $271.00 | $271.00 | $16.88 – $28.13 | 19 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | not published | not published | $149.16 – $837.38 | 2 |
| Mayo deoxyribonuclease antibody titer CPT 86215 | $550.00 | $550.00 | $11.53 – $19.21 | 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.