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 |
|---|---|---|---|---|
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $999.00 | $999.00 | $42.56 – $129.87 | 4 |
| Amphotericin b lipid complex HCPCS J0287 | not published | not published | $8.76 – $31.05 | 4 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | not published | not published | $19.81 – $62.16 | 4 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | not published | not published | $0.51 – $1.77 | 4 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | not published | not published | $1.33 – $3.99 | 4 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $262.99 – $281.40 | 15 |
| Amylase CPT 82150 | not published | not published | $5.64 – $9.40 | 19 |
| Anacaulase-bcdb 8.8% gel 1 g HCPCS J7353 | not published | not published | $171.51 – $171.51 | 1 |
| Ana ds-dna CPT 86226 | $254.00 | $254.00 | $10.54 – $17.56 | 19 |
| Analysis gene f2 20210g>a variant CPT 81240 | $2,206.00 | $2,206.00 | $57.16 – $95.25 | 19 |
| Analysis gene f5 leiden variant CPT 81241 | $1,483.00 | $1,483.00 | $63.85 – $106.39 | 19 |
| Analysis nerve CPT 88356 | $921.00 | $921.00 | $49.76 – $279.35 | 2 |
| Analysis tumor CPT 88358 | $811.00 | $811.00 | $149.16 – $837.38 | 2 |
| Anaplsma phgcytophlm amp prb CPT 87468 | $533.00 | $533.00 | $30.54 – $50.88 | 19 |
| Anca screen with reflex to titer -quest CPT 86021 | not published | not published | $13.10 – $21.82 | 19 |
| Androstanediol CPT 82154 | not published | not published | $25.09 – $41.80 | 19 |
| An fluoro guide for cvp CPT 77001 | $1,930.00 | $1,930.00 | $80.02 – $80.02 | 1 |
| Angiotensin ii CPT 82163 | not published | not published | $17.86 – $29.75 | 19 |
| Anidulafungin injection HCPCS J0348 | not published | not published | $0.40 – $1.53 | 4 |
| Ank-foot sys dors-plant flex HCPCS L5973 | not published | not published | $17,884.85 – $22,513.87 | 18 |
| Ankle X-ray CPT 73610 | not published | not published | $38.15 – $182.03 | 2 |
| Ank symes mold sckt sach ft HCPCS L5050 | not published | not published | $2,388.15 – $3,006.26 | 18 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | not published | not published | $58.96 – $67.29 | 3 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | not published | not published | $64.03 – $73.07 | 3 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | not published | not published | $64.50 – $73.60 | 3 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | not published | not published | $78.13 – $89.16 | 3 |
| Anodyne therapy charges pt CPT 97026 | not published | not published | $5.64 – $7.50 | 18 |
| Anora (draw only) CPT 99001 | not published | not published | $6.63 – $37.22 | 2 |
| Anterior asis pad HCPCS L1250 | not published | not published | $84.60 – $106.50 | 18 |
| Anterior swing band HCPCS L2335 | not published | not published | $259.73 – $326.95 | 18 |
| Anterior thoracic derotation HCPCS L1260 | not published | not published | $86.39 – $108.74 | 18 |
| Anterior thoracic extension HCPCS L1220 | not published | not published | $244.15 – $307.35 | 18 |
| Anthrax vaccine sc or im CPT 90581 | not published | not published | $348.18 – $348.18 | 1 |
| Antibody CPT 86744 | $1,642.00 | $1,642.00 | $13.91 – $23.19 | 19 |
| Antibody bacterium, not elsewhere specified CPT 86609 | not published | not published | $11.21 – $18.68 | 19 |
| Antibody elution rbc reference CPT 86860 | $1,552.00 | $1,552.00 | $149.16 – $837.38 | 2 |
| Antibody htlv/hiv confirm test CPT 86689 | $271.00 | $271.00 | $16.84 – $28.06 | 19 |
| Antibody htlv-i CPT 86687 | $182.00 | $182.00 | $7.91 – $13.18 | 19 |
| Antibody htlv-ii CPT 86688 | $194.00 | $194.00 | $12.18 – $20.30 | 19 |
| Antibody identification platelet antibodies heparin-pf4 igg CPT 86022 | not published | not published | $15.99 – $26.64 | 19 |
| Antibody id rbc panel CPT 86870 | not published | not published | $291.26 – $1,635.13 | 2 |
| Antibody influenza virus CPT 86710 | not published | not published | $11.79 – $19.65 | 19 |
| Antibody lymphocytic choriomeningitis CPT 86727 | not published | not published | $11.20 – $18.66 | 19 |
| Antibody screen rbc CPT 86850 | $780.00 | $780.00 | $9.77 – $14.17 | 16 |
| Antibody tetanus CPT 86774 | not published | not published | $12.88 – $21.46 | 19 |
| Antihemophilic factor-vwf 250 unit-600 unit intravenous solution HCPCS J7187 | not published | not published | $1.23 – $4.47 | 4 |
| Antihemophilic viii/vwf comp HCPCS J7186 | not published | not published | $1.02 – $3.72 | 4 |
| Anti-inhibitor HCPCS J7198 | $5.00 | $5.00 | $2.04 – $7.32 | 4 |
| Anti mog serum - sendout CPT 86362 | $150.00 | $150.00 | $10.49 – $17.47 | 19 |
| Antineutrophil cytoplasmic antibody screen each antibody CPT 86036 | not published | not published | $10.49 – $17.47 | 19 |
| Antineutrophil cytoplasmic antibody titer each antibody CPT 86037 | not published | not published | $10.49 – $17.47 | 19 |
| Antinuclear antibodies CPT 86038 | $533.00 | $533.00 | $10.52 – $17.53 | 19 |
| Antinuclear antibodies titer CPT 86039 | not published | not published | $9.72 – $16.18 | 19 |
| Antiphosphatidylserine antibody CPT 86148 | not published | not published | $13.98 – $23.30 | 19 |
| Antistreptolysin o screen CPT 86063 | not published | not published | $5.02 – $8.37 | 19 |
| Antistreptolysin o titer CPT 86060 | $683.00 | $683.00 | $6.35 – $10.58 | 19 |
| Antithrombin iii activity CPT 85300 | $1,087.00 | $1,087.00 | $10.31 – $17.18 | 19 |
| Antithrombin iii injection HCPCS J7197 | not published | not published | $3.35 – $12.15 | 4 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | not published | not published | $3,719.85 – $15,923.79 | 4 |
| Antithymocyte globuln rabbit HCPCS J7511 | not published | not published | $798.45 – $3,029.25 | 4 |
| Aoi transducer/actuator repl HCPCS L8694 | not published | not published | $964.73 – $1,214.43 | 18 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $504.00 – $730.80 | 16 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,350.19 – $1,957.78 | 16 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $200.00 – $290.00 | 16 |
| Apc gene full sequence CPT 81201 | not published | not published | $780.00 – $1,131.00 | 16 |
| Apc gene known fam variants CPT 81202 | not published | not published | $280.00 – $406.00 | 16 |
| Apl(pml-rara) quant - sendout CPT 81315 | $259.00 | $259.00 | $207.31 – $300.60 | 16 |
| Apomorphine hydrochloride HCPCS J0364 | not published | not published | $129.36 – $129.36 | 1 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $225.00 | $225.00 | $5.11 – $6.77 | 18 |
| Appl modality 1/> areas vasopneumatic devices 97016 CPT 97016 | not published | not published | $9.76 – $11.65 | 18 |
| Apply interstit radiat compl CPT 77778 | not published | not published | $2,115.80 – $2,115.80 | 1 |
| Apply intrcav radiat compl CPT 77763 | not published | not published | $1,610.38 – $1,610.38 | 1 |
| Apply intrcav radiat interm CPT 77762 | not published | not published | $1,221.29 – $1,221.29 | 1 |
| Apply intrcav radiat simple CPT 77761 | not published | not published | $928.39 – $928.39 | 1 |
| Apply srs headframe add-on CPT 61800 | not published | not published | $100.08 – $114.21 | 3 |
| Apply surf ldr radionuclide CPT 77789 | not published | not published | $275.02 – $275.02 | 1 |
| App mdlty 1+hubbrd tnk ea 15 CPT 97036 | not published | not published | $28.76 – $37.80 | 18 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | not published | not published | $1.45 – $5.13 | 4 |
| #aptt mix-1:1 incubated CPT 87532 | $1,710.00 | $1,710.00 | $30.54 – $50.88 | 19 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | not published | not published | $12.05 – $54.71 | 19 |
| Aqmbf pet rest & rx stress CPT 78434 | not published | not published | $131.69 – $131.69 | 1 |
| Aquaporin-4 antibody cba each CPT 86052 | $42.00 | $42.00 | $10.49 – $17.47 | 19 |
| Aquaporin-4 antibody elisa CPT 86051 | not published | not published | $10.03 – $16.72 | 19 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | not published | not published | $30.74 – $35.41 | 18 |
| Aquatic exercise - group charge CPT 97150 | not published | not published | $14.70 – $17.34 | 18 |
| Architect ecm px fx 1 sq cm HCPCS Q4147 | not published | not published | $381.42 – $381.42 | 1 |
| Arch supp att to shoe long/m HCPCS L3090 | not published | not published | $41.51 – $52.25 | 18 |
| Arch supp att to shoe metata HCPCS L3080 | not published | not published | $32.39 – $40.78 | 18 |
| Arch suprt att to sho longit HCPCS L3070 | not published | not published | $32.39 – $40.78 | 18 |
| Arformoterol non-comp unit HCPCS J7605 | not published | not published | $0.59 – $2.16 | 4 |
| Argatroban dialysis (accord) HCPCS J0892 | not published | not published | $14.25 – $14.25 | 1 |
| Argatroban dialysis, auromed HCPCS J0899 | not published | not published | $1.14 – $4.35 | 4 |
| Argatroban esrd dialysis 1mg HCPCS J0884 | not published | not published | $0.81 – $1.83 | 4 |
| Argatroban nonesrd (accord) HCPCS J0891 | not published | not published | $5.46 – $5.46 | 1 |
| Argatroban nonesrd (auromed) HCPCS J0898 | not published | not published | $1.14 – $4.35 | 4 |
| Argatroban nonesrd use 1mg HCPCS J0883 | not published | not published | $0.81 – $1.83 | 4 |
| Ar gene charac alleles CPT 81204 | not published | not published | $137.00 – $198.65 | 16 |
| Ar gene full gene sequence CPT 81173 | not published | not published | $301.35 – $436.96 | 16 |
| Ar gene known famil variant CPT 81174 | not published | not published | $185.20 – $268.54 | 16 |
| Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 | not published | not published | $2.77 – $10.02 | 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.