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 |
|---|---|---|---|---|
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $400.00 | $400.00 | $21.99 – $36.64 | 19 |
| Mayo dihydrotestosterone CPT 82642 | $610.00 | $610.00 | $25.48 – $42.46 | 19 |
| Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid CPT 83518 | not published | not published | $8.39 – $13.98 | 19 |
| Mayo efpo chloride stool CPT 82438 | $139.00 | $139.00 | $4.35 – $7.25 | 19 |
| Mayo estriol CPT 82677 | not published | not published | $21.05 – $35.06 | 19 |
| Mayo estrone CPT 82679 | $926.00 | $926.00 | $21.71 – $36.18 | 19 |
| Mayo ethosuximide therapeutic drug level CPT 80168 | $326.00 | $326.00 | $14.22 – $23.69 | 19 |
| Mayo everolimus therapeutic drug level CPT 80169 | $445.00 | $445.00 | $11.95 – $19.91 | 19 |
| Mayo factor ii CPT 85210 | $406.00 | $406.00 | $11.30 – $18.82 | 19 |
| Mayo factor v CPT 85220 | $1,079.00 | $1,079.00 | $15.36 – $25.59 | 19 |
| Mayo factor vii CPT 85230 | $486.00 | $486.00 | $15.58 – $25.95 | 19 |
| Mayo factor viii vw factor antigen CPT 85246 | $1,068.00 | $1,068.00 | $19.97 – $33.26 | 19 |
| Mayo factor viii vw factor multimetric analysis CPT 85247 | $630.00 | $630.00 | $19.97 – $33.26 | 19 |
| Mayo factor viii vw factor ristocetin cofactor CPT 85245 | $1,053.00 | $1,053.00 | $19.97 – $33.26 | 19 |
| Mayo factor x CPT 85260 | $962.00 | $962.00 | $15.58 – $25.95 | 19 |
| Mayo factor xi CPT 85270 | $962.00 | $962.00 | $15.58 – $25.95 | 19 |
| Mayo fat/lipids feces quantitative CPT 82710 | $493.00 | $493.00 | $14.62 – $24.36 | 19 |
| Mayo fbl culture fungi blood CPT 87103 | $128.00 | $128.00 | $17.81 – $29.67 | 19 |
| Mayo fdp/fsp paracoagulation CPT 85366 | not published | not published | $70.01 – $116.67 | 19 |
| Mayo ffspg allergen clam igg CPT 86001 | $117.00 | $117.00 | $6.81 – $11.34 | 19 |
| Mayo fibrinogen antigen CPT 85385 | $196.00 | $196.00 | $12.58 – $20.97 | 19 |
| Mayo gabapentin bld/srm/plasma therapeutic drug level CPT 80171 | $1,125.00 | $1,125.00 | $18.86 – $31.42 | 19 |
| Mayo hemosiderin qualitative urine CPT 83070 | $293.00 | $293.00 | $4.13 – $6.89 | 19 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $1,402.00 | $1,402.00 | $30.54 – $50.88 | 19 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $122.00 | $122.00 | $30.54 – $50.88 | 19 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | not published | not published | $12.00 – $20.00 | 19 |
| Mayo hla typing a/b/c single antigen CPT 86812 | $357.00 | $357.00 | $22.46 – $37.42 | 19 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $950.00 | $950.00 | $7.73 – $12.89 | 19 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $201.00 | $201.00 | $11.76 – $19.60 | 19 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $831.00 | $831.00 | $23.65 – $39.40 | 19 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | not published | not published | $15.03 – $25.04 | 19 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | not published | not published | $13.05 – $21.74 | 19 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | not published | not published | $18.11 – $30.17 | 19 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | not published | not published | $18.11 – $30.17 | 19 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | $94.00 | $94.00 | $35.09 – $37.55 | 15 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | not published | not published | $13.98 – $23.30 | 19 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $131.00 | $131.00 | $10.43 – $17.37 | 19 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $1,455.00 | $1,455.00 | $30.54 – $50.88 | 19 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | $505.00 | $505.00 | $30.54 – $50.88 | 19 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $1,164.00 | $1,164.00 | $30.54 – $50.88 | 19 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | $94.00 | $94.00 | $35.09 – $37.55 | 15 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $1,390.00 | $1,390.00 | $37.28 – $62.12 | 19 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $2,948.00 | $2,948.00 | $72.19 – $104.68 | 16 |
| Mayo infliximab therapeutic drug level CPT 80230 | $606.00 | $606.00 | $33.57 – $55.93 | 19 |
| Mayo inhab inhibin a CPT 86336 | $1,709.00 | $1,709.00 | $13.57 – $22.61 | 19 |
| Mayo insft insulin free CPT 83527 | $184.00 | $184.00 | $11.27 – $18.78 | 19 |
| Mayo insulin antibodies CPT 86337 | $280.00 | $280.00 | $18.63 – $31.04 | 19 |
| Mayo iodine CPT 83789 | $163.00 | $163.00 | $20.98 – $34.96 | 19 |
| Mayo itraconazole therapeutic drug level CPT 80189 | $378.00 | $378.00 | $23.60 – $39.31 | 19 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $1,266.00 | $1,266.00 | $23.60 – $39.31 | 19 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $1,283.00 | $1,283.00 | $11.53 – $19.21 | 19 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $518.00 | $518.00 | $11.13 – $18.55 | 19 |
| Mayo legionella antibody CPT 86713 | not published | not published | $13.31 – $22.18 | 19 |
| Mayo leptospira antibody igm CPT 86720 | $737.00 | $737.00 | $14.10 – $23.49 | 19 |
| Mayo lipoprotein electrophoresis CPT 83700 | $363.00 | $363.00 | $9.80 – $16.33 | 19 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | not published | not published | $13.48 – $22.46 | 19 |
| Mayo manganese CPT 83785 | $363.00 | $363.00 | $23.19 – $38.64 | 19 |
| Mayo metanephrines plasma CPT 83835 | not published | not published | $14.74 – $24.56 | 19 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $1,456.00 | $1,456.00 | $10.49 – $17.47 | 19 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $54.00 | $54.00 | $16.01 – $26.68 | 19 |
| Mayo microsomal antibody liver-kidney CPT 86376 | not published | not published | $12.66 – $21.10 | 19 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | not published | not published | $16.22 – $27.03 | 19 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | not published | not published | $137.00 – $198.65 | 16 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | $1,498.00 | $1,498.00 | $185.20 – $268.54 | 16 |
| Mayo muramidase CPT 85549 | $157.00 | $157.00 | $16.32 – $27.19 | 19 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $54.00 | $54.00 | $16.01 – $26.68 | 19 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | $230.00 | $230.00 | $15.71 – $26.17 | 19 |
| Mayo myoglobin CPT 83874 | not published | not published | $11.25 – $18.73 | 19 |
| Mayo nickel CPT 83885 | $534.00 | $534.00 | $21.33 – $35.54 | 19 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $746.00 | $746.00 | $18.45 – $30.75 | 19 |
| Mayo organic acids qualitative each specimen CPT 83919 | $553.00 | $553.00 | $14.31 – $23.85 | 19 |
| Mayo oxalate 24 hour urine CPT 83945 | $163.00 | $163.00 | $12.57 – $20.95 | 19 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | $1,663.00 | $1,663.00 | $10.03 – $16.72 | 19 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | not published | not published | $13.08 – $21.79 | 19 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | not published | not published | $10.49 – $17.47 | 19 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $2,293.00 | $2,293.00 | $30.54 – $50.88 | 19 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $754.00 | $754.00 | $15.65 – $26.07 | 19 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $193.00 | $193.00 | $11.98 – $19.95 | 19 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $120.00 | $120.00 | $7.34 – $12.24 | 19 |
| Mayo pregnenolone CPT 84140 | $289.00 | $289.00 | $17.99 – $29.97 | 19 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $233.00 | $233.00 | $14.43 – $24.06 | 19 |
| Mayo proinsulin CPT 84206 | $479.00 | $479.00 | $23.23 – $38.70 | 19 |
| Mayo psaft prostate specific antigen free CPT 84154 | $758.00 | $758.00 | $16.01 – $26.67 | 19 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | not published | not published | $16.01 – $26.68 | 19 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | not published | not published | $11.63 – $19.37 | 19 |
| Mayo receptor assay transferrin soluble CPT 84238 | $661.00 | $661.00 | $31.82 – $53.03 | 19 |
| Mayo renin CPT 84244 | $1,386.00 | $1,386.00 | $19.13 – $31.89 | 19 |
| Mayo repu protein electrophoresis urine CPT 84166 | not published | not published | $15.51 – $25.85 | 19 |
| Mayo selenium CPT 84255 | $581.00 | $581.00 | $22.22 – $37.02 | 19 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $13.49 – $22.47 | 19 |
| Mayo serotonin CPT 84260 | $251.00 | $251.00 | $26.96 – $44.92 | 19 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | not published | not published | $16.84 – $28.06 | 19 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $569.00 | $569.00 | $11.95 – $19.91 | 19 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | $2,007.00 | $2,007.00 | $92.03 – $98.47 | 15 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | not published | not published | $3.71 – $6.19 | 19 |
| Mayo tau phosphorylated 217 each CPT 84393 | $564.00 | $564.00 | $128.92 – $137.94 | 15 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | $1,483.00 | $1,483.00 | $208.92 – $302.93 | 16 |
| Mayo tgrp testosterone free CPT 84402 | $664.00 | $664.00 | $22.17 – $36.93 | 19 |
| Mayo tgrp testosterone total CPT 84403 | $1,498.00 | $1,498.00 | $22.46 – $37.42 | 19 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $323.00 | $323.00 | $19.29 – $32.15 | 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.