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 thyroglobulin CPT 84432 | $285.00 | $285.00 | $13.97 – $23.29 | 19 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | not published | not published | $8.86 – $14.76 | 19 |
| Mayo ticks babesia microti antibody igg CPT 86753 | not published | not published | $10.78 – $17.97 | 19 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | not published | not published | $44.63 – $74.36 | 19 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $124.00 | $124.00 | $12.32 – $20.53 | 19 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $104.00 | $104.00 | $11.78 – $19.63 | 19 |
| Mayo vasoactive intestinal peptide CPT 84586 | $507.00 | $507.00 | $30.74 – $51.23 | 19 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $843.00 | $843.00 | $17.61 – $29.35 | 19 |
| Mayo vitamin b3 (niacin) CPT 84591 | $301.00 | $301.00 | $14.85 – $24.74 | 19 |
| Mayo vitamin k CPT 84597 | $373.00 | $373.00 | $11.94 – $19.89 | 19 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $561.00 | $561.00 | $11.53 – $19.21 | 19 |
| Mcoln1 gene CPT 81290 | $607.00 | $607.00 | $39.31 – $57.00 | 16 |
| Md inr test revie inter mgmt HCPCS G0250 | not published | not published | $6.00 – $6.85 | 3 |
| Md service required for pmd HCPCS G0372 | not published | not published | $6.00 – $6.85 | 3 |
| Mecasermin injection HCPCS J2170 | not published | not published | $1,388.97 – $1,388.97 | 1 |
| Mech hip extension assist HCPCS L5855 | not published | not published | $321.38 – $404.56 | 18 |
| Mechlorethamine hcl inj HCPCS J9230 | not published | not published | $392.79 – $392.79 | 1 |
| Mecp2 gene dup/delet variant CPT 81304 | not published | not published | $150.00 – $217.50 | 16 |
| Mecp2 gene full seq CPT 81302 | not published | not published | $527.87 – $765.41 | 16 |
| Mecp2 gene known variant CPT 81303 | not published | not published | $120.00 – $174.00 | 16 |
| Med physic dos eval rad exps CPT 76145 | not published | not published | $285.46 – $285.46 | 1 |
| Medroxyprogesterone 150 mg/ml im injection (wrapper) HCPCS J1050 | $1,603.00 | $1,603.00 | $1.44 – $1.44 | 1 |
| Melphalan oral 2 mg HCPCS J8600 | not published | not published | $14.04 – $14.04 | 1 |
| Membrane affinity fresh amniotic 2.5x2.5cm -cost per sq cm HCPCS Q4159 | not published | not published | $223.49 – $381.42 | 4 |
| Membrane amnioband 2x2cm -cost per sq cm HCPCS Q4151 | $3,757.00 | $3,757.00 | $116.01 – $381.42 | 4 |
| Membrane amnio clarix 4x3cm 1k -cost per sq cm HCPCS Q4155 | not published | not published | $22.36 – $102.30 | 4 |
| Membrane amniotic barrier 4x4cm-q4163-cost per sq cm HCPCS Q4163 | not published | not published | $154.85 – $381.42 | 4 |
| Membrane collgn porcine maci w/autologous cult chondrocytes HCPCS J7330 | not published | not published | $251,178.75 – $251,178.75 | 1 |
| Membrane placenta tiss biodfence g3 2x2cm-4sqcm-q4116-cost per sq cm HCPCS Q4140 | not published | not published | $143.58 – $381.42 | 4 |
| Membrane placenta tiss enverse sheet 2x3cm-cost per sq cm HCPCS Q4258 | not published | not published | $61.05 – $381.42 | 4 |
| Memoderm/derma/tranz/integup HCPCS Q4126 | not published | not published | $53.80 – $381.42 | 4 |
| Menacwy-tt menb-fhbp vacc im CPT 90623 | not published | not published | $207.91 – $906.24 | 4 |
| Meperidine (pf) 25 mg/ml injection (wrapper) HCPCS J2175 | $228.00 | $228.00 | $8.62 – $24.45 | 4 |
| Meperidine/promethazine inj HCPCS J2180 | not published | not published | $23.04 – $23.04 | 1 |
| Mepolizumab 100 mg/ml subcutaneous auto-injector HCPCS J2182 | not published | not published | $25.96 – $95.67 | 4 |
| Meropenem 1 gram intravenous solution HCPCS J2185 | not published | not published | $0.37 – $1.14 | 4 |
| Mesh ez derm 7x18 xenograft porcine -cost per sq cm HCPCS Q4136 | not published | not published | $381.42 – $381.42 | 1 |
| Mesna 100 mg/ml intravenous solution HCPCS J9209 | $561.00 | $561.00 | $1.16 – $5.10 | 4 |
| Metabolic Blood Panel (Basic) CPT 80048 | not published | not published | $7.36 – $12.27 | 19 |
| Metabolic Blood Panel (Comprehensive) CPT 80053 | not published | not published | $9.19 – $15.31 | 19 |
| Metabolic panel ionized ca CPT 80047 | not published | not published | $11.95 – $19.91 | 19 |
| Metal frame recipro hip & ca HCPCS L2628 | not published | not published | $1,736.08 – $2,185.42 | 18 |
| Metatarsal joint implant HCPCS L8641 | not published | not published | $364.27 – $458.55 | 18 |
| Methacholine chloride 0.0625 mg/ml nebulization soln HCPCS J7674 | not published | not published | $1.39 – $5.70 | 4 |
| Methadone injection HCPCS J1230 | not published | not published | $17.77 – $53.10 | 4 |
| Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain) HCPCS J2800 | not published | not published | $5.41 – $13.62 | 4 |
| Methotrexate sodium 2.5 mg tablet HCPCS J8610 | $51.00 | $51.00 | $0.17 – $0.45 | 4 |
| Methotrexate sodium (pf) 1 gram solution for injection HCPCS J9260 | not published | not published | $2.19 – $7.74 | 4 |
| Methotrexate therapeutic drug level CPT 80204 | $914.00 | $914.00 | $33.57 – $55.93 | 19 |
| Methyldopate hcl injection HCPCS J0210 | $1,015.00 | $1,015.00 | $29.07 – $29.07 | 1 |
| Methylene blue (antidote) 5 mg/ml intravenous solution HCPCS Q9968 | not published | not published | $29.43 – $29.43 | 1 |
| Methylergonovine 0.2 mg/ml (1 ml) injection solution HCPCS J2210 | $428.00 | $428.00 | $18.10 – $64.08 | 4 |
| Methylnaltrexone 12 mg/0.6 ml subcutaneous injection (wrapper) HCPCS J2212 | not published | not published | $6.30 – $6.30 | 1 |
| Methylprednisolone 4 mg tablet HCPCS J7509 | not published | not published | $0.20 – $0.42 | 4 |
| Methylprednisolone acetate 40 mg/ml suspension for injection HCPCS J1010 | $238.00 | $238.00 | $0.09 – $0.36 | 4 |
| Methylprednisolone sodium succinate 1,000 mg intravenous solution HCPCS J2919 | not published | not published | $0.21 – $0.78 | 4 |
| Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr HCPCS J2765 | $196.00 | $196.00 | $0.96 – $3.24 | 4 |
| Metoprolol tartrate 5 mg/5 ml intravenous (wrapper) HCPCS J0616 | $232.00 | $232.00 | $0.36 – $0.36 | 1 |
| Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback HCPCS J1836 | not published | not published | $0.03 – $0.09 | 4 |
| Metyrapone panel CPT 80436 | not published | not published | $79.33 – $132.18 | 19 |
| Mgmt promoter methylation analysis CPT 81287 | $1,679.00 | $1,679.00 | $124.64 – $180.73 | 16 |
| Micafungin 100 mg intravenous solution HCPCS J2248 | not published | not published | $0.24 – $0.75 | 4 |
| Microalbumin urine screen CPT 82044 | not published | not published | $5.42 – $9.03 | 19 |
| Microbe susceptible mlc CPT 87187 | not published | not published | $34.96 – $58.25 | 19 |
| Microdissection laser CPT 88380 | $301.00 | $301.00 | $78.86 – $442.72 | 2 |
| Microdissection manual CPT 88381 | $2,242.00 | $2,242.00 | $180.05 – $1,010.80 | 2 |
| Microfluid analy tears CPT 83861 | not published | not published | $19.57 – $32.60 | 19 |
| Microprcsr cu combo vad, rep HCPCS Q0482 | not published | not published | $4,649.48 – $5,852.88 | 18 |
| Microsatellite instability CPT 81301 | not published | not published | $348.56 – $505.41 | 16 |
| Midazolam 1 mg/ml injection solution HCPCS J2250 | not published | not published | $0.11 – $0.42 | 4 |
| Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper) HCPCS J2251 | $281.00 | $281.00 | $0.14 – $0.54 | 4 |
| Middle cerebral artery echo CPT 76821 | not published | not published | $153.08 – $245.18 | 2 |
| Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk HCPCS J2260 | not published | not published | $1.33 – $4.05 | 4 |
| Milwaukee type superstructur HCPCS L1230 | not published | not published | $625.83 – $787.81 | 18 |
| Minocycline hydrochloride HCPCS J2265 | not published | not published | $8.01 – $8.01 | 1 |
| Miroderm HCPCS Q4175 | not published | not published | $58.28 – $381.42 | 4 |
| Mirvetuximab soravtansine-gynx 5 mg/ml intravenous solution HCPCS J9063 | not published | not published | $57.86 – $213.51 | 4 |
| Mitochondrial gene CPT 81440 | not published | not published | $3,324.00 – $4,819.80 | 16 |
| Mitomycin 40 mg intravenous solution HCPCS J9280 | not published | not published | $21.76 – $78.30 | 4 |
| Mitomycin instillation HCPCS J9281 | not published | not published | $266.05 – $971.73 | 4 |
| Mitoxantrone 2 mg/ml concentrate,intravenous HCPCS J9293 | $2,537.00 | $2,537.00 | $23.54 – $92.64 | 4 |
| Mlh1 gene CPT 81288 | $1,387.00 | $1,387.00 | $192.32 – $278.86 | 16 |
| Mlh1 gene dup/delete variant CPT 81294 | not published | not published | $202.40 – $293.48 | 16 |
| Mlh1 gene full seq CPT 81292 | not published | not published | $675.40 – $979.33 | 16 |
| Mlh1 gene known variants CPT 81293 | not published | not published | $331.00 – $479.95 | 16 |
| Mlt fam grp bhv train 1st 60 CPT 96202 | not published | not published | $19.63 – $22.40 | 18 |
| Mlt fam grp bhv train ea add CPT 96203 | not published | not published | $4.93 – $6.02 | 18 |
| Mnl appl strs jt radiography CPT 77071 | not published | not published | $182.03 – $273.35 | 2 |
| Mnt subs tx for change dx HCPCS G0270 | not published | not published | $27.38 – $29.30 | 15 |
| Mobility cart pneum vad, rep HCPCS Q0502 | not published | not published | $664.18 – $836.09 | 18 |
| Mog-igg1 antb flo cytmtry ea CPT 86363 | not published | not published | $12.05 – $54.71 | 19 |
| Molded inner boot HCPCS L2280 | $12,089.00 | $12,089.00 | $444.63 – $559.72 | 18 |
| Molded socket shin sach foot HCPCS L5100 | not published | not published | $2,487.81 – $3,131.72 | 18 |
| Mold sckt ext knee shin sach HCPCS L5150 | not published | not published | $3,654.30 – $4,600.12 | 18 |
| Mold socket ank hgt with toe f HCPCS L5010 | not published | not published | $1,266.88 – $1,594.78 | 18 |
| Mold socket bent knee shin s HCPCS L5160 | not published | not published | $3,974.70 – $5,003.45 | 18 |
| Molecular pathology interpr HCPCS G0452 | not published | not published | $3.14 – $17.63 | 2 |
| Mometasone sinus sinuva HCPCS J7402 | $64.00 | $64.00 | $9.65 – $34.05 | 4 |
| Mon cable elec/pneum vad rep HCPCS Q0486 | not published | not published | $298.90 – $376.27 | 18 |
| Monitor cable elec vad, rep HCPCS Q0485 | not published | not published | $359.10 – $452.04 | 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.