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 |
|---|---|---|---|---|
| Potassium chloride 10 meq/100ml in sterile water intravenous piggyback HCPCS J3480 | not published | not published | $0.18 – $0.36 | 4 |
| Potassium hydroxide preps HCPCS Q0112 | not published | not published | $5.07 – $8.45 | 19 |
| Potassium serum/plasma/whole blood CPT 84132 | not published | not published | $4.14 – $6.90 | 19 |
| Pouch clsd w barr attached HCPCS A5051 | not published | not published | $2.50 – $3.15 | 18 |
| Pouch drainable w barrier at HCPCS A5061 | not published | not published | $4.28 – $5.39 | 18 |
| Pouch high output 2pc 50mm red HCPCS A4413 | not published | not published | $6.67 – $8.40 | 18 |
| Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp HCPCS A4388 | not published | not published | $5.28 – $6.64 | 18 |
| Pouch ostmy nb pouchkin ctf HCPCS A5062 | not published | not published | $2.70 – $3.40 | 18 |
| Pouch uros new (both sides) 2.75in clr HCPCS A4432 | not published | not published | $4.34 – $5.47 | 18 |
| Powder prem protct 1oz HCPCS A4371 | not published | not published | $4.42 – $5.56 | 18 |
| Ppp2r2b gen detc abnor allel CPT 81343 | not published | not published | $137.00 – $198.65 | 16 |
| Pq biliary strict dil s&i CPT 74363 | not published | not published | $173.92 – $173.92 | 1 |
| Pq dr cath chg w cont s&i CPT 75984 | not published | not published | $168.35 – $168.35 | 1 |
| Pralatrexate injection HCPCS J9307 | not published | not published | $317.70 – $1,178.16 | 4 |
| Pralidoxime 1 gram solution for injection HCPCS J2730 | $2,984.00 | $2,984.00 | $312.12 – $312.12 | 1 |
| Pr debridement open wound topical appl/wound asmt per session 20 sq cm/< CPT 97597 | not published | not published | $103.86 – $111.13 | 15 |
| Prealbumin CPT 84134 | $273.00 | $273.00 | $12.70 – $21.16 | 19 |
| Pr ecg external < 48 hours continuous recording/storage r&i by a phys/qhp CPT 93227 | not published | not published | $12.53 – $14.30 | 3 |
| Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution HCPCS J7510 | $76.00 | $76.00 | $0.41 – $2.76 | 4 |
| Prednisone 1 mg tablet HCPCS J7512 | not published | not published | $0.01 – $0.03 | 4 |
| Prefab glove for term device HCPCS L6890 | not published | not published | $177.00 – $222.81 | 18 |
| Pregnancy associated plasma protein-a CPT 84163 | $138.00 | $138.00 | $13.10 – $21.82 | 19 |
| Pregnancy Ultrasound (complete, after first trimester) CPT 76805 | $3,574.00 | $3,574.00 | $215.44 – $245.18 | 2 |
| Pregnancy Ultrasound (first trimester) CPT 76801 | $1,860.00 | $1,860.00 | $212.25 – $245.18 | 2 |
| Pr e&m preventive medicine initial comprehensive new patient 12-17 years CPT 99384 | not published | not published | $67.29 – $76.79 | 3 |
| Prep ak ischial direct form HCPCS L5570 | not published | not published | $2,102.70 – $2,646.92 | 18 |
| Prep ak ischial laminated HCPCS L5590 | not published | not published | $2,501.56 – $3,149.02 | 18 |
| Prep ak ischial plast molded HCPCS L5560 | not published | not published | $2,022.52 – $2,545.99 | 18 |
| Prep ak ischial thermo mold HCPCS L5580 | not published | not published | $2,454.75 – $3,090.10 | 18 |
| Prepare embryo for transfer CPT 89255 | not published | not published | $49.76 – $279.35 | 2 |
| Prep bk ptb laminated socket HCPCS L5540 | not published | not published | $1,971.17 – $2,481.35 | 18 |
| Prep bk ptb open end socket HCPCS L5535 | not published | not published | $1,866.72 – $2,349.87 | 18 |
| Prep bk ptb plaster molded HCPCS L5510 | not published | not published | $1,514.99 – $1,907.10 | 18 |
| Prep bk ptb thermopls molded HCPCS L5530 | not published | not published | $1,894.21 – $2,384.47 | 18 |
| Pre-tibial shell molded to p HCPCS L2340 | not published | not published | $562.28 – $707.82 | 18 |
| Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref CPT 86977 | $393.00 | $393.00 | $149.16 – $837.38 | 2 |
| Pretreat rbc absorption reference CPT 86978 | $349.00 | $349.00 | $33.84 – $189.98 | 2 |
| Pretreat rbc density gradient separation reference CPT 86972 | $1,535.00 | $1,535.00 | $149.16 – $837.38 | 2 |
| Pretreat rbc w chem/drugs reference CPT 86970 | $1,210.00 | $1,210.00 | $33.84 – $189.98 | 2 |
| Pretreat rbc w enzyme reference CPT 86971 | $2,041.00 | $2,041.00 | $291.26 – $1,635.13 | 2 |
| Prev med cnsl indiv apprx 15 CPT 99401 | not published | not published | $16.13 – $18.41 | 3 |
| Prev med cnsl indiv apprx 30 CPT 99402 | not published | not published | $32.57 – $37.17 | 3 |
| Prev med cnsl indiv apprx 45 CPT 99403 | not published | not published | $48.70 – $55.58 | 3 |
| Prev med cnsl indiv apprx 60 CPT 99404 | not published | not published | $65.66 – $74.93 | 3 |
| Procainamide 100 mg/ml injection (wrapper) HCPCS J2690 | not published | not published | $241.69 – $1,033.59 | 4 |
| Procalcitonin CPT 84145 | $794.00 | $794.00 | $23.69 – $39.47 | 19 |
| Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution HCPCS J0780 | $306.00 | $306.00 | $2.48 – $7.56 | 4 |
| Prochlorperazine maleate 5 mg tablet HCPCS Q0164 | not published | not published | $2.34 – $2.34 | 1 |
| Progenamatrix, per sq cm HCPCS Q4222 | not published | not published | $115.54 – $381.42 | 4 |
| Progesterone CPT 84144 | $243.00 | $243.00 | $18.16 – $30.25 | 19 |
| Prolactin CPT 84146 | $1,422.00 | $1,422.00 | $16.86 – $28.10 | 19 |
| Prolng off/op e/m ea 15 min 99417 CPT 99417 | not published | not published | $20.51 – $23.41 | 3 |
| Promethazine 25 mg tablet HCPCS Q0169 | not published | not published | $0.87 – $0.87 | 1 |
| Promethazine hcl injection HCPCS J2550 | not published | not published | $2.81 – $11.91 | 4 |
| Propofol infusion 10 mg/ml HCPCS J2704 | not published | not published | $0.08 – $0.27 | 4 |
| Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J1800 | $506.00 | $506.00 | $32.97 – $32.97 | 1 |
| Pros sheath/sock w gel cushn HCPCS L8417 | not published | not published | $76.77 – $96.64 | 18 |
| Pros soc insert gasket/seal HCPCS L7700 | not published | not published | $149.96 – $188.77 | 18 |
| Pros sock multi ply upper lm HCPCS L8435 | not published | not published | $21.88 – $27.54 | 18 |
| Pros sock single ply ak HCPCS L8480 | not published | not published | $9.58 – $12.06 | 18 |
| Pros sock single ply upper l HCPCS L8485 | not published | not published | $12.04 – $15.15 | 18 |
| Prostate biopsy, any mthd HCPCS G0416 | $1,058.00 | $1,058.00 | $291.26 – $1,635.13 | 2 |
| Prosthesis voc advantage 20f 14mm HCPCS L8509 | not published | not published | $111.55 – $140.43 | 18 |
| Prosthesis voc lopres 20f 22mm HCPCS L8507 | not published | not published | $42.79 – $53.86 | 18 |
| Prosthetic sock multi ply bk HCPCS L8420 | not published | not published | $21.32 – $26.84 | 18 |
| Prosthetic type socket molde HCPCS L2350 | not published | not published | $971.11 – $1,222.45 | 18 |
| Prost sock sgl ply blw knee ea HCPCS L8470 | not published | not published | $6.94 – $8.74 | 18 |
| Protamine 10 mg/ml intravenous solution HCPCS J2720 | not published | not published | $1.19 – $4.71 | 4 |
| Protect body sock ea pre ots HCPCS L0984 | not published | not published | $66.02 – $83.11 | 18 |
| Protein analysis w/probe CPT 88372 | not published | not published | $26.22 – $38.02 | 16 |
| Protein c activity CPT 85303 | $683.00 | $683.00 | $12.04 – $20.07 | 19 |
| Protein c concentrate HCPCS J2724 | not published | not published | $12.77 – $45.03 | 4 |
| Protein electrophoretic fractionation & quantitation serum CPT 84165 | $414.00 | $414.00 | $9.35 – $15.57 | 19 |
| Protein s total CPT 85305 | $163.00 | $163.00 | $10.11 – $16.83 | 19 |
| Protein total 24 hour urine CPT 84156 | $462.00 | $462.00 | $3.20 – $5.32 | 19 |
| Protein total body fluid CPT 84157 | not published | not published | $3.48 – $5.80 | 19 |
| Protein total serum plasma whole blood CPT 84155 | $462.00 | $462.00 | $3.20 – $5.32 | 19 |
| Protein western blot tissue CPT 88371 | not published | not published | $22.23 – $32.23 | 16 |
| Prothrombin complex kcentra HCPCS J7168 | not published | not published | $6.27 – $6.27 | 1 |
| Prothrombin time substitution plasma fractions each CPT 85611 | $416.00 | $416.00 | $3.43 – $5.71 | 19 |
| Protoporphyrin rbc screen CPT 84203 | not published | not published | $8.47 – $14.12 | 19 |
| Pr planning advance care 1st 30 minutes CPT 99497 | not published | not published | $89.71 – $95.99 | 15 |
| PSA (Prostate) Test CPT 84153 | $674.00 | $674.00 | $16.01 – $26.67 | 19 |
| Pt application of modality >=1 area electrical stimulation each 15 minutes CPT 97032 | not published | not published | $11.96 – $14.16 | 18 |
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $655.00 | $655.00 | $15.76 – $18.30 | 18 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | not published | not published | $11.68 – $13.86 | 18 |
| Pt application of modality traction mechanical CPT 97012 | $623.00 | $623.00 | $11.96 – $13.85 | 18 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $300.00 – $435.00 | 16 |
| Pten gene full sequence CPT 81321 | $3,962.00 | $3,962.00 | $600.00 – $870.00 | 16 |
| Pten gene known fam variant CPT 81322 | not published | not published | $46.60 – $67.57 | 16 |
| Pt evaluation high complexity patient/family CPT 97163 | not published | not published | $82.48 – $94.13 | 18 |
| Pt evaluation low complexity patient/family CPT 97161 | not published | not published | $82.48 – $94.13 | 18 |
| Pt evaluation moderate complexity patient/family CPT 97162 | not published | not published | $82.48 – $94.13 | 18 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | not published | not published | $16.67 – $19.02 | 3 |
| Pt prgrm for implt neurostim HCPCS L8681 | not published | not published | $1,122.61 – $1,413.17 | 18 |
| Pt re-evaluation patient/family CPT 97164 | not published | not published | $56.89 – $64.92 | 18 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | not published | not published | $34.54 – $39.42 | 18 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | not published | not published | $10.30 – $12.28 | 18 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | not published | not published | $24.24 – $27.79 | 18 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | not published | not published | $25.00 – $28.53 | 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.