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 |
|---|---|---|---|---|
| Repl cushions for jaw motion HCPCS E1701 | not published | not published | $12.26 – $15.43 | 18 |
| Repl girdle milwaukee orth HCPCS L4000 | not published | not published | $1,344.61 – $1,692.62 | 18 |
| Repl leath cuff kafo-afo cal HCPCS L4110 | not published | not published | $88.00 – $110.78 | 18 |
| Repl leath cuff kafo prox th HCPCS L4100 | not published | not published | $116.83 – $147.07 | 18 |
| Repl met band kafo-afo calf/ HCPCS L4090 | not published | not published | $88.97 – $112.00 | 18 |
| Repl met band kafo-afo prox HCPCS L4080 | not published | not published | $112.76 – $141.95 | 18 |
| Repl trach puncture dilator HCPCS L8514 | not published | not published | $96.31 – $121.24 | 18 |
| Repl zinc air battery HCPCS L8621 | not published | not published | $0.64 – $0.80 | 18 |
| Repriza, 1cm HCPCS Q4143 | not published | not published | $28.83 – $381.42 | 4 |
| Reptilase test CPT 85635 | $811.00 | $811.00 | $8.57 – $14.28 | 19 |
| Reslizumab 10 mg/ml intravenous solution HCPCS J2786 | not published | not published | $8.92 – $33.39 | 4 |
| Respirator motion mgmt simul CPT 77293 | not published | not published | $479.99 – $479.99 | 1 |
| #resp virpnl dfa-adenovirus CPT 87260 | $667.00 | $667.00 | $12.55 – $20.92 | 19 |
| #resp virpnl dfa-parainfluenza CPT 87279 | $238.00 | $238.00 | $14.30 – $23.82 | 19 |
| Resp virus 6-11 targets CPT 87632 | not published | not published | $189.76 – $316.19 | 19 |
| Restorigin 1 sq cm HCPCS Q4191 | not published | not published | $381.42 – $911.95 | 4 |
| Reteplase injection HCPCS J2993 | not published | not published | $8,713.74 – $8,713.74 | 1 |
| Reticulated platelet assay CPT 85055 | not published | not published | $31.10 – $51.82 | 19 |
| Reticulocyte automated CPT 85045 | $233.00 | $233.00 | $3.47 – $5.79 | 19 |
| Reticulocyte direct measurement automated CPT 85046 | not published | not published | $4.84 – $8.08 | 19 |
| Retifanlimab-dlwr 500 mg/20 ml intravenous solution HCPCS J9345 | not published | not published | $25.28 – $91.59 | 4 |
| Retrograde ejaculation anal CPT 89331 | not published | not published | $17.05 – $28.41 | 19 |
| Reusable nipple prosthesis HCPCS L8032 | not published | not published | $40.02 – $50.38 | 18 |
| Revefenacin inh non-com 1mcg HCPCS J7677 | not published | not published | $0.17 – $0.60 | 4 |
| Revise kneecap CPT 27437 | not published | not published | $8,849.72 – $8,849.72 | 1 |
| Revise kneecap with implant CPT 27438 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revise reconst elbow joint CPT 24370 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revise reconst elbow joint CPT 24371 | not published | not published | $21,384.35 – $21,384.35 | 1 |
| Revision of ankle joint CPT 27700 | not published | not published | $8,849.72 – $8,849.72 | 1 |
| Revision of knee joint CPT 27440 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revision of knee joint CPT 27441 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revision of knee joint CPT 27442 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revision of knee joint CPT 27443 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revision of knee joint CPT 27446 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revis reconst shoulder joint CPT 23473 | not published | not published | $15,658.14 – $15,658.14 | 1 |
| Revitalon 1 square cm HCPCS Q4157 | not published | not published | $381.42 – $381.42 | 1 |
| Revita, per sq cm HCPCS Q4180 | not published | not published | $381.42 – $999.24 | 4 |
| Rezafungin 200 mg intravenous solution HCPCS J0349 | not published | not published | $8.86 – $32.46 | 4 |
| Rheumatoid factor qualitative CPT 86430 | $489.00 | $489.00 | $5.35 – $8.90 | 19 |
| Rheumatoid factor quantitative CPT 86431 | $489.00 | $489.00 | $4.93 – $8.22 | 19 |
| Rh ig IV CPT 90386 | not published | not published | $1,994.25 – $1,994.25 | 1 |
| Rh ig minidose im CPT 90385 | not published | not published | $240.00 – $240.00 | 1 |
| Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe HCPCS J2791 | not published | not published | $4.15 – $14.49 | 4 |
| Rho d immune globulin 50 mcg HCPCS J2788 | not published | not published | $20.08 – $68.79 | 4 |
| Rho(d) immune globulin h, sd HCPCS J2792 | not published | not published | $27.63 – $101.73 | 4 |
| Rho d immune globulin inj HCPCS J2790 | $2,143.00 | $2,143.00 | $65.59 – $241.59 | 4 |
| Rho(d) immune globulin (rhig) human full dose im CPT 90384 | not published | not published | $394.56 – $394.56 | 1 |
| Rib gusset (elastic) each HCPCS L1280 | not published | not published | $100.94 – $127.06 | 18 |
| Riboflavin 5'phos opth<=3ml HCPCS J2787 | not published | not published | $8,208.00 – $8,208.00 | 1 |
| Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr HCPCS J2804 | $3,853.00 | $3,853.00 | $0.12 – $0.45 | 4 |
| Rilonacept injection HCPCS J2793 | not published | not published | $101.88 – $101.88 | 1 |
| Ring barrier skin cx 1 9/16 adapt HCPCS A4411 | not published | not published | $6.17 – $7.77 | 18 |
| Ring flange plas/leather mol HCPCS L1110 | not published | not published | $249.47 – $314.03 | 18 |
| Ring flange plastic/leather HCPCS L1100 | not published | not published | $184.56 – $232.33 | 18 |
| Ring fx reform 11-13x17mm HCPCS L8610 | not published | not published | $612.21 – $770.67 | 18 |
| Ring ostmy barr adapt 48mm HCPCS A4385 | not published | not published | $6.17 – $7.77 | 18 |
| Risankizumab-rzaa 60 mg/ml intravenous solution HCPCS J2327 | not published | not published | $12.63 – $44.79 | 4 |
| Risperidone microspheres 12.5 mg/2 ml inj HCPCS J2794 | $9,568.00 | $9,568.00 | $8.92 – $33.54 | 4 |
| Rituximab 10 mg/ml concentrate,intravenous HCPCS J9312 | not published | not published | $64.97 – $224.31 | 4 |
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $31.90 – $110.61 | 4 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | not published | not published | $29.55 – $90.45 | 4 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $28.13 – $62.70 | 4 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | not published | not published | $21.20 – $39.81 | 4 |
| Rocker bottom, contact afo HCPCS L2232 | not published | not published | $101.47 – $127.74 | 18 |
| Rolapitant, oral, 1mg HCPCS J8670 | not published | not published | $1.52 – $6.00 | 4 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | $189.00 | $189.00 | $26.81 – $92.73 | 4 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | not published | not published | $8.94 – $33.15 | 4 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | not published | not published | $9.77 – $36.33 | 4 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | not published | not published | $0.05 – $0.15 | 4 |
| Rotation wrst with cable lock HCPCS L6625 | not published | not published | $558.46 – $703.00 | 18 |
| Rotavirus antibody CPT 86759 | $384.00 | $384.00 | $15.86 – $26.43 | 19 |
| Round caliper and plate atta HCPCS L2240 | not published | not published | $92.77 – $116.78 | 18 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | not published | not published | $19.41 – $70.14 | 4 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | $4,941.00 | $4,941.00 | $150.83 – $848.52 | 2 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | $5,617.00 | $5,617.00 | $297.48 – $2,938.37 | 2 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | not published | not published | $428.72 – $3,330.77 | 2 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $561.65 – $561.65 | 1 |
| Rsv assay w/optic CPT 87807 | $737.00 | $737.00 | $11.40 – $18.99 | 19 |
| Rsv vacc mrna lipid nano im CPT 90683 | not published | not published | $1,044.00 – $1,044.00 | 1 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $22.52 – $24.10 | 15 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $52.37 – $56.04 | 15 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $53.05 – $56.76 | 15 |
| Rtm tx mgmt 1st 20 min CPT 98980 | not published | not published | $55.34 – $59.21 | 15 |
| Rtm tx mgmt ea addl 20 min CPT 98981 | not published | not published | $42.49 – $45.46 | 15 |
| Rubella antibody igg CPT 86762 | not published | not published | $12.52 – $20.87 | 19 |
| Rubeola ag if CPT 87283 | not published | not published | $52.91 – $88.16 | 19 |
| Rubeola antibody igg CPT 86765 | not published | not published | $11.21 – $18.68 | 19 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $329.51 – $477.79 | 16 |
| Russell viper venom diluted CPT 85613 | not published | not published | $8.34 – $13.89 | 19 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $798.07 – $1,329.77 | 19 |
| Sach foot, replacement HCPCS L5971 | not published | not published | $228.45 – $287.57 | 18 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $11,434.00 | $11,434.00 | $30.43 – $110.94 | 4 |
| Safety plan interven HCPCS G0560 | not published | not published | $29.50 – $33.67 | 3 |
| Salivary gland function exam CPT 78232 | not published | not published | $83.79 – $848.52 | 2 |
| Salivary gland imaging CPT 78230 | not published | not published | $95.88 – $848.52 | 2 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $93.01 – $848.52 | 2 |
| Salmonella antibody CPT 86768 | $1,289.00 | $1,289.00 | $11.47 – $19.13 | 19 |
| Sargramostim injection HCPCS J2820 | $896.00 | $896.00 | $50.90 – $185.25 | 4 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $42.22 – $86.82 | 19 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | not published | not published | $137.31 – $575.76 | 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.