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 |
|---|---|---|---|---|
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $99.99 – $261.33 | 4 |
| Six volt bat otto bock/eq ea HCPCS L7360 | not published | not published | $310.94 – $391.42 | 18 |
| Skin barrier with flange HCPCS A4373 | not published | not published | $7.60 – $9.57 | 18 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $24.67 – $138.50 | 2 |
| Skyla, 13.5 mg HCPCS J7301 | not published | not published | $3,814.26 – $3,814.26 | 1 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $253.47 | 16 |
| Sleeve fing rolyan med HCPCS L3933 | not published | not published | $197.96 – $249.19 | 18 |
| Sling arm deluxe w/pad xs HCPCS A4565 | not published | not published | $9.33 – $11.75 | 18 |
| Sling pelv split sam med HCPCS L0621 | not published | not published | $65.02 – $81.86 | 18 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $25.77 – $29.41 | 3 |
| Slp eval non-spch gen comm dev CPT 92605 | not published | not published | $73.70 – $84.10 | 3 |
| Slp pure tone screening CPT 92551 | not published | not published | $10.22 – $11.66 | 3 |
| Slp ther svc non-spch gen CPT 92606 | not published | not published | $63.49 – $72.46 | 3 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $9,479.40 – $9,479.40 | 1 |
| Small animal inoculation CPT 87003 | not published | not published | $14.65 – $24.42 | 19 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | not published | not published | $0.03 – $277.61 | 4 |
| Smear fluorescent and/or acid fast stain CPT 87206 | not published | not published | $4.69 – $7.82 | 19 |
| Smear gram stain CPT 87205 | not published | not published | $3.71 – $6.19 | 19 |
| Smear nasal eosinophil CPT 89190 | $201.00 | $201.00 | $5.04 – $8.40 | 19 |
| Smear special stain inclusion bodies/parasites CPT 87207 | not published | not published | $5.21 – $8.69 | 19 |
| Smear wet mount CPT 87210 | not published | not published | $5.07 – $8.44 | 19 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $301.35 – $436.96 | 16 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $185.20 – $268.54 | 16 |
| Smpd1 gene common variants CPT 81330 | $734.00 | $734.00 | $47.00 – $68.15 | 16 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $51.07 – $74.05 | 16 |
| So airplane w/wo joint cf HCPCS L3674 | not published | not published | $1,096.81 – $1,380.70 | 18 |
| So cap design without jnts cf HCPCS L3671 | not published | not published | $836.13 – $1,052.54 | 18 |
| Socket insert above knee HCPCS L5658 | not published | not published | $400.86 – $504.61 | 18 |
| Socket insert below knee HCPCS L5655 | not published | not published | $292.20 – $367.82 | 18 |
| Socket insert knee articulat HCPCS L5656 | not published | not published | $411.62 – $518.16 | 18 |
| Socket insert symes HCPCS L5654 | not published | not published | $345.12 – $434.44 | 18 |
| Socket insert without lock mech HCPCS L5679 | not published | not published | $609.23 – $766.91 | 18 |
| Socket insert w lock mech HCPCS L5673 | not published | not published | $731.09 – $920.31 | 18 |
| Sock fracture or equal each HCPCS L3995 | not published | not published | $34.09 – $42.92 | 18 |
| Sock wool above knee HCPCS L8430 | not published | not published | $23.04 – $29.00 | 18 |
| Sodium 24 hour urine CPT 84300 | $184.00 | $184.00 | $4.40 – $7.34 | 19 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $506.00 | $506.00 | $2.10 – $5.97 | 4 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $442.00 | $442.00 | $1.05 – $3.87 | 4 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | not published | not published | $0.53 – $1.98 | 4 |
| Sodium chloride 3 % ivpb HCPCS J7131 | not published | not published | $0.30 – $0.30 | 1 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $1,339.00 | $1,339.00 | $1.65 – $6.63 | 4 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | not published | not published | $62.87 – $218.91 | 4 |
| Sodium serum/plasma/whole blood CPT 84295 | not published | not published | $4.18 – $6.97 | 19 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $1,137.00 | $1,137.00 | $2.64 – $2.64 | 1 |
| Soft interface below knee se HCPCS L2820 | not published | not published | $84.82 – $106.78 | 18 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,345.31 – $1,439.48 | 15 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,195.83 – $1,279.54 | 15 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $3,288.51 – $3,518.71 | 15 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,046.35 – $1,119.59 | 15 |
| Solid skin barrier HCPCS A4362 | not published | not published | $3.58 – $4.50 | 18 |
| Solid skin barrier 6x6 HCPCS A5121 | not published | not published | $7.68 – $9.66 | 18 |
| Somatropin injection HCPCS J2941 | not published | not published | $494.70 – $494.70 | 1 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $2,989.55 – $3,198.82 | 15 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $896.87 – $959.65 | 15 |
| Sotalol hydrochloride IV HCPCS C9482 | not published | not published | $75.27 – $75.27 | 1 |
| So vest canvas/web pre ots HCPCS L3675 | not published | not published | $162.84 – $204.99 | 18 |
| Special radiation dosimetry CPT 77331 | not published | not published | $92.20 – $92.20 | 1 |
| Special radiation treatment CPT 77470 | not published | not published | $184.39 – $184.39 | 1 |
| Special teletx port plan CPT 77321 | not published | not published | $213.55 – $213.55 | 1 |
| Specific gravity body fluid CPT 84315 | $73.00 | $73.00 | $2.86 – $4.76 | 19 |
| Specimen fat stain CPT 89125 | $193.00 | $193.00 | $5.12 – $8.53 | 19 |
| Speech evaluation complex CPT 70371 | not published | not published | $188.30 – $517.79 | 2 |
| Sperm antibody test CPT 89325 | not published | not published | $9.28 – $15.47 | 19 |
| Sperm evaluation test CPT 89329 | not published | not published | $17.05 – $28.41 | 19 |
| Sperm identification CPT 89257 | not published | not published | $49.76 – $279.35 | 2 |
| Sperm isolation complex CPT 89261 | not published | not published | $49.76 – $279.35 | 2 |
| Sperm isolation simple CPT 89260 | not published | not published | $49.76 – $279.35 | 2 |
| Spleen imaging CPT 78185 | not published | not published | $71.57 – $848.52 | 2 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | not published | not published | $408.56 – $514.31 | 18 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | not published | not published | $48.03 – $60.47 | 18 |
| Splint finger fold over sm HCPCS L3924 | not published | not published | $89.56 – $112.75 | 18 |
| Splint finger frog med HCPCS L3927 | not published | not published | $32.44 – $40.84 | 18 |
| Splint fing stax assort 1-7in HCPCS Q4049 | not published | not published | $2.28 – $2.87 | 18 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | not published | not published | $89.56 – $112.75 | 18 |
| Split blood or products CPT 86985 | not published | not published | $149.16 – $837.38 | 2 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $74.94 – $94.34 | 18 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $767.46 – $966.09 | 18 |
| Sputum specimen collection CPT 89220 | not published | not published | $149.16 – $837.38 | 2 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $12,439.02 – $12,439.02 | 1 |
| Srs cranial lesion complex CPT 61798 | not published | not published | $938.37 – $1,070.85 | 3 |
| Srs cran les complex addl CPT 61799 | not published | not published | $201.26 – $229.68 | 3 |
| Srs cran les simple addl CPT 61797 | not published | not published | $145.82 – $166.40 | 3 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $175.40 – $254.33 | 16 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $224.27 – $282.32 | 18 |
| St analysis behavior qualitative voice/resonance CPT 92524 | not published | not published | $89.91 – $118.71 | 18 |
| Stance phase only HCPCS L5858 | not published | not published | $18,986.02 – $23,900.06 | 18 |
| Standard control cable extra HCPCS L6655 | not published | not published | $78.17 – $98.41 | 18 |
| Staph a dna amp probe CPT 87640 | $439.00 | $439.00 | $30.54 – $50.88 | 19 |
| Static or dynami afo pre ots HCPCS L4397 | not published | not published | $171.07 – $215.35 | 18 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $58.04 – $73.06 | 18 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $58.04 – $73.06 | 18 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | not published | not published | $83.86 – $111.86 | 18 |
| Stem cells total count CPT 86367 | not published | not published | $67.69 – $112.78 | 19 |
| Stereotactic radiation trmt CPT 77432 | not published | not published | $296.15 – $1,941.74 | 4 |
| Sterile gauze <= 16 sq in HCPCS A6402 | not published | not published | $0.13 – $0.16 | 18 |
| Sterile water/saline, 10 ml HCPCS A4216 | not published | not published | $0.49 – $0.62 | 18 |
| Sterile water/saline, 500 ml HCPCS A4217 | not published | not published | $3.43 – $4.32 | 18 |
| Sternal pad HCPCS L1050 | not published | not published | $98.02 – $123.39 | 18 |
| St evaluate speech sound production CPT 92522 | not published | not published | $91.47 – $121.53 | 18 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | not published | not published | $188.22 – $243.96 | 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.