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 |
|---|---|---|---|---|
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | not published | not published | $74.75 – $100.01 | 18 |
| St evaluation swallow function CPT 92610 | not published | not published | $70.19 – $91.63 | 18 |
| Stocking sup grips 4 pre ots HCPCS L0982 | not published | not published | $15.90 – $20.02 | 18 |
| Stoma absorptive cover HCPCS A5083 | not published | not published | $0.78 – $0.98 | 18 |
| Storage/year embryo(s) CPT 89342 | not published | not published | $149.16 – $837.38 | 2 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $291.26 – $1,635.13 | 2 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $149.16 – $837.38 | 2 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $149.16 – $837.38 | 2 |
| Straight knee joint heavy du HCPCS L2385 | not published | not published | $130.83 – $164.69 | 18 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $11.32 – $14.25 | 18 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | not published | not published | $4.00 – $5.03 | 18 |
| Strep a ag ia CPT 87430 | not published | not published | $14.63 – $24.37 | 19 |
| Strep a dna dir probe CPT 87650 | not published | not published | $17.45 – $29.07 | 19 |
| Strep a dna quant CPT 87652 | not published | not published | $36.34 – $60.55 | 19 |
| Strep b assay w/optic CPT 87802 | $386.00 | $386.00 | $11.08 – $18.46 | 19 |
| Strep b dna amp probe CPT 87653 | not published | not published | $30.54 – $50.88 | 19 |
| Streptokinase antibody CPT 86590 | not published | not published | $11.02 – $18.36 | 19 |
| Streptomycin injection HCPCS J3000 | not published | not published | $21.75 – $101.64 | 4 |
| Streptozocin injection HCPCS J9320 | not published | not published | $526.05 – $526.05 | 1 |
| Str markers spec anal addl CPT 81266 | not published | not published | $304.81 – $441.97 | 16 |
| Str markers specimen anal CPT 81265 | not published | not published | $233.07 – $337.95 | 16 |
| St treatment speech individual CPT 92507 | not published | not published | $63.21 – $82.23 | 18 |
| St treatment swallow dysfunction/oral CPT 92526 | not published | not published | $69.73 – $90.90 | 18 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | not published | not published | $4.65 – $4.65 | 1 |
| Suction socket HCPCS L6686 | not published | not published | $674.53 – $849.11 | 18 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $453.69 – $571.11 | 18 |
| Sugars multiple quant CPT 84379 | not published | not published | $10.03 – $16.72 | 19 |
| Sugars single quant CPT 84378 | $196.00 | $196.00 | $10.03 – $16.72 | 19 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $162.00 | $162.00 | $0.05 – $0.12 | 4 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | not published | not published | $568.50 – $568.50 | 1 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $2.95 – $3.71 | 18 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $21.99 – $27.68 | 18 |
| Support clav 29.6-40.5in med HCPCS L3650 | not published | not published | $64.95 – $81.76 | 18 |
| Supprelin la implant HCPCS J9226 | not published | not published | $38,430.20 – $129,556.02 | 4 |
| Suprv interfacilty transport CPT 99485 | not published | not published | $50.11 – $57.18 | 3 |
| Suprv interfac trnsport addl CPT 99486 | not published | not published | $43.40 – $49.53 | 3 |
| Surgical pathology level 1 gross examination only CPT 88300 | $439.00 | $439.00 | $24.67 – $138.50 | 2 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $862.00 | $862.00 | $24.67 – $138.50 | 2 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $1,220.00 | $1,220.00 | $49.76 – $279.35 | 2 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $1,378.00 | $1,378.00 | $49.76 – $279.35 | 2 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $1,673.00 | $1,673.00 | $291.26 – $1,635.13 | 2 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $2,019.00 | $2,019.00 | $656.15 – $3,683.63 | 2 |
| Surgigraft, 1 sq cm HCPCS Q4183 | not published | not published | $381.42 – $381.42 | 1 |
| Susceptibility agar dilution per agent CPT 87181 | not published | not published | $4.13 – $6.89 | 19 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $85.00 | $85.00 | $4.13 – $6.89 | 19 |
| Susceptibility mic per plate CPT 87186 | not published | not published | $7.53 – $12.54 | 19 |
| Suscept studies macrobroth dilution ea CPT 87188 | $342.00 | $342.00 | $5.78 – $9.63 | 19 |
| Suspension sleeve lower ext HCPCS L2397 | not published | not published | $119.06 – $149.87 | 18 |
| Svc venogram s&i CPT 75827 | not published | not published | $237.68 – $3,163.82 | 2 |
| Sweat collection by iontophoresis CPT 89230 | not published | not published | $49.76 – $279.35 | 2 |
| Symes ankle without (sach) foot HCPCS L5703 | not published | not published | $2,176.82 – $2,740.23 | 18 |
| Symes met fr leath socket ar HCPCS L5060 | not published | not published | $2,874.17 – $3,618.08 | 18 |
| Symes type medial opening so HCPCS L5636 | not published | not published | $265.15 – $333.78 | 18 |
| Symes type poster opening so HCPCS L5634 | not published | not published | $316.54 – $398.47 | 18 |
| Symes type ptb brim design s HCPCS L5632 | not published | not published | $231.06 – $290.86 | 18 |
| Syme typ expandabl wall sckt HCPCS L5630 | not published | not published | $467.02 – $587.90 | 18 |
| Synojoynt, inj., 1 mg HCPCS J7331 | not published | not published | $7.17 – $9.36 | 4 |
| Synvisc or synvisc-one HCPCS J7325 | not published | not published | $7.86 – $22.68 | 4 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | not published | not published | $3.82 – $6.38 | 19 |
| T3 (triiodothyronine) free CPT 84481 | $235.00 | $235.00 | $14.74 – $24.56 | 19 |
| T3 (triiodothyronine) total CPT 84480 | $889.00 | $889.00 | $12.34 – $20.56 | 19 |
| T4 (thyroxine) free CPT 84439 | $365.00 | $365.00 | $7.85 – $13.08 | 19 |
| T4 (thyroxine) total CPT 84436 | $303.00 | $303.00 | $5.98 – $9.96 | 19 |
| Tacrol astagraf ex rel oral HCPCS J7508 | not published | not published | $0.48 – $1.77 | 4 |
| Tacrol envarsus ex rel oral HCPCS J7503 | not published | not published | $1.54 – $5.61 | 4 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | not published | not published | $0.16 – $0.60 | 4 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $4,509.00 | $4,509.00 | $216.80 – $787.35 | 4 |
| Tacrolimus therapeutic drug level CPT 80197 | $792.00 | $792.00 | $11.95 – $19.91 | 19 |
| Tafasitamab-cxix 200 mg intravenous solution HCPCS J9349 | not published | not published | $11.84 – $42.72 | 4 |
| Talimogene laherparepvec 10exp6 (1 million) pfu/ml susp for injection HCPCS J9325 | not published | not published | $59.82 – $221.82 | 4 |
| Talquetamab-tgvs 2 mg/ml subcutaneous solution HCPCS J3055 | not published | not published | $59.50 – $224.76 | 4 |
| Talymed HCPCS Q4127 | not published | not published | $58.22 – $381.42 | 4 |
| Tape plstc 1inx5yd hosp tb pk HCPCS A4452 | not published | not published | $0.42 – $0.54 | 18 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,048.00 | $2,048.00 | $759.53 – $1,101.32 | 16 |
| Target gsa panel organ/hmtlmph neop CPT 81455 | $6,316.00 | $6,316.00 | $2,919.60 – $4,233.42 | 16 |
| Target gsa panel organ neop CPT 81445 | $3,444.00 | $3,444.00 | $597.91 – $866.97 | 16 |
| Tarlatamab-dlle 10 mg intravenous solution HCPCS J9026 | not published | not published | $1,335.15 – $4,699.77 | 4 |
| Tbo-filgrastim 300 mcg/0.5 ml subcutaneous syringe HCPCS J1447 | not published | not published | $0.31 – $0.75 | 4 |
| Tbp gene detc abnor alleles CPT 81344 | not published | not published | $137.00 – $198.65 | 16 |
| Tbs dxa cal w/i&r fx risk CPT 77089 | not published | not published | $93.44 – $187.18 | 2 |
| Tbs i&r fx rsk qhp CPT 77092 | not published | not published | $23.36 – $23.36 | 1 |
| Tbs techl calculation only CPT 77091 | not published | not published | $127.33 – $185.87 | 2 |
| Tbs techl prep&transmis data CPT 77090 | not published | not published | $13.93 – $185.87 | 2 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $309.00 | $309.00 | $87.02 – $145.00 | 19 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $973.00 | $973.00 | $53.94 – $89.87 | 19 |
| Tc-99m apcitide diag HCPCS A9504 | not published | not published | $1,577.19 – $1,577.19 | 1 |
| Tc-99m arcitumomab HCPCS A9568 | not published | not published | $3,887.85 – $3,887.85 | 1 |
| Tc-99m bicisate HCPCS A9557 | not published | not published | $2,326.56 – $2,326.56 | 1 |
| Tc-99m depreotide HCPCS A9536 | not published | not published | $2,401.86 – $2,401.86 | 1 |
| Tc-99m disofenin HCPCS A9510 | $281.00 | $281.00 | $185.37 – $185.37 | 1 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | not published | not published | $2,802.39 – $2,802.39 | 1 |
| Tc-99m exametazime diag HCPCS A9521 | $2,751.00 | $2,751.00 | $2,783.13 – $2,783.13 | 1 |
| Tc-99m graphite crucible HCPCS A9506 | not published | not published | $985.80 – $985.80 | 1 |
| Tc-99m labeled rbc HCPCS A9560 | $1,277.00 | $1,277.00 | $326.67 – $326.67 | 1 |
| Tc-99m maa HCPCS A9540 | $120.00 | $120.00 | $91.17 – $91.17 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | $228.00 | $228.00 | $340.38 – $340.38 | 1 |
| Tc-99m medronate HCPCS A9503 | $686.00 | $686.00 | $193.38 – $193.38 | 1 |
| Tc-99m mertiatide HCPCS A9562 | $1,104.00 | $1,104.00 | $2,379.81 – $2,379.81 | 1 |
| Tc-99m oxidronate HCPCS A9561 | not published | not published | $156.33 – $156.33 | 1 |
| Tc-99m pentetate dtpa HCPCS A9539 | $595.00 | $595.00 | $86.16 – $86.16 | 1 |
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.