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 |
|---|---|---|---|---|
| Trh stimulation panel CPT 80439 | not published | not published | $58.49 – $97.45 | 19 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | not published | not published | $0.74 – $2.22 | 4 |
| Triamcinolone a inj prs-free HCPCS J3300 | not published | not published | $21.27 – $73.47 | 4 |
| Triamcinolone diacetate inj HCPCS J3302 | not published | not published | $0.99 – $0.99 | 1 |
| Triamcinolone hexacetonl inj HCPCS J3303 | not published | not published | $29.25 – $29.25 | 1 |
| Trichinella antibody CPT 86784 | $851.00 | $851.00 | $10.93 – $18.21 | 19 |
| Trichomonas assay w/optic CPT 87808 | not published | not published | $13.30 – $22.17 | 19 |
| Triglycerides CPT 84478 | not published | not published | $5.00 – $8.32 | 19 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | not published | not published | $4.58 – $16.26 | 4 |
| Trimethobenzamide hci 250mg HCPCS Q0173 | not published | not published | $2.01 – $2.01 | 1 |
| Trimethobenzamide hcl inj HCPCS J3250 | $280.00 | $280.00 | $42.53 – $172.80 | 4 |
| Triptorelin pamoate HCPCS J3315 | $15,954.00 | $15,954.00 | $400.89 – $1,389.60 | 4 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | not published | not published | $557.58 – $929.06 | 19 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | not published | not published | $3,240.00 – $3,466.80 | 15 |
| Troponin quantitative CPT 84484 | not published | not published | $10.85 – $18.08 | 19 |
| Truskin, per sq centimeter HCPCS Q4167 | not published | not published | $381.42 – $381.42 | 1 |
| Truss addition to std pad wa HCPCS L8320 | not published | not published | $62.13 – $78.22 | 18 |
| Truss add to std pad scrotal HCPCS L8330 | not published | not published | $51.37 – $64.67 | 18 |
| Truss double with standard pad HCPCS L8310 | not published | not published | $138.59 – $174.46 | 18 |
| Truss single with standard pad HCPCS L8300 | not published | not published | $87.79 – $110.51 | 18 |
| Tube drain vert dev st 5-40f HCPCS A5200 | not published | not published | $13.69 – $17.23 | 18 |
| Tube trach disp innr can 5 xlt HCPCS A7521 | not published | not published | $56.98 – $71.73 | 18 |
| Tube trach disp innr can 6 xlt HCPCS A4623 | not published | not published | $7.94 – $9.99 | 18 |
| Tube trach fen sz 6 uncuffed HCPCS A7520 | not published | not published | $57.51 – $72.40 | 18 |
| Tubing (oxygen) per foot HCPCS A4616 | not published | not published | $0.07 – $0.09 | 18 |
| Tubular dressing HCPCS A6457 | not published | not published | $1.38 – $1.73 | 18 |
| Twelve volt battery utah/equ HCPCS L7364 | not published | not published | $517.77 – $651.78 | 18 |
| Tx septic abortion surgical 59830 CPT 59830 | not published | not published | $314.76 – $359.20 | 3 |
| Tyms gene com variants CPT 81346 | not published | not published | $174.81 – $253.47 | 16 |
| Typhoid vaccine oral CPT 90690 | not published | not published | $422.22 – $422.22 | 1 |
| U2af1 gene common variants CPT 81357 | not published | not published | $193.25 – $280.21 | 16 |
| Ua w/micro/comp poc CPT 81000 | not published | not published | $3.50 – $5.83 | 19 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $58.36 – $210.54 | 4 |
| Ue triple control harness HCPCS L6677 | not published | not published | $303.04 – $381.48 | 18 |
| Ugt1a1 gene analy common variants CPT 81350 | $1,687.00 | $1,687.00 | $234.00 – $339.30 | 16 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $2,033.00 | $2,033.00 | $117.04 – $245.18 | 2 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $11.95 – $245.18 | 2 |
| Ultrasound breast complete CPT 76641 | not published | not published | $154.02 – $245.18 | 2 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | not published | not published | $143.24 – $182.03 | 2 |
| Ultrasound chest CPT 76604 | not published | not published | $126.30 – $245.18 | 2 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $899.00 | $899.00 | $100.15 – $245.18 | 2 |
| Ultrasound dx ophth b-scan CPT 76512 | not published | not published | $87.39 – $245.18 | 2 |
| Ultrasound elastography ea l target les CPT 76983 | not published | not published | $110.12 – $110.12 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | $606.00 | $606.00 | $133.13 – $245.18 | 2 |
| Ultrasound encephalogram CPT 76506 | $2,771.00 | $2,771.00 | $134.07 – $245.18 | 2 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $1,244.00 | $1,244.00 | $158.60 – $245.18 | 2 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $2,805.00 | $2,805.00 | $168.08 – $245.18 | 2 |
| Ultrasound guidance for vascular access CPT 76937 | not published | not published | $61.91 – $61.91 | 1 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | not published | not published | $143.73 – $143.73 | 1 |
| Ultrasound guide intraoperative CPT 76998 | not published | not published | $219.39 – $219.39 | 1 |
| Ultrasound guide tissue ablation CPT 76940 | not published | not published | $462.69 – $462.69 | 1 |
| Ultrasound hips infant dynamic CPT 76885 | not published | not published | $155.55 – $182.03 | 2 |
| Ultrasound infant hips ltd without stress CPT 76886 | not published | not published | $130.93 – $182.03 | 2 |
| Ultrasound joint complete left CPT 76881 | not published | not published | $52.25 – $245.18 | 2 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | not published | not published | $146.38 – $245.18 | 2 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $77.82 – $240.48 | 2 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $2,563.00 | $2,563.00 | $197.56 – $197.56 | 1 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $1,860.00 | $1,860.00 | $100.60 – $100.60 | 1 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $4,121.00 | $4,121.00 | $414.88 – $517.79 | 2 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $1,650.00 | $1,650.00 | $186.64 – $245.18 | 2 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | not published | not published | $140.27 – $245.18 | 2 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $3,491.00 | $3,491.00 | $161.84 – $245.18 | 2 |
| Ultrasound prostate/transrectal CPT 76872 | not published | not published | $145.75 – $245.18 | 2 |
| Ultrasound retroperitoneal limited CPT 76775 | $2,033.00 | $2,033.00 | $123.60 – $245.18 | 2 |
| Ultrasound scrotum and contents CPT 76870 | $2,867.00 | $2,867.00 | $135.55 – $245.18 | 2 |
| Ultrasound spinal canal and contents CPT 76800 | $754.00 | $754.00 | $245.18 – $289.80 | 2 |
| Ultrasound transabd ea addl gest CPT 76812 | $693.00 | $693.00 | $391.79 – $391.79 | 1 |
| Ultrasound transvaginal non obstetric CPT 76830 | $3,030.00 | $3,030.00 | $147.95 – $245.18 | 2 |
| Ultrasound trgt dyn mbubb 1st les CPT 76978 | not published | not published | $340.34 – $401.74 | 2 |
| Ultrasound trgt dyn mbubb ea addl CPT 76979 | not published | not published | $179.81 – $179.81 | 1 |
| Ultraviolet therapy CPT 97028 | not published | not published | $6.74 – $9.30 | 18 |
| Unit mobile power mpu HCPCS Q0479 | not published | not published | $12,267.03 – $15,442.03 | 18 |
| Unlisted CT procedure CPT 76497 | not published | not published | $182.03 – $182.03 | 1 |
| Unlisted cv px dx nuc med CPT 78499 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted cytogenetic study CPT 88299 | not published | not published | $49.76 – $279.35 | 2 |
| Unlisted cytopathology px CPT 88199 | not published | not published | $49.76 – $279.35 | 2 |
| Unlisted endocrine px dx nuc CPT 78099 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted fluoroscopic px CPT 76496 | not published | not published | $182.03 – $182.03 | 1 |
| Unlisted gi px dx nuc med CPT 78299 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted gu px dx nuc med CPT 78799 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted misc path test CPT 89240 | not published | not published | $49.76 – $279.35 | 2 |
| Unlisted mr procedure CPT 76498 | not published | not published | $182.03 – $182.03 | 1 |
| Unlisted muscskel px dx nuc CPT 78399 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted nrvs sys px dx nuc CPT 78699 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted reprod med lab proc CPT 89398 | not published | not published | $49.76 – $279.35 | 2 |
| Unlisted resp px dx nuc med CPT 78599 | not published | not published | $848.52 – $848.52 | 1 |
| Unlisted surgical path px CPT 88399 | not published | not published | $49.76 – $279.35 | 2 |
| Unlisted transfusion med px CPT 86999 | not published | not published | $24.67 – $138.50 | 2 |
| Unlisted ultrasound procedure CPT 76999 | not published | not published | $182.03 – $182.03 | 1 |
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $848.52 – $848.52 | 1 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | $11,037.00 | $11,037.00 | $481.65 – $828.27 | 2 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | $9,731.00 | $9,731.00 | $375.39 – $828.27 | 2 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | $8,879.00 | $8,879.00 | $311.10 – $517.79 | 2 |
| Upper ext fx orthosis rad/ul HCPCS L3982 | not published | not published | $356.81 – $449.16 | 18 |
| Urea nitrogen CPT 84520 | not published | not published | $3.43 – $5.73 | 19 |
| Urea nitrogen 24 hour urine CPT 84540 | $243.00 | $243.00 | $4.84 – $8.06 | 19 |
| Urea nitrogen clearance CPT 84545 | $221.00 | $221.00 | $6.26 – $10.44 | 19 |
| Urea nitrogen semi-quant CPT 84525 | not published | not published | $4.46 – $7.44 | 19 |
| Ureteral reflux study CPT 78740 | $995.00 | $995.00 | $124.10 – $848.52 | 2 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | $980.00 | $980.00 | $70.09 – $517.79 | 2 |
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.