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 |
|---|---|---|---|---|
| Warde virus isolation tissue culture innoculation presumptive id herpes simplex CPT 87252 | not published | not published | $22.69 – $37.80 | 19 |
| Warde viscosity CPT 85810 | $221.00 | $221.00 | $10.16 – $16.92 | 19 |
| Warde vitamin a CPT 84590 | $351.00 | $351.00 | $10.11 – $16.83 | 19 |
| Warde vitamin b-1 (thiamine) CPT 84425 | not published | not published | $18.48 – $30.78 | 19 |
| Warde vitamin b6 (pyridoxine) CPT 84207 | $387.00 | $387.00 | $24.45 – $40.74 | 19 |
| Warde vitamin c (ascorbic acid) CPT 82180 | $139.00 | $139.00 | $8.61 – $14.34 | 19 |
| Warde vitamin d (1 25 dihydroxy) CPT 82652 | $889.00 | $889.00 | $33.51 – $55.82 | 19 |
| Warde vitamin e (alpha-tocopherol) CPT 84446 | $462.00 | $462.00 | $12.34 – $20.56 | 19 |
| Warde zinc CPT 84630 | $289.00 | $289.00 | $9.91 – $16.52 | 19 |
| Warfarin respon genetic test HCPCS G9143 | not published | not published | $120.72 – $175.04 | 16 |
| Water distilled w/nebulizer HCPCS A7018 | not published | not published | $0.35 – $0.44 | 18 |
| Wbc automated CPT 85048 | not published | not published | $2.21 – $3.68 | 19 |
| Western blot test CPT 84181 | not published | not published | $14.82 – $24.69 | 19 |
| Wet mounts/ w preparations HCPCS Q0111 | not published | not published | $15.15 – $25.75 | 19 |
| Whfo electric custom fitted HCPCS L3904 | not published | not published | $2,799.02 – $3,523.47 | 18 |
| Whfo nontorsion joint prefab HCPCS L3931 | not published | not published | $174.28 – $219.39 | 18 |
| Whfo w/joint(s) custom fab HCPCS L3806 | not published | not published | $421.51 – $530.60 | 18 |
| Whole mitochondrial genome CPT 81460 | $9,280.00 | $9,280.00 | $1,287.00 – $1,866.15 | 16 |
| Whole mitochondrial genome CPT 81465 | $6,750.00 | $6,750.00 | $936.00 – $1,357.20 | 16 |
| Who nontorsion jnts pre cst HCPCS L3915 | not published | not published | $493.24 – $620.90 | 18 |
| Who nontorsion jnts pre ots HCPCS L3916 | not published | not published | $493.24 – $620.90 | 18 |
| Wilate injection HCPCS J7183 | not published | not published | $1.09 – $3.96 | 4 |
| Wipe adh remover univ ostomy adh/barrier remover HCPCS A4456 | not published | not published | $0.30 – $0.37 | 18 |
| Woman's shoe oxford brace HCPCS L3224 | not published | not published | $64.97 – $81.79 | 18 |
| Woundfix biowound plus xplus HCPCS Q4217 | not published | not published | $232.48 – $381.42 | 4 |
| Wound pouch each HCPCS A6154 | not published | not published | $16.88 – $21.25 | 18 |
| Wound therapy negative pressure per session <= 50 sq cm CPT 97607 | not published | not published | $373.61 – $399.76 | 15 |
| Wound therapy negative pressure per session > 50 sq cm CPT 97608 | not published | not published | $403.89 – $432.16 | 15 |
| Wound therapy negative pressure per session <= 50 sq cm dme CPT 97605 | not published | not published | $42.66 – $45.65 | 15 |
| Wound therapy negative pressure per session > 50 sq cm dme CPT 97606 | not published | not published | $51.10 – $54.68 | 15 |
| Wrist/elbow bowden cable mol HCPCS L6580 | not published | not published | $1,680.63 – $2,115.61 | 18 |
| Wrist/elbow bowden cbl dir f HCPCS L6582 | not published | not published | $1,432.20 – $1,802.89 | 18 |
| Wrist X-ray CPT 73110 | not published | not published | $39.76 – $182.03 | 2 |
| Wrst mld sck flx hng tri pad HCPCS L6050 | not published | not published | $1,976.76 – $2,488.39 | 18 |
| Xcellistem, 1 mg HCPCS A2004 | not published | not published | $46.80 – $46.80 | 1 |
| Xe133 xenon 10mci HCPCS A9558 | not published | not published | $918.87 – $918.87 | 1 |
| X-linked intellectual dblt CPT 81470 | not published | not published | $914.00 – $1,325.30 | 16 |
| X-linked intellectual dblt CPT 81471 | not published | not published | $914.00 – $1,325.30 | 16 |
| Xm archive tissue molec anal CPT 88363 | not published | not published | $24.67 – $138.50 | 2 |
| X-ray abdomen 1 view CPT 74018 | $1,062.00 | $1,062.00 | $39.67 – $182.03 | 2 |
| X-ray abdomen 2 views CPT 74019 | $990.00 | $990.00 | $48.97 – $245.18 | 2 |
| X-ray abdomen >=3 views CPT 74021 | $1,635.00 | $1,635.00 | $56.61 – $245.18 | 2 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $1,784.00 | $1,784.00 | $68.56 – $245.18 | 2 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $1,233.00 | $1,233.00 | $42.86 – $182.03 | 2 |
| X-ray ankle 2 views (both sides) CPT 73600 | not published | not published | $36.66 – $182.03 | 2 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | not published | not published | $122.34 – $828.27 | 2 |
| X-ray assay calculus CPT 82370 | not published | not published | $10.90 – $18.15 | 19 |
| X-ray bone age studies CPT 77072 | $395.00 | $395.00 | $41.20 – $245.18 | 2 |
| X-ray bone length studies CPT 77073 | not published | not published | $59.49 – $245.18 | 2 |
| X-ray bone survey complete CPT 77075 | $2,796.00 | $2,796.00 | $117.45 – $245.18 | 2 |
| X-ray bone survey infant CPT 77076 | $2,429.00 | $2,429.00 | $147.86 – $245.18 | 2 |
| X-ray cervical spine 2-3 views CPT 72040 | $1,440.00 | $1,440.00 | $47.45 – $182.03 | 2 |
| X-ray cervical spine 4-5 views CPT 72050 | $2,043.00 | $2,043.00 | $59.40 – $245.18 | 2 |
| X-ray cervical spine >= 6 views CPT 72052 | $2,204.00 | $2,204.00 | $65.55 – $245.18 | 2 |
| X-ray clavicle complete (both sides) CPT 73000 | not published | not published | $36.66 – $182.03 | 2 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $2,717.00 | $2,717.00 | $217.91 – $401.74 | 2 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $3,508.00 | $3,508.00 | $263.65 – $401.74 | 2 |
| X-ray consultation CPT 76140 | not published | not published | $232.64 – $265.49 | 3 |
| X-ray elbow 2 views (both sides) CPT 73070 | not published | not published | $36.66 – $182.03 | 2 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | not published | not published | $38.15 – $182.03 | 2 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $2,070.00 | $2,070.00 | $126.66 – $401.74 | 2 |
| X-ray exam entire spi 4/5 vw CPT 72083 | not published | not published | $77.95 – $245.18 | 2 |
| X-ray exam entire spi 6/> vw CPT 72084 | $1,233.00 | $1,233.00 | $90.22 – $245.18 | 2 |
| X-ray exam of arm infant CPT 73092 | not published | not published | $35.05 – $245.18 | 2 |
| X-ray exam of eye sockets CPT 70200 | $1,544.00 | $1,544.00 | $59.76 – $245.18 | 2 |
| X-ray exam of femur 1 CPT 73551 | not published | not published | $36.66 – $182.03 | 2 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $39.67 – $182.03 | 2 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $114.35 – $517.79 | 2 |
| X-ray exam of mastoids CPT 70120 | $1,419.00 | $1,419.00 | $39.67 – $245.18 | 2 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $76.83 – $1,086.50 | 2 |
| X-ray exam of penis CPT 74445 | not published | not published | $245.18 – $246.71 | 2 |
| X-ray exam of perineum CPT 74775 | not published | not published | $130.93 – $517.79 | 2 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $36.57 – $182.03 | 2 |
| X-ray exam of sinuses CPT 70210 | not published | not published | $38.15 – $182.03 | 2 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $63.94 – $517.79 | 2 |
| X-ray exam of teeth CPT 70300 | not published | not published | $24.35 – $182.03 | 2 |
| X-ray exam of teeth CPT 70310 | not published | not published | $36.66 – $517.79 | 2 |
| X-ray exam si joints CPT 72200 | not published | not published | $38.15 – $245.18 | 2 |
| X-ray exam thorac spine4/>vw CPT 72074 | $2,449.00 | $2,449.00 | $51.98 – $245.18 | 2 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $1,267.00 | $1,267.00 | $39.67 – $182.03 | 2 |
| X-ray facial bones complete > 3 views CPT 70150 | $1,527.00 | $1,527.00 | $56.70 – $245.18 | 2 |
| X-ray fallopian tube CPT 74742 | not published | not published | $128.23 – $128.23 | 1 |
| X-ray femur >=2 views (both sides) CPT 73552 | not published | not published | $39.67 – $182.03 | 2 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | not published | not published | $30.51 – $182.03 | 2 |
| X-ray foot 2 views (both sides) CPT 73620 | not published | not published | $35.05 – $182.03 | 2 |
| X-ray forearm 2 views (both sides) CPT 73090 | not published | not published | $35.05 – $182.03 | 2 |
| X-ray hand 2 views (both sides) CPT 73120 | not published | not published | $36.66 – $245.18 | 2 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $39.76 – $182.03 | 2 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | not published | not published | $35.05 – $182.03 | 2 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | not published | not published | $60.97 – $245.18 | 2 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $645.00 | $645.00 | $49.02 – $245.18 | 2 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $645.00 | $645.00 | $64.03 – $245.18 | 2 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $1,233.00 | $1,233.00 | $67.08 – $245.18 | 2 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | not published | not published | $41.29 – $182.03 | 2 |
| X-ray humerus >= 2 views left CPT 73060 | not published | not published | $36.66 – $182.03 | 2 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $74.90 – $245.18 | 2 |
| X-ray knee 1-2 views (both sides) CPT 73560 | not published | not published | $36.66 – $182.03 | 2 |
| X-ray knee 3 views (both sides) CPT 73562 | not published | not published | $42.86 – $182.03 | 2 |
| X-ray knee ap standing bilateral CPT 73565 | not published | not published | $38.24 – $182.03 | 2 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | not published | not published | $35.05 – $182.03 | 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.