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 |
|---|---|---|---|---|
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | not published | not published | $49.02 – $245.18 | 2 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $1,928.00 | $1,928.00 | $57.87 – $245.18 | 2 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $2,075.00 | $2,075.00 | $65.55 – $245.18 | 2 |
| X-ray male genital tract CPT 74440 | not published | not published | $82.90 – $517.79 | 2 |
| X-ray mandible complete > 4 views CPT 70110 | $1,610.00 | $1,610.00 | $53.60 – $245.18 | 2 |
| X-ray mandible ltd <4 views CPT 70100 | not published | not published | $41.29 – $182.03 | 2 |
| X-ray nasal bones complete > 3 views CPT 70160 | $1,069.00 | $1,069.00 | $38.15 – $182.03 | 2 |
| X-ray neck soft tissue CPT 70360 | $1,005.00 | $1,005.00 | $39.67 – $182.03 | 2 |
| X-ray nose to rectum for foreign body child CPT 76010 | not published | not published | $38.10 – $182.03 | 2 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $95.88 – $517.79 | 2 |
| X-ray optic foramina CPT 70190 | not published | not published | $47.54 – $182.03 | 2 |
| X-ray pelvis 1-2 views CPT 72170 | $1,047.00 | $1,047.00 | $38.15 – $245.18 | 2 |
| X-ray pelvis complete > 3 views CPT 72190 | not published | not published | $56.34 – $245.18 | 2 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $3,718.00 | $3,718.00 | $113.31 – $828.27 | 2 |
| X-ray ribs 2 views left CPT 71100 | not published | not published | $47.45 – $182.03 | 2 |
| X-ray ribs 3 views bilateral CPT 71110 | $1,605.00 | $1,605.00 | $61.24 – $245.18 | 2 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | not published | not published | $57.78 – $245.18 | 2 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $2,606.00 | $2,606.00 | $68.56 – $245.18 | 2 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $1,156.00 | $1,156.00 | $47.36 – $245.18 | 2 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $1,166.00 | $1,166.00 | $38.15 – $182.03 | 2 |
| X-ray scapula complete (both sides) CPT 73010 | not published | not published | $41.38 – $245.18 | 2 |
| X-ray sella turcica CPT 70240 | not published | not published | $41.20 – $182.03 | 2 |
| X-ray shoulder 1 view (both sides) CPT 73020 | not published | not published | $33.52 – $182.03 | 2 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $1,619.00 | $1,619.00 | $47.45 – $182.03 | 2 |
| X-ray sinus tract/fistula/abscess CPT 76080 | not published | not published | $109.13 – $1,086.50 | 2 |
| X-ray skull < 4 views CPT 70250 | $1,187.00 | $1,187.00 | $39.67 – $245.18 | 2 |
| X-ray skull > 4 views complete CPT 70260 | $1,668.00 | $1,668.00 | $59.76 – $245.18 | 2 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $2,508.00 | $2,508.00 | $123.60 – $245.18 | 2 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $2,036.00 | $2,036.00 | $170.55 – $401.74 | 2 |
| X-ray small intestine follow-through study CPT 74248 | $3,396.00 | $3,396.00 | $146.29 – $146.29 | 1 |
| X-ray spine single view CPT 72020 | $958.00 | $958.00 | $35.05 – $182.03 | 2 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $793.00 | $793.00 | $47.45 – $182.03 | 2 |
| X-ray sternum > 2 views CPT 71120 | $1,131.00 | $1,131.00 | $42.73 – $182.03 | 2 |
| X-ray surgical specimen CPT 76098 | not published | not published | $67.08 – $1,086.50 | 2 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $2,070.00 | $2,070.00 | $112.82 – $401.74 | 2 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $1,095.00 | $1,095.00 | $52.07 – $182.03 | 2 |
| X-ray thoracic spine 2 views CPT 72070 | $1,441.00 | $1,441.00 | $44.30 – $245.18 | 2 |
| X-ray thoracic spine 3 views CPT 72072 | $1,928.00 | $1,928.00 | $47.36 – $245.18 | 2 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $1,197.00 | $1,197.00 | $45.92 – $182.03 | 2 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | not published | not published | $57.87 – $182.03 | 2 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $645.00 | $645.00 | $68.65 – $245.18 | 2 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | not published | not published | $35.05 – $182.03 | 2 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | not published | not published | $28.89 – $182.03 | 2 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $3,012.00 | $3,012.00 | $190.59 – $401.74 | 2 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $2,569.00 | $2,569.00 | $172.67 – $401.74 | 2 |
| X-ray wrist 2 views (both sides) CPT 73100 | not published | not published | $38.24 – $182.03 | 2 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | not published | not published | $123.56 – $401.74 | 2 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | not published | not published | $48.53 – $55.38 | 3 |
| Xwrap 1 sq cm HCPCS Q4204 | not published | not published | $381.42 – $2,841.15 | 4 |
| Xylose absorption test blood &/or urine CPT 84620 | not published | not published | $11.24 – $18.72 | 19 |
| Xyntha inj HCPCS J7185 | not published | not published | $1.27 – $4.77 | 4 |
| Yersinia antibody CPT 86793 | not published | not published | $11.47 – $19.13 | 19 |
| Yttrium y-90 ibritumomab ther HCPCS A9543 | $215,923.00 | $215,923.00 | $170,473.65 – $170,473.65 | 1 |
| Zenith amniotic membrane psc HCPCS Q4253 | not published | not published | $60.77 – $381.42 | 4 |
| Ziconotide injection HCPCS J2278 | not published | not published | $8.24 – $31.71 | 4 |
| Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr HCPCS J3485 | $392.00 | $392.00 | $1.28 – $4.53 | 4 |
| Zika virus dna/rna amp probe CPT 87662 | $1,002.00 | $1,002.00 | $44.65 – $74.40 | 19 |
| Zika virus igm antibody CPT 86794 | $132.00 | $132.00 | $14.66 – $24.43 | 19 |
| Zinc paste band w >=3"<5"/yd HCPCS A6456 | not published | not published | $1.52 – $1.92 | 18 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $2,002.00 | $2,002.00 | $4.40 – $27.45 | 4 |
| Ziv-aflibercept 25 mg/ml intravenous solution (wrapper) HCPCS J9400 | not published | not published | $7.06 – $21.66 | 4 |
| Zolbetuximab-clzb 100 mg intravenous solution HCPCS J1326 | not published | not published | $101.01 – $101.01 | 1 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | not published | not published | $8.09 – $15.24 | 4 |
| Zoster vaccine-live inj CPT 90736 | not published | not published | $428.88 – $428.88 | 1 |
| Zrsr2 gene common variants CPT 81360 | not published | not published | $193.25 – $280.21 | 16 |
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.