Sentara Northern Virginia Medical Center
2300 Opitz Boulevard, Woodbridge, VA · Sentara · · NPI 1548366404
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 |
|---|---|---|---|---|
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $115.50 | $231.00 | not published | 0 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $1,972.00 – $1,972.00 | 1 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $1,972.00 – $1,972.00 | 1 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $177.50 | $355.00 | $105.71 – $184.56 | 4 |
| Liver elastography 91200 CPT 91200 | not published | not published | $128.06 – $131.82 | 4 |
| Liver Function Test CPT 80076 | $155.00 | $310.00 | $7.16 – $43.05 | 6 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Liver imaging CPT 78201 | $1,143.00 | $2,286.00 | $411.60 – $556.26 | 5 |
| Liver imag w/vasclr flow CPT 78202 | $1,143.00 | $2,286.00 | $494.90 – $556.26 | 5 |
| Liver/spleen imag static only CPT 78215 | $1,123.00 | $2,246.00 | $397.85 – $499.36 | 5 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $1,208.00 | $2,416.00 | $397.85 – $591.09 | 5 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $2,366.07 – $2,435.66 | 4 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $3,256.29 – $4,039.00 | 6 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $221.24 – $282.36 | 5 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | not published | not published | $1.78 – $1.78 | 1 |
| Loudness balance test CPT 92562 | not published | not published | $214.89 – $221.21 | 4 |
| Low back disk surgery CPT 63030 | not published | not published | $3,988.00 – $7,889.00 | 6 |
| Low cost skin substitute app HCPCS C5271 | $1,130.50 | $2,261.00 | $484.00 – $484.00 | 1 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $2,464.00 – $2,464.00 | 1 |
| Low cost skin substitute app HCPCS C5275 | $1,012.00 | $2,024.00 | $484.00 – $484.00 | 1 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $484.00 – $484.00 | 1 |
| Low cost skin substitute app HCPCS C5272 | $568.00 | $1,136.00 | $484.00 – $484.00 | 1 |
| Low cost skin substitute app HCPCS C5274 | not published | not published | $484.00 – $484.00 | 1 |
| Low cost skin substitute app HCPCS C5276 | not published | not published | $484.00 – $484.00 | 1 |
| Low cost skin substitute app HCPCS C5278 | not published | not published | $484.00 – $484.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,140.00 | $4,280.00 | $174.56 – $1,474.43 | 5 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,862.00 | $3,724.00 | $347.20 – $1,211.61 | 5 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,608.50 | $3,217.00 | $104.04 – $1,036.66 | 5 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $3,315.50 | $6,631.00 | $347.20 – $3,941.93 | 6 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,644.00 | $5,288.00 | $347.20 – $2,215.26 | 6 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $2,000.00 | $4,000.00 | $237.46 – $2,020.31 | 6 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $366.50 | $733.00 | $104.04 – $132.70 | 5 |
| Lower jaw bone graft CPT 21215 | not published | not published | $5,891.41 – $7,889.00 | 6 |
| Low frequency non-thermal Ultrasound CPT 97610 | $508.50 | $1,017.00 | $199.67 – $205.54 | 4 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $9,860.00 – $10,889.94 | 6 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $7,889.00 – $10,889.94 | 6 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $10,469.00 – $12,325.00 | 6 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $10,469.00 – $12,325.00 | 6 |
| Lso corset front HCPCS L0972 | $94.70 | $189.41 | not published | 0 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $131.44 | $262.89 | not published | 0 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $230.29 | $460.58 | not published | 0 |
| Lso s/c shell/panel custom HCPCS L0640 | $829.04 | $1,658.07 | not published | 0 |
| Lso s/c shell/panel prefab HCPCS L0639 | $850.77 | $1,701.54 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $19.25 – $116.69 | 6 |
| Lumbar diskogram s&i CPT 72295 | $2,089.50 | $4,179.00 | $1,259.78 – $2,000.51 | 5 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $3,988.00 – $17,920.08 | 6 |
| Lumizyme injection HCPCS J0221 | not published | not published | $210.72 – $275.86 | 5 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $58.71 – $60.44 | 4 |
| Lung Function Test (Spirometry) CPT 94010 | $326.00 | $652.00 | $214.89 – $221.21 | 4 |
| Lung perfusion imaging CPT 78580 | $494.00 | $988.00 | $397.85 – $613.73 | 5 |
| Lung transplant double CPT 32853 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Lung transplant single CPT 32851 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Lung transplant with bypass CPT 32852 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Lung transplant with bypass CPT 32854 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $211.27 – $277.36 | 5 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $42.82 – $55.65 | 5 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $238.50 | $477.00 | $323.33 – $332.84 | 4 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $19,657.58 | $39,315.15 | $260.96 – $268.63 | 4 |
| Lvad shower bag heartmate HCPCS Q0501 | $411.42 | $822.83 | not published | 0 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $28.78 – $3,988.00 | 6 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $17.56 – $105.58 | 6 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $778.00 – $8,373.38 | 6 |
| Lymphatics/lymph node imaging CPT 78195 | $1,392.50 | $2,785.00 | $540.36 – $785.26 | 5 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $37.29 – $298.66 | 6 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $42.95 – $259.76 | 6 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $45.80 – $276.44 | 6 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $41.69 – $251.42 | 6 |
| Lymph vessel x-ray arm/leg CPT 75801 | $1,096.00 | $2,192.00 | $624.29 – $911.56 | 5 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,096.00 | $2,192.00 | $967.29 – $1,612.67 | 5 |
| Lymph vessel x-ray trunk CPT 75805 | $1,782.50 | $3,565.00 | $1,008.11 – $3,234.74 | 5 |
| Lymph vessel x-ray trunk CPT 75807 | $1,782.50 | $3,565.00 | $1,065.94 – $3,234.74 | 5 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $484.00 – $3,486.00 | 6 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $2,587.00 – $3,316.33 | 6 |
| Lysis penil circumic lesion CPT 54162 | $3,503.00 | $7,006.00 | $2,080.35 – $3,486.00 | 6 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $21.24 – $21.24 | 1 |
| Macro exam dissect molec study ea CPT 88387 | $65.50 | $131.00 | $3.87 – $36.19 | 2 |
| Macroscopic exam arthropod CPT 87168 | $60.50 | $121.00 | $3.74 – $22.22 | 6 |
| Macroscopic exam parasite CPT 87169 | $14.00 | $28.00 | $3.74 – $22.22 | 6 |
| Magnesium CPT 83735 | $83.50 | $167.00 | $5.87 – $34.71 | 6 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | not published | not published | $0.68 – $0.68 | 1 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $237.46 – $1,897.15 | 6 |
| Malaria antibody CPT 86750 | $148.50 | $297.00 | $11.55 – $69.46 | 6 |
| Male sling procedure CPT 53440 | not published | not published | $3,486.00 – $13,484.11 | 6 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $1,972.00 – $3,988.00 | 2 |
| Manipulate finger w/anesth CPT 26340 | $2,514.00 | $5,028.00 | $484.00 – $2,603.00 | 6 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $1,600.27 – $3,988.00 | 6 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $99.00 | $198.00 | $132.41 – $136.30 | 4 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $149.00 | $298.00 | $132.41 – $136.30 | 4 |
| Manipulation of hip joint CPT 27275 | not published | not published | $1,600.27 – $3,486.00 | 6 |
| Manipulation of spine CPT 22505 | not published | not published | $1,600.27 – $3,486.00 | 6 |
| Manipulat palm cord post inj CPT 26341 | $1,186.00 | $2,372.00 | $245.48 – $2,603.00 | 6 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | not published | not published | $3.96 – $3.96 | 1 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $3.26 – $19.45 | 6 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $671.50 | $1,343.00 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $484.00 – $3,988.00 | 3 |
| Map tachycard site(s) CPT 93609 | $3,695.00 | $7,390.00 | $484.00 – $484.00 | 1 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $53.54 – $65.86 | 5 |
| Marker biop eviva buckle ss HCPCS A4648 | $417.10 | $834.21 | not published | 0 |
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.