Supplies, drugs & other prices at UVA Health Prince William Medical Center

Manassas, VA · every code in this section with a posted price and a Medicare benchmark.

169 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
2019-ncov diagnostic p (U0001) $32.50 $65 0.9×
2d tee w or w/o fol w/con,in (C8925) $1,627 $3,254 2.0×
2d tte w or w/o fol w/con,fu (C8924) $1,016 $2,032 2.8×
3D cntr simula trgt lvr les (0944T) $317 $634 1.3×
Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound… (0950T) $12,089.50 $24,179 1.2×
Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each… (0970T) $5,000.50 $10,001 1.2×
Ablation, benign thyroid nodule(s), percutaneous, laser, including imaging guidance (0673T) $6,510 $13,020 3.8×
Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral (0581T) $1,447 $2,894 0.4×
Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral (0971T) $5,000.50 $10,001 1.2×
Abltj perc cryoabltj img gdn nrv plex/trncl nrv (0442T)
unusually low: confirm this is the full procedure
$3,941.50 $7,883 0.4×
Admin hepatitis b vaccine (G0010) $10.50 $21 0.2×
Admin influenza virus vac (G0008) $23,508.35 $47,016.71 485.2×
Admin pneumococcal vaccine (G0009) $10.50 $21 0.2×
Adrnl Cortcl Tum Bchm Asy 25 (0015M) $791.50 $1,583 0.6×
Bdy surf activation mapg pm/cvdfb leads tm f/up (0696T) $50 $100 1.3×
Bia whole body composition assessment w/i&r (0358T) $31.50 $63 1.1×
Bone strength & fracture rsk cncrnt vrt fx assmt (0743T) $262.50 $525 1.1×
Ca screen;flexi sigmoidscope (G0104) $1,239.15 $2,478.30 1.3×
Chemo extend iv infus w/pump (G0498) $781 $1,562 2.3×
Collagen crosslinking cornea (0402T) $1,286.50 $2,573 0.5×
Colon ca scrn not hi rsk ind (G0121) $2,666.89 $5,333.78 2.8×
Colorectal scrn; hi risk ind (G0105) $2,280.72 $4,561.44 2.4×
Colsc flx trnsorl 1st tndsc dilat rx balo cath (0885T) $7,813 $15,626 1.2×
Covid-19 lab test non-cdc (U0002) $42.50 $85 0.8×
Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation… (0446T) $2,401 $4,802 0.6×
CYP1A2 (cytochrome P450 family 1, subfamily A, member 2) (eg, drug metabolism) gene analysis, common variants (ie, *1F,… (0031U) $301 $602 1.7×
Cyp2d6 gen com&slct rar vrnt (0070U) $443.50 $887 0.7×
Cysto impl 4 or more (C9740) $13,715.68 $27,431.36 1.4×
Cysto, litho, vacuum kidney (C9761) $20,009.36 $40,018.72 2.0×
Cystoscopy prostatic imp 1-3 (C9739) $4,725 $9,450 0.9×
Diab manage trn per indiv (G0108) $161.50 $323 2.9×
Diab manage trn ind/group (G0109) $45.50 $91 2.8×
Direct refer hospital observ (G0379) $747.50 $1,495 1.2×
Drug test def 1-7 classes (G0480) $831 $1,662 7.3×
Drug test def 22+ classes (G0483) $1,372.50 $2,745 5.6×
Egd flexible transnasal w/biopsy single/multiple (0653T) $1,083.50 $2,167 0.5×
Egd flexible transnasal w/insj intral tube/cath (0654T) $2,276 $4,552 0.6×
Elec Alys Cplx Prgrmg Iins Sp/Sac Nrv 4+Param (0789T) $121.50 $243 1.2×
Elec Alys Smpl Prgrmg Iins Sp/Sac Nrv 1-3 Param (0788T) $121.50 $243 1.2×
Electrophysiological eval icds w/ss electrode (0577T) $1,593.50 $3,187 1.3×
Endo outlet restrict w/tube (C9785) $12,886 $25,772 1.2×
Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or… (0524T) $7,293.50 $14,587 2.2×
Ephys eval ccm-d ld 1st impl (0930T) $1,593.50 $3,187 1.3×
Ephys eval ccm-d ld separate (0931T) $1,593.50 $3,187 1.3×
Esd endoscopy or colonoscopy (C9779) $6,398.50 $12,797 1.6×
Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon)… (0884T) $7,813 $15,626 1.2×
Fecal microbiota prep instil (G0455) $191.50 $383 0.2×
Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater or equal to… (0072T) $9,746.50 $19,493 2.9×
Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume less than 200 cc of… (0071T) $7,163.50 $14,327 2.1×
Glyca nuc mr spectroscopy quantitative (0024U) $30.50 $61 0.9×
Hbot, full body chamber, 30m (G0277) $259 $518 1.8×
Hdr electronic brachytherapy ntrstl/intrcav (0395T) $976.50 $1,953 1.4×
Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging… (0888T) $22,969.50 $45,939 1.3×
Histotripsy mal hepatocellular tiss w/img gdn (0686T) $22,969 $45,938 1.3×
Home sleep test/type 2 porta (G0398) $130 $260 0.6×
Ig paraprotein qual bld/ur (0077U) $98.50 $197 2.3×
Iliac Atherectomy (0238T) $9,526.50 $19,053 0.5×
Inj for sacroiliac jt anesth (G0260) $1,017.25 $2,034.50 1.4×
Insertion and scleral fixation of a capsular bag prosthesis containing an intraocular lens prosthesis, with vitrectomy,… (0996T) $2,947.50 $5,895 1.2×
Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space;… (0449T) $3,913 $7,826 0.7×
Insertion of sinus tarsi implant (0335T) $6,339.50 $12,679 0.8×
Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming,… (0517T) $10,699.50 $21,399 1.0×
Insertion perm ccm-d system pulse generator only (0916T) $29,460.50 $58,921 1.3×
Insj Perm Ccm-D Sys 1 Transvns Lead Only (0917T) $10,862.50 $21,725 1.3×
Insj Perm Ccm-D Sys Dual Transvns Leads Only (0918T) $10,862.50 $21,725 1.3×
Insj perm ccm-d sys pg&eltrd (0915T) $42,081 $84,162 1.3×
Insj Wcs Lv Eltrd Only (0516T)
unusually low: confirm this is the full procedure
$5,350 $10,700 0.5×
Insj/Rplcmt Icds W/Substernal Electrode (0571T) $40,623 $81,246 1.3×
Instlj fecal microbiota ssp (0780T) $159.50 $319 1.2×
Interrog dev eval impl ccm-d system in person (0927T) $65.50 $131 1.7×
Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode,… (0576T) $72.50 $145 1.9×
Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator… (0579T) $72.50 $145 1.9×
Ire Ablation 1+Tumors per Organ W/Img Gdn Perq (0600T) $9,647 $19,294 0.9×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $434 $868 3.6×
Liver Dis 10 Assays W/Nash (0003M) $422 $844 0.8×
Low-intensity extracorporeal shock wave therapy involving corpus cavernosum, low energy (0864T) $314.50 $629 1.2×
Mnt subs tx for change dx (G0270) $43.50 $87 1.4×
Mri hyperpolarized xenon129 (C9791) $16,411.50 $32,823 13.0×
N-Invas Augmnt Arrhyt Alys (0897T) $1,335 $2,670 1.5×
N-invs det hrt fail aug echo (0932T) $394 $788 1.2×
Neuro csf prion prtn qual (0035U) $282 $564 0.5×
Njx pltlt plasma w/img harvest/preparation (0232T) $194 $388 0.4×
Noninvasive arterial plaque analysis using software processing of data from non-coronary computerized tomography… (0712T) $109 $218 0.5×
Onc merkel cell carc detcj antb serum reprtd +/- (0059U) $250 $500 0.8×
Onc Merkel Cll Carc Srm Quan (0058U) $250 $500 0.8×
Onc Thyr Dna&Mrna 112 Genes Fna Ndul Alg Alys (0026U) $895.50 $1,791 0.2×
Ortho impl mvmt alys pair CT (0946T) $139.50 $279 1.3×
Oth resp proc, group (G0239) $97 $194 2.5×
Oth resp proc, indiv (G0238) $76 $152 2.5×
Pathogen test for platelets (P9100) $31 $62 0.5×
Pemivibart infusion (M0224) $13,265.36 $26,530.73 29.1×
Perc d-e cor revasc chro sin (C9607) $34,607 $69,214 1.8×
Perc d-e cor revasc t cabg s (C9604) $27,112.73 $54,225.46 2.3×
Perc d-e cor stent ather s (C9602) $33,038.83 $66,077.67 1.7×
Perc drug-el cor stent sing (C9600) $22,078.32 $44,156.65 1.8×
Percutaneous transcatheter thermal ablation of nerves innervating the pulmonary arteries, including right heart… (0793T) $22,545.50 $45,091 1.2×
Perq Sacral Augmt Bilat Inj (0201T) $14,531.12 $29,062.24 1.9×
Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) $27,800.11 $55,600.23 2.3×
Place device/marker, non pro (C9728) $3,566.61 $7,133.22 2.5×
Prgrmg dev eval ldls pm single car chamber ip (0826T) $47.50 $95 1.2×
Prgrmg dev eval ldls pm sys 2chmbr in person (0804T) $46 $92 1.2×
Prgrmg Dev Eval Scrms Phys/Qhp Remote (0650T) $50 $100 1.3×
Programming device eval impl ccm-d sys in person (0926T) $65.50 $131 1.7×
Prolonged iv inf, req pump (C8957) $414.50 $829 1.9×
Psa screening (G0103) $80.50 $161 4.2×
Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph… (0808T) $367.50 $735 1.6×
Pulmonary tissue ventilation analysis using software-based processing of data from separately captured cinefluorograph… (0807T) $191 $382 0.9×
Qmrcp W/Diagnostic MRI Same Anatomy (0724T) $787.50 $1,575 0.8×
Qmrcp W/O Diagnostic MRI Sm Anatomy Drg Sm Sess (0723T) $945 $1,890 1.0×
Quan mr alys tis compj wo MRI same sess mlt orgn (0697T) $787.50 $1,575 0.8×
Quan mr alys tiss compj w/o MRI same sess 1orgn (0648T) $1,228.50 $2,457 1.3×
Quan mr alys tiss composition w/MRI 1orgn (0649T) $551.50 $1,103 0.6×
Quan mr alys tiss composition w/MRI mlt organs (0698T) $787.50 $1,575 0.8×
Quan us tiss charac i&r w/o dx us same anat (0689T) $113 $226 1.3×
Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device… (0863T) $2,282.50 $4,565 1.1×
Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device… (0862T) $2,282.50 $4,565 1.1×
Relocation skin pocket implanted ccm-d pg (0925T) $2,401 $4,802 1.1×
Rem mntr s-sclp impl cont bi EEG sys fitg set-up (1008T) $170 $340 1.2×
Remote interrog dev eval ccm-d sys <90d tech (0929T) $65.50 $131 1.7×
Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of… (0983T) $47.50 $95 1.2×
Remote monitoring of implantable inferior vena cava sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse… (0982T) $170 $340 1.2×
Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s)… (0519T) $8,039 $16,078 0.7×
Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision (0447T) $261 $522 1.3×
Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and… (0448T) $2,401 $4,802 0.6×
Removal of substernal implantable defibrillator electrode (0573T) $4,772.50 $9,545 1.2×
Removal perm ccm-d system pulse generator only (0919T) $4,776.50 $9,553 1.2×
Removal Pg Wcs Lv Pacing Both Components (0861T) $4,916 $9,832 1.3×
Repositioning prev impl ccm-d transvns eltrd/ld (0924T) $811.50 $1,623 1.3×
Revasc intra lithotrip-stent (C9765) $28,947.58 $57,895.18 1.5×
Revasc intravasc lithotripsy (C9764) $22,046.15 $44,092.31 1.8×
Revasc lithotrip tibi/perone (C9772) $16,908.16 $33,816.32 1.4×
Revasc lithotrip-stent-ather (C9767) $24,294.45 $48,588.90 1.3×
Revision or removal of integrated neurostimulation system for bladder dysfunction, including analysis, programming, and… (0989T) $4,465 $8,930 1.2×
Revision or removal of neurostimulator electrode array, sacral, with integrated neurostimulator (0787T) $2,491 $4,982 0.7×
Rmvl Perm Ccm-D Sys 1 Transvns Dfb Lead Only (0921T) $4,776.50 $9,553 1.2×
Rmvl perm ccm-d sys 1 transvns pacing lead only (0920T) $4,776.50 $9,553 1.2×
Rmvl Perm Ccm-D Sys Dual Transvns Leads Only (0922T) $4,776.50 $9,553 1.2×
Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) $4,772.50 $9,545 1.2×
Rmvl&rplcmt permanent ccm-d pulse generator only (0923T) $29,460.50 $58,921 1.3×
Rx Metab Advrs Trgt Seq Alys (0029U) $261 $522 0.4×
Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by… (0886T) $7,813 $15,626 1.2×
Syphilis tst non-treponemal antibody ia qual rpr (0065U) $34.50 $69 1.9×
Tactile breast img uni/bi (0422T) $162 $324 1.8×
Tcat Impl Wrls Ivc Snr L-T Hemodyn Mntr (0981T) $23,411 $46,822 1.2×
Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) $43,833.36 $87,666.72 2.2×
Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) $24,393 $48,786 1.2×
Tcat insj perm 2chmbr ldls pm r ventr pm compnt (0797T) $22,545.50 $45,091 1.1×
Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) $57,654.05 $115,308.10 2.9×
Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) $3,990 $7,980 1.2×
Tcat rmvl perm 2chmbr ldls pm r atr pm compnt (0799T) $3,990 $7,980 1.2×
Tcat rmvl perm 2chmbr ldls pm r ventr pm compnt (0800T) $3,909.50 $7,819 1.2×
Tcat rmvl perm dual chamber ldls pm compl sys (0798T) $3,990 $7,980 1.2×
Tcat rmvl&rplcmt perm 1chmbr ldls pm r atrial (0825T) $24,393 $48,786 1.2×
Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) $24,393 $48,786 1.2×
Tcat rmvl&rplcmt perm 2chmbr ldls pm r atr cmpnt (0802T) $24,393 $48,786 1.2×
Tcat rmvl&rplcmt prm 2chmbr ldls pm r vntr cmpnt (0803T) $22,545.50 $45,091 1.1×
Tcat Rmvl/Debulk Icar Mass Suction Device Perq (0644T)
unusually low: confirm this is the full procedure
$2,790.50 $5,581 0.5×
Tee w or w/o fol w/cont, mon (C8927) $1,673.50 $3,347 2.1×
Tee w or w/o fol w/cont,cong (C8926) $1,673.50 $3,347 2.1×
Therapeutic procd strg endur (G0237) $69 $138 2.3×
Therapeutic ultrafiltration (0692T) $535.50 $1,071 0.3×
Tpmt nudt15 gene analysis common variants (0034U) $421 $842 0.9×
Transcatheter Renal Sympath Denervation Bilat (0339T) $7,023 $14,046 1.2×
Trluml periph athrc w/rs&i brchiocphl ea vsl (0237T) $13,609.50 $27,219 1.1×
Trluml Peripheral Atherectomy Renal Artery Ea (0234T) $12,961.50 $25,923 1.1×
Tte w or w/o contr, cont ecg (C8930) $1,977 $3,954 2.4×
Tte w or w/o fol w/con,stres (C8928) $4,516 $9,032 5.6×
Tte w or wo fol wcon,doppler (C8929) $2,169.50 $4,339 2.7×
Unsched dialysis esrd pt hos (G0257) $888 $1,776 1.3×