Bon Secours St Francis Medical Center LLC
Bon Secours St Francis Medical Center LLC in Midlothian, VA publishes cash prices for 48 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
13710 St. Francis Boulevard,Midlothian,VA 23114 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 HC CT Abd/Pel W Cont | $4,449.60 | $7,416.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 HC CT Abd/Pel W Cont | $2,972.40 | $4,954.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 HC CT Brain W/O Contrast | $1,683.00 | $2,805.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 HC CT Brain W/O Contrast | $976.80 | $1,628.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 HC CT Pelvis W/ Contrast | $2,887.80 | $4,813.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 HC CT Pelvis W/ Contrast | $1,646.40 | $2,744.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 HC Mammo Dgx Bilateral Incl Cad if Perf | $433.80 | $723.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 HC Mammo Dgx Bilateral Incl Cad if Perf | $433.80 | $723.00 | 40% |
| Diagnostic mammogram, one breast one side CPT 77065 HC Mammo Dgx Unilateral Incl Cad if Perf | $340.80 | $568.00 | 40% |
| Diagnostic mammogram, one breast inpatient one side CPT 77065 HC Mammo Dgx Unilateral Incl Cad if Perf | $340.80 | $568.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 HC MRI Lower Ext Jnt W/O Cont | $2,225.40 | $3,709.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 HC MRI Lower Ext Jnt W/O Cont | $1,884.00 | $3,140.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 HC MRI Lower Ext Jnt W&W/O Cont | $4,688.40 | $7,814.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 HC MRI Lower Ext Jnt W&W/O Cont | $2,434.20 | $4,057.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 HC MRI Brain WO Ctrst | $2,070.00 | $3,450.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 HC MRI Brain WO Ctrst | $1,244.40 | $2,074.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 HC MRI-Brain WO & W Contrast | $3,297.60 | $5,496.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 HC MRI-Brain WO & W Contrast | $1,440.00 | $2,400.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 HC MRI-Spine Lumbar WO Contrast | $1,954.80 | $3,258.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 HC MRI-Spine Lumbar WO Contrast | $1,483.80 | $2,473.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 HC Fetal Eval 2-3 Trim Sgl Gest | $1,944.60 | $3,241.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 HC Fetal Eval 2-3 Trim Sgl Gest | $1,105.80 | $1,843.00 | 40% |
| Screening mammogram, both breasts CPT 77067 HC Mammo Screening Incl Cad if Perf | $471.00 | $785.00 | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 HC Mammo Screening Incl Cad if Perf | $201.60 | $336.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 HC US Transvaginal, Non OB | $1,605.00 | $2,675.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 HC US Transvaginal, Non OB | $1,364.40 | $2,274.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 HC US Abdomen Complete | $1,733.40 | $2,889.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 HC US Abdomen Complete | $2,041.20 | $3,402.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 HC L-Spine Min 4 Views | $1,033.80 | $1,723.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 HC L-Spine Min 4 Views | $844.20 | $1,407.00 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 HC Basic Metabolic Panel Calcium Total | $58.20 | $97.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 HC Basic Metabolic Panel Calcium Total | $171.00 | $285.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 HC Lipid Panel | $73.80 | $123.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 HC Lipid Panel | $168.60 | $281.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 HC So Cbc | $28.80 | $48.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 HC POC Cbc | $54.00 | $90.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 HC Cbc | $63.60 | $106.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC So Cbc | $28.80 | $48.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC POC Cbc | $54.00 | $90.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 HC Cbc | $108.60 | $181.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 HC Cbc (Hemogram) | $108.60 | $181.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 HC Cbc (Hemogram) | $93.60 | $156.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC Comprehensive Metabolic Panel | $70.80 | $118.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 HC So Comp Metabolic Panel | $97.80 | $163.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC So Comp Metabolic Panel | $97.80 | $163.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 HC Comprehensive Metabolic Panel | $397.80 | $663.00 | 40% |
| Kidney function blood test panel CPT 80069 HC Renal Function Panel | $50.40 | $84.00 | 40% |
| Kidney function blood test panel inpatient CPT 80069 HC Renal Function Panel | $233.40 | $389.00 | 40% |
| Liver function blood test panel CPT 80076 HC So Hepatic Function Panel | $28.80 | $48.00 | 40% |
| Liver function blood test panel CPT 80076 HC Hepatic Function Panel | $79.20 | $132.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 HC So Hepatic Function Panel | $28.80 | $48.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 HC Hepatic Function Panel | $208.20 | $347.00 | 40% |
| Obstetric blood test panel CPT 80055 HC Obstetric Panel | $180.60 | $301.00 | 40% |
| Obstetric blood test panel inpatient CPT 80055 HC Obstetric Panel | $180.60 | $301.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 HC So Prostate Specific Antigen/Free | $108.00 | $180.00 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 HC So Prostate Specific Antigen/Free | $108.00 | $180.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC Assay of Prostate Specific Antigen Total | $102.00 | $170.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 HC So Assay of Psa Total | $121.20 | $202.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC So Assay of Psa Total | $124.80 | $208.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 HC Assay of Prostate Specific Antigen Total | $166.80 | $278.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC Ptt | $43.20 | $72.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 HC So Ptt | $49.20 | $82.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC So Ptt | $52.80 | $88.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 HC Ptt | $213.00 | $355.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC So Prothrombin Time | $25.20 | $42.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 HC Prothrombin Time | $30.00 | $50.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC So Prothrombin Time | $25.20 | $42.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 HC Prothrombin Time | $58.20 | $97.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC Thyroid Stimulating Hormone | $93.60 | $156.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 HC So Tsh 3rd Generation | $101.40 | $169.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC So Tsh 3rd Generation | $102.00 | $170.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 HC Thyroid Stimulating Hormone | $250.20 | $417.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 HC Urinalysis W/ Microscopy | $78.60 | $131.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 HC Urinalysis W/ Microscopy | $163.20 | $272.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 HC So Urinalysis Routine | $13.20 | $22.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 HC Urinalysis, Auto, W/O Scope | $34.20 | $57.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC So Urinalysis Routine | $13.20 | $22.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 HC Urinalysis, Auto, W/O Scope | $34.20 | $57.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 HC Non-Auto,Urine W/O Microscopy | $51.00 | $85.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 HC Non-Auto,Urine W/O Microscopy | $37.20 | $62.00 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Colonoscopy with polyp removal CPT 45385 Colsc Flx W/Rmvl of Tumor Polyp Lesion Snare Tq | $5,110.30 | $8,517.17 | 40% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy W/Biopsy Single/Multiple | $4,652.33 | $7,753.88 | 40% |
| Colonoscopy, diagnostic CPT 45378 Colonoscopy Flx Dx W/Collj Spec When Pfrmd | $3,969.41 | $6,615.68 | 40% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopy Surg Cholecystectomy | $12,679.67 | $21,132.78 | 40% |
| Left heart catheterization, diagnostic CPT 93452 HC L Heart W Lvgram | $14,047.20 | $23,412.00 | 40% |
| Left heart catheterization, diagnostic inpatient CPT 93452 HC L Heart W Lvgram | $7,031.40 | $11,719.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $2,089.20 | $3,482.00 | 40% |
| Lower-back epidural injection, with imaging guidance CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $3,530.40 | $5,884.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $2,089.20 | $3,482.00 | 40% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 HC Njx Dx/Ther Sbst Intrlmnr Lmbr/Sac W/Img Gdn | $2,448.60 | $4,081.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 HC Inj a/S Transforam Lumbar | $2,544.60 | $4,241.00 | 40% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 HC Inj a/S Transforam Lumbar | $1,837.20 | $3,062.00 | 40% |
| Prostate biopsy CPT 55700 HC Biopsy Prostate Needle or Punc | $7,283.65 | $12,139.42 | 40% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 Laps Surg Prst8ect Rpbic Rad W/Nrv Sparing Robot | $34,029.50 | $56,715.83 | 40% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Tonsillectomy & Adenoidectomy <Age 12 | $13,341.61 | $22,236.02 | 40% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd Transoral Biopsy Single/Multiple | $4,418.10 | $7,363.50 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diagnostic Brush Wash | $1,720.80 | $2,868.00 | 40% |
| Upper endoscopy (EGD), diagnostic CPT 43235 HC Egd Diagnostic Brush Wash | $3,662.18 | $6,103.63 | 40% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 HC Egd Diagnostic Brush Wash | $1,720.80 | $2,868.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 HC New Pt, Outpt Visit Level 3 | $122.40 | $204.00 | 40% |
| New patient office visit, about 30 minutes CPT 99203 HC New Pt, E/M Level 3 | $122.40 | $204.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC New Pt, E/M Level 3 | $267.00 | $445.00 | 40% |
| New patient office visit, about 30 minutes inpatient CPT 99203 HC New Pt, Outpt Visit Level 3 | $280.20 | $467.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 HC New Pt, E/M Level 4 | $145.80 | $243.00 | 40% |
| New patient office visit, about 45 minutes CPT 99204 HC New Pt, Outpt Visit Level 4 | $145.80 | $243.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC New Pt, E/M Level 4 | $294.00 | $490.00 | 40% |
| New patient office visit, about 45 minutes inpatient CPT 99204 HC New Pt, Outpt Visit Level 4 | $309.00 | $515.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 HC New Pt, Outpt Visit Level 5 | $165.60 | $276.00 | 40% |
| New patient office visit, about 60 minutes CPT 99205 HC New Pt, E/M Level 5 | $165.60 | $276.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC New Pt, Outpt Visit Level 5 | $165.60 | $276.00 | 40% |
| New patient office visit, about 60 minutes inpatient CPT 99205 HC New Pt, E/M Level 5 | $165.60 | $276.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Ot Ther Ex per 15 Min | $148.80 | $248.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 HC Pt Therapeutic Exercise,Ea 15 Min | $210.00 | $350.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Ot Ther Ex per 15 Min | $107.40 | $179.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 HC Pt Therapeutic Exercise,Ea 15 Min | $114.60 | $191.00 | 40% |
| Preventive checkup, new patient aged 18–39 CPT 99385 HC Prev Visit New Age18-39 | $213.60 | $356.00 | 40% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 HC Prev Visit New Age18-39 | $213.60 | $356.00 | 40% |