Does BON SECOURS DEPAUL MEDICAL CENTER publish its standard charges and chargemaster?

Yes. BON SECOURS DEPAUL MEDICAL CENTER publishes a machine-readable file with 6,643 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does BON SECOURS DEPAUL MEDICAL CENTER charge for procedures?

BON SECOURS DEPAUL MEDICAL CENTER (Norfolk, VA) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · VA · CCN 490011

BON SECOURS DEPAUL MEDICAL CENTER

Norfolk, VA, 23505-

57 beds1

Compliance grade

100/100

Rates published

6,643

last crawl 2026-05-24

Procedures tracked

158

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All VA hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://www.rsfh.com/upload/docs/Patients%20and%20Visitors/571067254_bon-secours-st-francis-xavier-hospital-inc_standardcharges.csv · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	10	—	—	$2,070	$11,404	0.89×	$27,485
Psychotherapy 30 minutes	CPT	90832	0	$1,103	$716.95	—	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$754	$490.1	—	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$862	$560.3	—	—	—	—
emergency
ED visit level 1	CPT	99281	0	$660	$429	—	—	—	—
ED visit level 2	CPT	99282	0	$987	$641.55	—	—	—	—
ED visit level 3	CPT	99283	0	$1,556	$1,011.4	—	—	—	—
ED visit level 4	CPT	99284	0	$2,334	$1,517.1	—	—	—	—
ED visit level 5	CPT	99285	0	$3,911	$2,542.15	—	—	—	—
Critical care, first hour	CPT	99291	0	$4,946	$3,214.9	—	—	—	—
imaging
CT head without contrast	CPT	70450	0	$2,762	$1,795.3	—	—	—	—
CT head with contrast	CPT	70460	0	$2,630	$1,709.5	—	—	—	—
CT head with and without contrast	CPT	70470	0	$1,973	$1,282.45	—	—	—	—
CT neck with contrast	CPT	70491	0	$2,388	$1,552.2	—	—	—	—
MRI brain without contrast	CPT	70551	0	$5,059	$3,288.35	—	—	—	—
MRI brain with contrast	CPT	70552	0	$4,146	$2,694.9	—	—	—	—
MRI brain with and without contrast	CPT	70553	0	$3,486	$2,265.9	—	—	—	—
Chest X-ray single view	CPT	71045	0	$270	$175.5	—	—	—	—
Chest X-ray 2 views	CPT	71046	0	$718	$466.7	—	—	—	—
Chest X-ray 3 views	CPT	71047	0	$827	$537.55	—	—	—	—
CT chest without contrast	CPT	71250	0	$1,973	$1,282.45	—	—	—	—
CT chest with contrast	CPT	71260	0	$1,973	$1,282.45	—	—	—	—
CT chest with and without contrast	CPT	71270	0	$2,630	$1,709.5	—	—	—	—
MRI chest without contrast	CPT	71550	0	$4,190	$2,723.5	—	—	—	—
MRI chest with contrast	CPT	71551	0	$4,190	$2,723.5	—	—	—	—
MRI chest with and without contrast	CPT	71552	0	$4,696	$3,052.4	—	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$471	$306.15	—	—	—	—
CT cervical spine without contrast	CPT	72125	0	$1,973	$1,282.45	—	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$2,630	$1,709.5	—	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$1,973	$1,282.45	—	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$3,143	$2,042.95	—	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$5,225	$3,396.25	—	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$4,976	$3,234.4	—	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$4,146	$2,694.9	—	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$3,486	$2,265.9	—	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$3,486	$2,265.9	—	—	—	—
CT pelvis without contrast	CPT	72192	0	$1,973	$1,282.45	—	—	—	—
CT pelvis with contrast	CPT	72193	0	$2,630	$1,709.5	—	—	—	—
Shoulder X-ray	CPT	73030	0	$425	$276.25	—	—	—	—
Humerus X-ray	CPT	73060	0	$386	$250.9	—	—	—	—
Hand X-ray 3 views	CPT	73130	0	$623	$404.95	—	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$3,764	$2,446.6	—	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$4,220	$2,743	—	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$424	$275.6	—	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$558	$362.7	—	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$3,764	$2,446.6	—	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$4,220	$2,743	—	—	—	—
CT abdomen without contrast	CPT	74150	0	$1,973	$1,282.45	—	—	—	—
CT abdomen with contrast	CPT	74160	0	$1,973	$1,282.45	—	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$1,973	$1,282.45	—	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$4,901	$3,185.65	—	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$4,901	$3,185.65	—	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$3,757	$2,442.05	—	—	—	—
MRI abdomen without contrast	CPT	74181	0	$3,764	$2,446.6	—	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$4,220	$2,743	—	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$1,432	$930.8	—	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$1,336	$868.4	—	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$1,764	$1,146.6	—	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$1,288	$837.2	—	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$1,288	$837.2	—	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$1,366	$887.9	—	—	—	—
Transvaginal ultrasound	CPT	76830	0	$1,439	$935.35	—	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$1,227	$797.55	—	—	—	—
Scrotal ultrasound	CPT	76870	0	$1,745	$1,134.25	—	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$629	$408.85	—	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$710	$461.5	—	—	—	—
Screening mammography bilateral	CPT	77067	0	$480	$312	—	—	—	—
EKG tracing only	CPT	93005	3	$29,925	$17,955	$55.22	$124.62	1.1×	$3,611.96
Transthoracic echocardiogram complete	CPT	93306	0	$3,365	$2,187.25	—	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$1,896	$1,232.4	—	—	—	—
Stress echocardiogram	CPT	93350	0	$1,944	$1,263.6	—	—	—	—
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	11	—	—	$15,564	$37,793	1.9×	$41,838
Intracranial hemorrhage/CVA w CC	MS-DRG	065	11	—	—	$8,786.76	$18,987	1.8×	$25,682
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	11	—	—	$6,579.76	$10,904	1.4×	$20,084
Respiratory infections & inflammations w MCC	MS-DRG	177	11	—	—	$12,528	$29,368	1.9×	$29,918
COPD w MCC	MS-DRG	190	11	—	—	$9,446.38	$19,604	1.7×	$21,796
COPD w CC	MS-DRG	191	11	—	—	$6,965	$9,019.77	1.0×	$16,613
COPD w/o CC/MCC	MS-DRG	192	7	—	—	$6,292.63	$11,012	1.6×	$12,754
Simple pneumonia & pleurisy w CC	MS-DRG	194	13	—	—	$7,402.56	$15,145	1.8×	$23,380
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	11	—	—	$5,937.41	$11,168	1.7×	$12,367
AMI discharged alive w MCC	MS-DRG	280	13	—	—	$1,969.25	$18,510	1.2×	$33,398
AMI discharged alive w CC	MS-DRG	281	10	—	—	$8,169.15	$17,273	1.8×	$23,859
AMI discharged alive w/o CC/MCC	MS-DRG	282	11	—	—	$1,920.06	$7,994	1.0×	$21,167
Heart failure & shock w MCC	MS-DRG	291	11	—	—	$10,639	$21,855	1.7×	$25,261
Heart failure & shock w CC	MS-DRG	292	9	—	—	$5,502	$15,550	1.7×	$16,706
Heart failure & shock w/o CC/MCC	MS-DRG	293	11	—	—	$5,065	$6,818.58	1.1×	$12,559
Cardiac arrhythmia w MCC	MS-DRG	308	11	—	—	$10,099	$22,627	1.9×	$24,259
Cardiac arrhythmia w CC	MS-DRG	309	7	—	—	$5,055.77	$6,965	0.90×	$14,547
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	11	—	—	$5,778.62	$6,965	1.1×	$11,681
GI hemorrhage w CC	MS-DRG	378	8	—	—	$8,586.33	$18,430	1.8×	$20,845
GI hemorrhage w/o CC/MCC	MS-DRG	379	10	—	—	$6,214.05	$11,847	1.7×	$15,319
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	11	—	—	$6,965	$8,312.1	1.0×	$15,340
Fractures of femur w/o MCC	MS-DRG	533	11	—	—	$6,852	$24,147	1.6×	$49,490
Kidney/UTI w MCC	MS-DRG	689	10	—	—	$9,802.58	$22,418	1.9×	$22,831
Kidney/UTI w/o MCC	MS-DRG	690	11	—	—	$7,426.94	$14,626	1.8×	$15,929
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	11	—	—	$7,605	$21,258	1.1×	$39,154
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	11	—	—	$8,874.81	$19,231	1.9×	$20,553
lab
Basic metabolic panel (BMP)	CPT	80048	0	$330	$214.5	—	—	—	—
General health panel	CPT	80050	0	$137	$89.05	—	—	—	—
Electrolyte panel	CPT	80051	0	$317	$206.05	—	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$477	$310.05	—	—	—	—
Lipid panel	CPT	80061	0	$191	$124.15	—	—	—	—
Renal function panel	CPT	80069	0	$109	$70.85	—	—	—	—
Hepatic function panel	CPT	80076	0	$317	$206.05	—	—	—	—
Urinalysis non-automated	CPT	81002	0	$14	$9.1	—	—	—	—
Urinalysis automated	CPT	81003	0	$96	$62.4	—	—	—	—
Glucose quantitative	CPT	82947	0	$125	$81.25	—	—	—	—
Hemoglobin A1c	CPT	83036	0	$141	$91.65	—	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$293	$190.45	—	—	—	—
Complete blood count with automated differential	CPT	85025	0	$180	$117	—	—	—	—
Complete blood count without differential	CPT	85027	0	$116	$75.4	—	—	—	—
Urine culture bacterial	CPT	87086	0	$150	$97.5	—	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$968	$629.2	—	—	—	—
maternity
Fetal non-stress test	CPT	59025	3	$3,921.67	$2,353	$189.24	$195.86	1.0×	$198.7
Vaginal delivery only	CPT	59409	0	$3,074	$1,998.1	—	—	—	—
Vaginal delivery w complicating dx	MS-DRG	774	3	—	—	$7,555.2	$13,532	147.1×	$20,089
Vaginal delivery w/o complicating dx	MS-DRG	775	3	—	—	$24,471	$25,083	26.8×	$25,695
office
Office visit, new patient, 15-29 min	CPT	99202	0	$365	$237.25	—	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$498	$323.7	—	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$654	$425.1	—	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$802	$521.3	—	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$180	$117	—	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$302	$196.3	—	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$393	$255.45	—	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$522	$339.3	—	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$672	$436.8	—	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	3	$9,545.25	$5,727.15	$848.96	$878.67	0.96×	$891.41
Upper GI endoscopy with biopsy	CPT	43239	3	$15,296	$9,177.86	$848.96	$1,796.14	1.9×	$1,885.95
Sigmoidoscopy diagnostic	CPT	45330	3	$7,047.73	$4,228.64	$870.46	$900.93	1.1×	$913.99
Sigmoidoscopy with biopsy	CPT	45331	3	$10,021	$6,012.69	$870.46	$900.93	1.0×	$913.99
Colonoscopy diagnostic	CPT	45378	3	$11,067	$6,640.01	$870.46	$900.93	1.0×	$913.99
Colonoscopy with biopsy	CPT	45380	3	$16,072	$9,643.34	$1,120.09	$1,159.29	0.96×	$1,176.09
Colonoscopy with polyp removal	CPT	45385	3	$19,830	$11,898	$1,120.09	$1,159.29	0.96×	$1,176.09
surgery
Shoulder arthroscopy with decompression	CPT	29826	3	$52,629	$31,577	$6,791.99	$7,029.71	21.5×	$7,131.59
Shoulder arthroscopy with rotator cuff repair	CPT	29827	2	$56,340	$33,804	$6,791.99	$6,961.79	2.1×	$7,131.59
Knee arthroscopy with meniscectomy	CPT	29881	3	$49,061	$29,437	$3,062.67	$5,003.9	2.4×	$7,131.59
ACL reconstruction	CPT	29888	3	$78,681	$47,209	$6,791.99	$9,574.45	2.9×	$12,618
Major small/large bowel procedures w MCC	MS-DRG	329	10	—	—	$33,073	$86,382	2.0×	$90,445
Major small/large bowel procedures w CC	MS-DRG	330	11	—	—	$18,179	$45,051	1.9×	$54,764
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	11	—	—	$13,342	$31,627	1.9×	$42,586
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	9	—	—	$13,401	$31,790	1.9×	$39,885
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	11	—	—	$11,194	$25,667	1.9×	$36,094
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	3	—	—	$2,103.71	$5,275.1	0.16×	$10,364
Laparoscopic appendectomy	CPT	44970	3	$79,982	$47,989	$5,658.76	$5,757.79	3.7×	$5,941.7
Laparoscopic cholecystectomy	CPT	47562	3	$31,749	$19,050	$5,658.76	$5,856.81	3.3×	$5,941.7
Lap cholecystectomy with cholangiography	CPT	47563	3	$55,308	$33,185	$5,658.76	$5,856.81	3.1×	$5,941.7
Hip & femur procedures except major joint w MCC	MS-DRG	480	11	—	—	$8,972	$40,630	1.5×	$81,524
Hip & femur procedures except major joint w CC	MS-DRG	481	11	—	—	$16,129	$39,362	1.9×	$59,610
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	11	—	—	$9,888	$22,903	1.4×	$43,399
Lap inguinal hernia repair	CPT	49650	3	$57,191	$34,315	$5,658.76	$5,856.81	5.2×	$5,941.7
Vaginal hysterectomy	CPT	58260	3	$41,231	$24,739	$4,682.41	$4,846.3	2.7×	$4,916.53
Lap-assisted vaginal hysterectomy	CPT	58550	3	$42,675	$25,605	$5,658.76	$5,899.26	4.0×	$5,941.7
Lap-assisted vaginal hysterectomy >250g	CPT	58552	2	$47,558	$28,535	$9,949.78	$9,949.78	4.5×	$10,298
Lap salpingo-oophorectomy	CPT	58661	3	$72,044	$43,226	$5,658.76	$5,856.81	2.9×	$5,941.7
OR procedure for obesity w CC	MS-DRG	620	11	—	—	$12,782	$30,074	1.9×	$43,754
OR procedure for obesity w/o CC/MCC	MS-DRG	621	11	—	—	$12,160	$28,347	1.9×	$36,670
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	11	—	—	$10,347	$23,316	1.9×	$28,821
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	11	—	—	$15,822	$36,856	1.9×	$40,320

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 13)

Payer	Codes covered	Median rate
Humana	62	$7,513.61
UnitedHealthcare	60	$10,347
Aetna	57	$7,477.31
Cigna	39	$16,465
Blue Cross Blue Shield	39	$22,418
pai [3082]	37	$24,259
Medicare	37	$10,852
select health of sc [4877]	37	$17,672
devoted health plan [4501]	35	$10,347
first choice vip care plus [4833]	34	$11,018
umr [3113]	34	$19,109
select health of sc [4890]	6	$9,167.63
Medicaid	6	$8,731.07

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