Bon Secours-St Francis Xavier Hospital

2095 Henry Tecklenburg Drive, Charleston, SC 29414 · (843) 402-1006

Acute Care HospitalsVoluntary non-profit - PrivateCMS rating 3/5Charleston, SC metro Part of Roper ST. Francis Healthcare · 3 hospitals Website ↗

Price file

Prices published

File dated 2026-04-01

461 price rows for 50 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · metro median $215

$215

cash

—

$330

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · metro median $3,186

$3,186

cash

—

$4,901

list

CT scan of the head, no contrast

CPT 70450 · metro median $1,795

$1,795

cash

—

$2,762

list

CT scan of the pelvis, with contrast

CPT 72193 · metro median $1,710

$1,710

cash

—

$2,630

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$8,438 to $20,142

39 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 3 lines · metro median $29

$29

cash

—

$44

list

Colonoscopy (diagnostic)

CPT 45378 · metro median $5,920

$6,372

cash

$870 to $914

5 negotiated rates

$10,619

list

Colonoscopy with biopsy

CPT 45380 · metro median $6,792

$6,426

cash

$1,120 to $1,176

6 negotiated rates

$10,710

list

Colonoscopy with polyp removal

CPT 45385 · metro median $7,927

$8,399

cash

$1,120 to $1,176

6 negotiated rates

$13,998

list

Complete blood count (CBC) with differential

CPT 85025 · metro median $117

$117

cash

—

$180

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 3 lines · metro median $247

$247

cash

—

$380

list

Diagnostic mammogram (both breasts)

CPT 77066 · metro median $462

$462

cash

—

$710

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 4 lines · metro median $240

$240

cash

—

$369

list

Family psychotherapy without the patient

CPT 90846 · metro median $164

$595

cash

—

$916

list

Gallbladder removal (laparoscopic)

CPT 47562 · metro median $18,157

$19,050

cash

$5,659 to $5,942

6 negotiated rates

$31,749

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 3 lines · metro median $29

$29

cash

—

$44

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$6,965 to $15,340

48 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$10,347 to $28,821

48 negotiated rates

—

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 5 lines · metro median $28

$28

cash

—

$43

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $20

$20

cash

—

$30

list

MRI of the brain, with and without contrast

CPT 70553 · metro median $2,266

$2,266

cash

—

$3,486

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · metro median $2,447

$2,447

cash

—

$3,764

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · metro median $3,234

$3,234

cash

—

$4,976

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · metro median $2,043

$2,043

cash

—

$3,143

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$18,478 to $62,077

48 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · metro median $1,831

$1,831

cash

—

$2,817

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 5 lines · metro median $209

$209

cash

—

$321

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 6 lines · metro median $224

$224

cash

—

$344

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 4 lines · metro median $252

$252

cash

—

$387

list

PSA test (prostate)

CPT 84153 · lowest of 4 lines · metro median $37

$37

cash

—

$57

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 4 lines · metro median $6

cash

—

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 2 lines · metro median $127

$127

cash

—

$195

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 2 lines · metro median $837

$837

cash

—

$1,288

list

Prostate removal (laparoscopic)

CPT 55866 · metro median $64,523

$64,523

cash

$9,950 to $10,447

3 negotiated rates

$107,538

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 4 lines · metro median $5

cash

—

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 2 lines · metro median $108

$582

cash

—

$896

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 2 lines · metro median $142

$317

cash

—

$487

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 2 lines · metro median $161

$306

cash

—

$470

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines · metro median $312

$312

cash

—

$480

list

Sleep study (overnight, attended)

CPT 95810 · metro median $3,658

$3,658

cash

—

$5,628

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · metro median $1,450

$1,450

cash

—

$2,230

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 2 lines · metro median $1,450

$1,450

cash

$661 to $694

7 negotiated rates

$2,230

list

TSH test (thyroid)

CPT 84443 · lowest of 2 lines · metro median $17

$17

cash

—

$26

list

Transvaginal ultrasound

CPT 76830 · metro median $935

$935

cash

—

$1,439

list

Ultrasound of the abdomen (complete)

CPT 76700 · metro median $931

$931

cash

—

$1,432

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 2 lines · metro median $1,591

$1,591

cash

$849 to $891

6 negotiated rates

$2,447

list

Upper endoscopy with biopsy

CPT 43239 · metro median $6,605

$6,598

cash

$849 to $879

3 negotiated rates

$10,996

list

Urinalysis with microscope

CPT 81001 · metro median $116

$116

cash

—

$179

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$5,354 to $13,266

48 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · metro median $536

$536

cash

—

$825

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://rsfh.com/getContentAsset/6c52d325-86f9-45ee-b404-e4b51cabe5a4/7ac1fecb-c286-4874-bc71-62e245e8a59a/571067254_bon-secours-st-francis-xavier-hospital-inc_standardcharges.csv?language=en
Bon Secours St Francis Hospital · parsed · tall v3.0.0 · file dated 2026-04-01 · 28 MB · 461 price rows read · read Nov 2026