Inova Loudoun Hospital — price list
← Hospital overviewVerified from Inova Loudoun Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
186 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC APP HIGH COST SS F/N/G/H/F <100SQ CM 1ST <25SQ CM Inpatient & outpatient | 15275 HCPCS | $6,464 | $3,232 | $1,829 – $5,042 | — | |
| HC APP HIGH COST SS F/N/G/H/F <100SQ CM ADDL <25SQ CM Inpatient & outpatient | 15276 HCPCS | $4,652 | $2,326 | $943 – $3,629 | — | |
| HC APP HIGH COST SS F/N/G/H/F >100SQ CM 1ST 100SQ CM Inpatient & outpatient | 15277 HCPCS | $9,291 | $4,646 | $1,829 – $7,247 | — | |
| HC APP HIGH COST SS F/N/G/H/F >100SQ CM ADDL 100SQ CM Inpatient & outpatient | 15278 HCPCS | $4,652 | $2,326 | $943 – $3,629 | — | |
| HC APP HIGH COST SS T/A/L <100SQ CM ADDL <25SQ CM Inpatient & outpatient | 15272 HCPCS | $4,184 | $2,092 | $943 – $3,264 | — | |
| HC APP HIGH COST SS T/A/L >100SQ CM 1ST 100SQ CM Inpatient & outpatient | 15273 HCPCS | $15,314 | $7,657 | $2,067 – $11,945 | — | |
| HC APP HIGH COST SS T/A/L >100SQ CM ADDL 100SQ CM Inpatient & outpatient | 15274 HCPCS | $7,657 | $3,829 | $943 – $5,972 | — | |
| HC APP SS T/A/L <100SQ CM 1ST <25SQ CM Inpatient & outpatient | 15271 HCPCS | $5,901 | $2,951 | $1,829 – $4,925 | — | |
| HC AVUL NAIL PLATE ADDL Inpatient & outpatient | 11732 HCPCS | $620 | $310 | $95.61 – $2,561 | — | |
| HC BENIGN LESION PARING Inpatient & outpatient | 11055 HCPCS | $383 | $192 | $175 – $2,561 | — | |
| HC BENIGN LESION PARING 2-4 Inpatient & outpatient | 11056 HCPCS | $397 | $199 | $181 – $2,561 | — | |
| HC BENIGN LESION PARING 4+ Inpatient & outpatient | 11057 HCPCS | $517 | $259 | $199 – $2,561 | — | |
| HC BX SKIN INCISNL EA SEP/ADD L LES Inpatient & outpatient | 11107 HCPCS | $914 | $457 | $621 – $2,561 | — | |
| HC BX SKIN INCISNL SGL LES Inpatient & outpatient | 11106 HCPCS | $1,554 | $777 | $612 – $2,678 | — | |
| HC BX SKIN PUNCH EA SEP/ ADDL LES Inpatient & outpatient | 11105 HCPCS | $412 | $206 | $321 – $2,561 | — | |
| HC BX SKIN PUNCH SGL LES Inpatient & outpatient | 11104 HCPCS | $872 | $436 | $399 – $2,561 | — | |
| HC BX SKIN TANGENTIAL EA SEP/ ADDL LES Inpatient & outpatient | 11103 HCPCS | $412 | $206 | $321 – $2,561 | — | |
| HC BX SKIN TANGENTIAL SGL LES Inpatient & outpatient | 11102 HCPCS | $821 | $411 | $199 – $2,561 | — | |
| HC DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL Inpatient & outpatient | 11005 HCPCS | $4,657 | $2,329 | $1,472 – $5,284 | — | |
| HC DEBRID NAILS 1-5 Inpatient & outpatient | 11720 HCPCS | $510 | $255 | $59.40 – $2,561 | — | |
| HC DEBRID NAILS 6+ Inpatient & outpatient | 11721 HCPCS | $533 | $267 | $59.40 – $2,561 | — | |
| HC DEBRIDE BONE 1ST 20 SQ CM OR LESS Inpatient & outpatient | 11044 HCPCS | $3,785 | $1,893 | $1,472 – $4,363 | — | |
| HC DEBRIDE BONE EA ADDL 20 SQ Inpatient & outpatient | 11047 HCPCS | $2,413 | $1,207 | $943 – $2,561 | — | |
| HC DEBRIDE INFECT SKIN <=10% Inpatient & outpatient | 11000 HCPCS | $2,572 | $1,286 | $564 – $2,561 | — | |
| HC DEBRIDE MSCL/FSA 1ST 20 SQ CM OR LESS Inpatient & outpatient | 11043 HCPCS | $1,868 | $934 | $564 – $3,645 | — | |
| HC DEBRIDE MSCL/FSA EA ADDL 20 Inpatient & outpatient | 11046 HCPCS | $1,224 | $612 | $559 – $2,561 | — | |
| HC DEBRIDE OPEN FX SITE SKIN/SUBQ TISSUE Inpatient & outpatient | 11010 HCPCS | $2,380 | $1,190 | $564 – $3,645 | — | |
| HC DEBRIDE SBQ TISS 1ST 20 SQ CM OR LESS Inpatient & outpatient | 11042 HCPCS | $1,621 | $811 | $400 – $3,645 | — | |
| HC DEBRIDE SBQ TISS EA ADDL 20 Inpatient & outpatient | 11045 HCPCS | $1,194 | $597 | $546 – $2,561 | — | |
| HC DEBRIDE SKIN BONE AT FX SITE Inpatient & outpatient | 11012 HCPCS | $8,999 | $4,500 | $1,472 – $7,706 | — |