DOMINION HOSPITAL (Falls Church, VA) prices

45 CFR § 180 compliance

C · 70

This hospital published part of what § 180 requires.

●Machine-readable file published: assessment threshold met

○Gross / standard charges: below assessment threshold

○Discounted cash price: below assessment threshold

●Payer-specific negotiated rates: assessment threshold met

●Min / max negotiated charges: assessment threshold met

●Free, public, no login required: assessment threshold met

Procedures listed

13,689

Insurances with rates

CPT / HCPCS codes

9,910

Source MRF

json ↗

File last updated: 2026-03-01 (per the hospital's file)

Retrieved: 2026-10-31

Most expensive procedures (gross)

965808

$17,285

INVEGA SUSTEN 234 MG INJ

Gross

$17,285

965874

$8,257

INVEGA SUSTEN 156 MG INJ

Gross

$8,257

996348

$5,964

INVEGA SUSTEN 117 MG INJ

Gross

$5,964

753001

$5,238

Electroconvulsive therapy (includes necessary monitoring)

Gross

$5,238

966197

$4,467

ADULT TRAUMA UNIT

Gross

$4,467

965912

$4,241

ADOLESCENT UNIT ROOMS

Gross

$4,241

965913

$4,136

ADULT UNIT ROOMS

Gross

$4,136

966369

$4,136

SEMI PVT - DETOX

Gross

$4,136

966214

$3,865

RISPERD CONSTA 50 MG INJ

Gross

$3,865

87535

$3,231

Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes

Gross

$3,231

966240

$3,012

RISPER CONSTA 37.5MG INJ

Gross

$3,012

966238

$1,887

RISPERD CONSTA 25 MG INJ

Gross

$1,887

80307

$1,597

Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instr

Gross

$1,597

966037

$1,597

Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug

Gross

$1,597

340441

$1,530

Testosterone; total

Gross

$1,530

87538

$1,517

Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes

Gross

$1,517

966248

$1,416

RISPER CONSTA 12.5MG INJ

Gross

$1,416

966491

$1,408

HUMULIN R U-500 3 ML PEN

Gross

$1,408

345032

$1,355

Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, tota

Gross

$1,355

341010

$1,351

Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibo

Gross

$1,351

340494

$1,246

Gonadotropin; follicle stimulating hormone (FSH)

Gross

$1,246

966228

$1,211

SUMATRIPTAN SUCC 6MG INJ

Gross

$1,211

965416

$1,146

OP VISIT LEVEL 3 NP

Gross

$1,146

36953

$1,141

C-peptide

Gross

$1,141

340215

$1,137

Prolactin

Gross

$1,137

966022

$1,085

MOMETASONE 110MCG 30INH

Gross

$1,085

965748

$1,073

LIRAGLUTIDE 18 MG INJ

Gross

$1,073

87110

$1,069

Culture, chlamydia, any source

Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-

Gross

$1,068

885402

$1,061

MOMET/FOR 100/5MCG 60INH

Gross

$1,061

966212

$987

ONDANSETRON 4 MG INJ

Gross

$987

Culture, typing; immunofluorescent method, each antiserum

Gross

$927

340305

$916

Thyroid stimulating hormone (TSH)

Gross

$916

966245

$908

GLUCAGON 1 MG INJ

Gross

$908

87081

$864

Culture, presumptive, pathogenic organisms, screening only;

Gross

$864

965858

$836

FLUPHENAZ DEC 25 MG INJ

Gross

$836

340714

$825

Vitamin D; 25 hydroxy, includes fraction(s), if performed

Gross

$825

82077

$812

Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT,

Gross

$812

966373

$773

MOMET/FOR100/5MCG 120INH

Gross

$773

966734

$773

MOMET/FOR 200/5MCG 60INH

Gross

$773

340734

$767

Triiodothyronine T3; total (TT-3)

Gross

$767

123748

$749

IVERMECTIN 0.5% 117G TOP

Gross

$749

122636

$735

Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation

Gross

$735

955649

$724

TOBRAMYCIN 0.3% 5 ML OPH

Gross

$724

340712

$706

Valproic acid (dipropylacetic acid); total

Gross

$706

966241

$703

ENOXAPARIN 100 MG INJ

Gross

$703

952352

$700

MUPIROCIN 2% 22G TOP

Gross

$700

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
965808	INVEGA SUSTEN 234 MG INJ	$17,285	$17,285	$8,124	$15,557	10
965874	INVEGA SUSTEN 156 MG INJ	$8,257	$8,257	$3,881	$7,431	10
996348	INVEGA SUSTEN 117 MG INJ	$5,964	$5,964	$2,803	$5,368	10
753001	Electroconvulsive therapy (includes necessary monitoring)	$5,238	$5,238	$142	$142	4
966197	ADULT TRAUMA UNIT	$4,467	$4,467	—	—	0
965912	ADOLESCENT UNIT ROOMS	$4,241	$4,241	—	—	0
965913	ADULT UNIT ROOMS	$4,136	$4,136	—	—	0
966369	SEMI PVT - DETOX	$4,136	$4,136	—	—	0
966214	RISPERD CONSTA 50 MG INJ	$3,865	$3,865	$1,817	$3,479	10
87535	Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique, includes	$3,231	$3,231	$35.09	$37.84	13
966240	RISPER CONSTA 37.5MG INJ	$3,012	$3,012	$1,416	$2,711	10
966238	RISPERD CONSTA 25 MG INJ	$1,887	$1,887	$887	$1,698	10
80307	Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instr	$1,597	$1,597	$62.14	$67.02	13
966037	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drug	$1,597	$1,597	$114	$123	11
340441	Testosterone; total	$1,530	$1,530	$25.81	$27.84	13
87538	Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique, includes	$1,517	$1,517	$35.09	$37.84	13
966248	RISPER CONSTA 12.5MG INJ	$1,416	$1,416	$665	$1,274	10
966491	HUMULIN R U-500 3 ML PEN	$1,408	$1,408	$662	$1,408	11
345032	Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, tota	$1,355	$1,355	$10.56	$11.39	13
341010	Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibo	$1,351	$1,351	$47.63	$51.37	13
86701	Antibody; HIV-1	$1,247	$1,247	$8.89	$9.58	13
340494	Gonadotropin; follicle stimulating hormone (FSH)	$1,246	$1,246	$18.58	$20.04	13
966228	SUMATRIPTAN SUCC 6MG INJ	$1,211	$1,211	$569	$1,211	11
965416	OP VISIT LEVEL 3 NP	$1,146	$1,146	$538	$1,146	9
36953	C-peptide	$1,141	$1,141	$20.81	$22.45	13
340215	Prolactin	$1,137	$1,137	$19.38	$20.9	13
966022	MOMETASONE 110MCG 30INH	$1,085	$1,085	$510	$1,085	11
965748	LIRAGLUTIDE 18 MG INJ	$1,073	$1,073	$504	$1,073	11
87110	Culture, chlamydia, any source	$1,069	$1,069	$19.6	$21.14	13
87806	Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-	$1,068	$1,068	$32.77	$35.34	13
885402	MOMET/FOR 100/5MCG 60INH	$1,061	$1,061	$499	$1,061	11
966212	ONDANSETRON 4 MG INJ	$987	$987	$464	$987	11
86702	Antibody; HIV-2	$943	$943	$13.52	$14.58	13
87140	Culture, typing; immunofluorescent method, each antiserum	$927	$927	$5.57	$6	13
340305	Thyroid stimulating hormone (TSH)	$916	$916	$16.8	$18.12	13
966245	GLUCAGON 1 MG INJ	$908	$908	$427	$817	10
87081	Culture, presumptive, pathogenic organisms, screening only;	$864	$864	$6.63	$7.15	13
965858	FLUPHENAZ DEC 25 MG INJ	$836	$836	$393	$836	11
340714	Vitamin D; 25 hydroxy, includes fraction(s), if performed	$825	$825	$29.6	$31.92	13
82077	Alcohol (ethanol); any specimen except urine and breath, immunoassay (eg, IA, EIA, ELISA, RIA, EMIT,	$812	$812	$17.27	$18.48	12
966373	MOMET/FOR100/5MCG 120INH	$773	$773	$363	$773	11
966734	MOMET/FOR 200/5MCG 60INH	$773	$773	$363	$773	11
340734	Triiodothyronine T3; total (TT-3)	$767	$767	$14.18	$15.3	13
123748	IVERMECTIN 0.5% 117G TOP	$749	$749	$352	$749	11
80177	Levetiracetam	$736	$736	$13.25	$14.29	13
122636	Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation	$735	$735	$10.8	$11.65	13
955649	TOBRAMYCIN 0.3% 5 ML OPH	$724	$724	$340	$724	11
340712	Valproic acid (dipropylacetic acid); total	$706	$706	$13.54	$14.6	13
966241	ENOXAPARIN 100 MG INJ	$703	$703	$331	$703	11
952352	MUPIROCIN 2% 22G TOP	$700	$700	$329	$700	11

Showing top 50 of 13,689 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.