CHI Memorial Hospital - Georgia
4710 Battlefield Pkwy, Ringgold, GA · CommonSpirit Health · · NPI 1356860621
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 17-hydroxypregnenolone CPT 84143 | $40.56 | $137.00 | $22.81 – $54.79 | 12 |
| 17-ketosteroids CPT 83586 | $17.17 | $58.00 | $12.80 – $30.75 | 12 |
| 2d tee w or without fol w/con,in HCPCS C8925 | $1,297.67 | $4,384.00 | $641.00 – $3,551.04 | 7 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $805.42 | $2,721.00 | $408.15 – $2,311.57 | 7 |
| 2nd order venous cath CPT 36012 | $1,048.14 | $3,541.00 | $531.15 – $5,206.00 | 7 |
| 3d ech img cgen car anomal CPT 93319 | $274.40 | $927.00 | $139.05 – $750.87 | 6 |
| 3-d radiotherapy plan CPT 77295 | $2,579.35 | $8,714.00 | $413.49 – $7,058.34 | 9 |
| 3d recon without postprocess indpndt CPT 76376 | $109.52 | $370.00 | $32.27 – $1,467.00 | 13 |
| 5' nucleotidase - sendout CPT 83915 | $35.82 | $121.00 | $11.15 – $26.58 | 12 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $22.50 | $76.00 | $18.04 – $61.56 | 8 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $3,057.83 | $10,330.49 | $43.98 – $5,012.58 | 11 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $42.63 | $144.00 | $12.01 – $28.83 | 12 |
| Abd aorta w/runoff s&i CPT 75630 | $1,835.50 | $6,201.00 | $144.98 – $5,022.81 | 9 |
| Abd/low ext cath 1st CPT 36245 | $1,511.68 | $5,107.00 | $766.05 – $5,206.00 | 7 |
| Abd/low ext cath 2nd CPT 36246 | $1,183.12 | $3,997.00 | $599.55 – $5,206.00 | 7 |
| Abd/low ext cath 3rd CPT 36247 | $1,183.12 | $3,997.00 | $599.55 – $5,206.00 | 7 |
| Abd/low ext cath addl CPT 36248 | $1,479.12 | $4,997.00 | $749.55 – $5,206.00 | 7 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $835.91 | $2,824.00 | $302.00 – $2,287.44 | 13 |
| Abdominal CT scan (with contrast) CPT 74160 | $794.17 | $2,683.00 | $302.00 – $2,173.23 | 13 |
| Abdominal CT scan (without contrast) CPT 74150 | $626.93 | $2,118.00 | $181.99 – $1,715.58 | 13 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,691.05 | $5,713.00 | $428.55 – $2,459.00 | 13 |
| Abdominal MRI (with contrast) CPT 74182 | $608.88 | $2,057.00 | $308.55 – $2,459.00 | 13 |
| Abdominal MRI (without contrast) CPT 74181 | $1,183.71 | $3,999.00 | $314.12 – $3,239.19 | 13 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,461.65 | $4,938.00 | $740.70 – $3,999.78 | 6 |
| Abdominal Ultrasound (complete) CPT 76700 | $625.16 | $2,112.00 | $160.56 – $1,710.72 | 9 |
| Abdominal Ultrasound (limited) CPT 76705 | $281.50 | $951.00 | $123.61 – $770.31 | 9 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $760.13 | $2,568.00 | $385.20 – $2,080.08 | 6 |
| Ablate arrhythmia add on CPT 93655 | $496.69 | $1,678.00 | $251.70 – $12,467.00 | 7 |
| Ablate bone tumor(s) perq CPT 20982 | $1,658.79 | $5,604.00 | $840.60 – $4,539.24 | 6 |
| Ablate heart dysrhythm focus CPT 93650 | $11,421.16 | $38,585.00 | $5,787.75 – $31,253.85 | 7 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $161.62 | $546.00 | $79.50 – $7,669.00 | 8 |
| Ablation of upper extremity nerves rf CPT 64999 | $302.52 | $1,022.00 | $153.30 – $827.82 | 6 |
| Abscess drain retroperitoneal surg code CPT 49406 | $1,338.52 | $4,522.00 | $678.30 – $3,662.82 | 6 |
| Access & clsr pq fem art endogft dlvry w/img uni CPT 34713 | $836.50 | $2,826.00 | $423.90 – $5,206.00 | 6 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $65.80 | $222.28 | $0.04 – $0.25 | 10 |
| Acetone qualitative CPT 82009 | $15.69 | $53.00 | $4.52 – $10.84 | 12 |
| Acetylcholine receptor modulating antibody CPT 86043 | $14.80 | $50.00 | $7.50 – $40.50 | 5 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $252.07 | $851.57 | $1.06 – $142.68 | 10 |
| Acetylcysteine non-comp unit HCPCS J7608 | $3.34 | $11.27 | $0.59 – $3.91 | 10 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $9.77 | $33.00 | $4.95 – $142.00 | 11 |
| Acute hepatitis panel CPT 80074 | $145.64 | $492.00 | $47.63 – $110.60 | 12 |
| Acyclovir 400 mg tablet HCPCS J8499 | $27,079.65 | $91,485.29 | $13,722.80 – $74,103.09 | 10 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $21.49 | $72.58 | $0.07 – $44.81 | 10 |
| Adapter b 8 channel 10cm HCPCS C1883 | $0.30 | $1.00 | $0.15 – $0.81 | 10 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $353.38 | $1,193.84 | $0.49 – $49.11 | 10 |
| Adenovirus antibody,serum - quest CPT 86603 | $14.80 | $50.00 | $12.87 – $30.89 | 12 |
| Adh-sendout CPT 84588 | $47.36 | $160.00 | $33.94 – $81.51 | 12 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $77.04 | $260.25 | $1.02 – $12.23 | 10 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $102.72 | $347.00 | $49.95 – $1,094.00 | 8 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $149.19 | $504.00 | $72.15 – $1,094.00 | 8 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $355.50 | $1,201.00 | $106.00 – $1,094.00 | 8 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $291.27 | $984.00 | $106.00 – $1,094.00 | 8 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $103.01 | $348.00 | $52.20 – $1,094.00 | 8 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $103.01 | $348.00 | $52.20 – $1,094.00 | 8 |
| Administration immunization 1 vaccine CPT 90471 | $63.35 | $214.00 | $32.10 – $173.34 | 6 |
| Administration immunization each additional vaccine CPT 90472 | $41.15 | $139.00 | $20.85 – $112.59 | 6 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $13,647.71 | $46,107.11 | $39.10 – $23,457.38 | 11 |
| _afb id by dna probe rflx ast CPT 87149 | $38.48 | $130.00 | $20.05 – $48.15 | 12 |
| #afb mycobacteria suscep. #1 CPT 87190 | $10.36 | $35.00 | $1.80 – $12.50 | 12 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $164.88 | $557.00 | $71.10 – $276.99 | 12 |
| Albumin body fluid quantitative each specimen CPT 82042 | $59.80 | $202.00 | $5.63 – $13.30 | 12 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $68.52 | $231.46 | $29.01 – $156.63 | 11 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $118.36 | $399.85 | $12.33 – $156.80 | 11 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $10.66 | $36.00 | $5.63 – $9.88 | 12 |
| Albumin serum plasma or whole blood CPT 82040 | $61.87 | $209.00 | $4.05 – $11.88 | 12 |
| Alkaline phosphatase CPT 84075 | $15.69 | $53.00 | $5.18 – $12.43 | 12 |
| Allergen alpha lactalbumin ige CPT 86008 | $6.52 | $22.00 | $17.82 – $38.97 | 12 |
| Allergen egg white ige CPT 86003 | $7.40 | $25.00 | $5.22 – $12.53 | 12 |
| All tstg perq&iq drugs/biol CPT 95018 | $39.67 | $134.00 | $20.10 – $259.00 | 6 |
| Alpha-fetoprotein tumor marker CPT 82105 | $27.24 | $92.00 | $16.77 – $40.29 | 12 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $1,829,398.30 | $6,180,399.63 | $90.66 – $1,226.86 | 11 |
| Alt/sgpt CPT 84460 | $8.00 | $27.00 | $5.30 – $12.71 | 12 |
| Aluminum - quest CPT 82108 | $37.60 | $127.00 | $23.72 – $49.61 | 12 |
| Amantadine (symmetrel)-sendout CPT 80375 | $104.79 | $354.00 | $20.42 – $286.74 | 5 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $22.81 | $77.04 | $1.03 – $54.25 | 10 |
| Aminolevulinic acid delta CPT 82135 | $19.24 | $65.00 | $16.45 – $39.51 | 12 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $33.36 | $112.70 | $7.72 – $73.93 | 10 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $24.21 | $81.77 | $0.26 – $46.60 | 10 |
| Amitriptyline (elavil) -sendout CPT 80335 | $40.26 | $136.00 | $25.18 – $110.16 | 5 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $7,682.85 | $25,955.57 | $3,893.34 – $21,024.02 | 10 |
| Ammonia CPT 82140 | $150.08 | $507.00 | $13.92 – $34.99 | 12 |
| Amphetamine confirm urine -sendout CPT 80324 | $150.08 | $507.00 | $21.87 – $410.67 | 5 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $59.44 | $200.81 | $30.13 – $162.66 | 10 |
| Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J0289 | $134.01 | $452.73 | $22.04 – $293.87 | 11 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $25.23 | $85.23 | $0.04 – $0.25 | 10 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $34.35 | $116.04 | $0.04 – $0.25 | 10 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | $320.28 | $1,082.00 | $162.30 – $876.42 | 5 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $1,555.48 | $5,255.00 | $788.25 – $4,256.55 | 5 |
| Amp thigh through femur re-amp 27596 CPT 27596 | $3,430.64 | $11,590.00 | $1,738.50 – $9,387.90 | 6 |
| Amputate metacarpal bone 26910 CPT 26910 | $3,214.86 | $10,861.00 | $1,629.15 – $8,797.41 | 5 |
| Amputate thigh through femur 27590 CPT 27590 | $3,378.25 | $11,413.00 | $1,711.95 – $9,244.53 | 6 |
| Amputation follow-up surgery CPT 27884 | $3,220.19 | $10,879.00 | $1,631.85 – $8,811.99 | 5 |
| Amputation leg thr tib/fib 27880 CPT 27880 | $975.92 | $3,297.00 | $494.55 – $2,670.57 | 6 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | $1,022.98 | $3,456.00 | $518.40 – $2,799.36 | 6 |
| Amputation of foot at ankle CPT 27889 | $7,109.92 | $24,020.00 | $3,603.00 – $19,456.20 | 5 |
| Amputation of lower leg CPT 27882 | $975.92 | $3,297.00 | $494.55 – $2,670.57 | 6 |
| Amputation thru metatarsal CPT 28805 | $1,723.91 | $5,824.00 | $873.60 – $4,717.44 | 6 |
| Amputation toe interphalangeal joint CPT 28825 | $1,705.26 | $5,761.00 | $864.15 – $4,666.41 | 5 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $1,024.46 | $3,461.00 | $519.15 – $2,803.41 | 5 |
| Amylase CPT 82150 | $15.40 | $52.00 | $6.48 – $15.56 | 12 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.