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 |
|---|---|---|---|---|
| ER Visit (level 2) CPT 99282 | $355.20 | $1,200.00 | $180.00 – $1,222.00 | 8 |
| ER Visit (level 3) CPT 99283 | $450.22 | $1,521.00 | $228.15 – $1,232.01 | 8 |
| ER Visit (level 4) CPT 99284 | $529.25 | $1,788.00 | $268.20 – $1,448.28 | 8 |
| ER Visit (level 5, high severity) CPT 99285 | $789.73 | $2,668.00 | $400.20 – $2,161.08 | 8 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | $16.60 | $56.07 | $8.42 – $45.42 | 10 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $132.38 | $447.21 | $9.50 – $51.29 | 10 |
| Esophageal dilat s&i CPT 74360 | $102.42 | $346.00 | $51.90 – $306.00 | 8 |
| Esoph imped function test CPT 91037 | $392.20 | $1,325.00 | $198.75 – $3,642.00 | 7 |
| Established Patient Office Visit (level 1) CPT 99211 | $54.17 | $183.00 | $27.45 – $3,642.00 | 8 |
| Established Patient Office Visit (level 2) CPT 99212 | $67.20 | $227.00 | $34.05 – $183.87 | 7 |
| Established Patient Office Visit (level 3) CPT 99213 | $71.04 | $240.00 | $36.00 – $194.40 | 7 |
| Established Patient Office Visit (level 4) CPT 99214 | $109.52 | $370.00 | $55.50 – $299.70 | 7 |
| Established Patient Office Visit (level 5) CPT 99215 | $279.72 | $945.00 | $94.76 – $765.45 | 7 |
| Estradiol total CPT 82670 | $33.45 | $113.00 | $27.94 – $67.09 | 12 |
| Estradiol valerate 10 mg inj HCPCS J1380 | $50.72 | $171.34 | $11.71 – $138.79 | 10 |
| Estrogens total-sendout CPT 82672 | $25.16 | $85.00 | $21.70 – $52.10 | 12 |
| Ethylene glycol -sendout CPT 82693 | $17.76 | $60.00 | $14.90 – $25.48 | 12 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | $242.33 | $818.65 | $0.95 – $359.34 | 10 |
| Etoposide 50 mg cap HCPCS J8560 | $408.17 | $1,378.94 | $85.91 – $1,116.95 | 10 |
| Evaluation of speech fluency 92521 CPT 92521 | $93.54 | $316.00 | $47.40 – $367.75 | 10 |
| Evasc prlng admn rx agnt 1st CPT 61650 | $619.53 | $2,093.00 | $313.95 – $1,695.33 | 5 |
| Evasc prlng admn rx agnt add CPT 61651 | $298.96 | $1,010.00 | $151.50 – $818.10 | 5 |
| Evasc repair of iliac artery; endograft 34718 CPT 34718 | $1,902.40 | $6,427.00 | $964.05 – $5,205.87 | 5 |
| Evasc rpr a-ao ndgft 34701 CPT 34701 | $3,125.76 | $10,560.00 | $1,584.00 – $8,553.60 | 5 |
| Evasc rpr a-ao ndgft rpt 34702 CPT 34702 | $3,034.60 | $10,252.00 | $1,537.80 – $8,304.12 | 5 |
| Evasc rpr a-biiliac ndgft rptr CPT 34706 | $1,997.12 | $6,747.00 | $1,012.05 – $5,465.07 | 5 |
| Evasc rpr a-iliac ndgft 34717 CPT 34717 | $1,664.12 | $5,622.00 | $843.30 – $4,553.82 | 5 |
| Evasc rpr a-unilac ndgft 34703 CPT 34703 | $1,664.71 | $5,624.00 | $843.60 – $4,555.44 | 5 |
| Evasc rpr a-unilac ndgft rpt CPT 34704 | $1,664.71 | $5,624.00 | $843.60 – $4,555.44 | 5 |
| Evasc rpr ilio-iliac ndgft CPT 34707 | $387.76 | $1,310.00 | $196.50 – $1,061.10 | 5 |
| Evasc rpr ilio-iliac rpt CPT 34708 | $1,901.80 | $6,425.00 | $963.75 – $5,204.25 | 5 |
| Exc back les sbq <3 cm 21930 CPT 21930 | $1,597.52 | $5,397.00 | $809.55 – $4,371.57 | 5 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 5 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | $1,462.24 | $4,940.00 | $741.00 – $4,001.40 | 5 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | $1,334.37 | $4,508.00 | $676.20 – $3,651.48 | 5 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $721.95 | $2,439.00 | $365.85 – $1,975.59 | 6 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $803.94 | $2,716.00 | $407.40 – $2,199.96 | 6 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $1,184.60 | $4,002.00 | $600.30 – $3,241.62 | 6 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $1,462.24 | $4,940.00 | $741.00 – $4,001.40 | 5 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $721.95 | $2,439.00 | $365.85 – $1,975.59 | 6 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $1,052.28 | $3,555.00 | $533.25 – $2,879.55 | 6 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exchange biliary drg cath CPT 47536 | $2,664.89 | $9,003.00 | $1,350.45 – $7,292.43 | 5 |
| Exchange drainage catheter CPT 49423 | $288.60 | $975.00 | $146.25 – $789.75 | 6 |
| Exchange nephrostomy cath CPT 50435 | $752.73 | $2,543.00 | $381.45 – $2,059.83 | 5 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $773.75 | $2,614.00 | $392.10 – $2,117.34 | 6 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $721.95 | $2,439.00 | $365.85 – $1,975.59 | 6 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $1,334.37 | $4,508.00 | $676.20 – $3,651.48 | 5 |
| Excision graft extremity CPT 35903 | $2,787.14 | $9,416.00 | $1,412.40 – $7,626.96 | 6 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | $1,334.37 | $4,508.00 | $676.20 – $3,651.48 | 5 |
| Exc malig feenl >4cm 11646 CPT 11646 | $1,462.24 | $4,940.00 | $741.00 – $4,001.40 | 5 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | $773.75 | $2,614.00 | $392.10 – $2,117.34 | 6 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $1,354.20 | $4,575.00 | $686.25 – $3,705.75 | 6 |
| Exc malig tal <0.5cm 11600 CPT 11600 | $942.76 | $3,185.00 | $477.75 – $2,579.85 | 6 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $773.75 | $2,614.00 | $392.10 – $2,117.34 | 6 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $1,209.16 | $4,085.00 | $612.75 – $3,308.85 | 5 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $1,051.40 | $3,552.00 | $532.80 – $2,877.12 | 6 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | $1,337.04 | $4,517.00 | $677.55 – $3,658.77 | 5 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | $1,462.24 | $4,940.00 | $741.00 – $4,001.40 | 5 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $1,334.37 | $4,508.00 | $676.20 – $3,651.48 | 5 |
| Expl lap celiotomy w/wo bx 49000 CPT 49000 | $2,357.35 | $7,964.00 | $1,194.60 – $6,450.84 | 6 |
| Exploration carotid artery 35701 CPT 35701 | $481.00 | $1,625.00 | $243.75 – $1,316.25 | 6 |
| Exploration of chest 39010 CPT 39010 | $819.92 | $2,770.00 | $415.50 – $2,243.70 | 6 |
| Explore limb vessels 35860 CPT 35860 | $3,079.00 | $10,402.00 | $1,560.30 – $8,425.62 | 6 |
| Explor not followed by surg repair artery; low extrem 35703 CPT 35703 | $999.89 | $3,378.00 | $506.70 – $2,736.18 | 5 |
| Explor not followed by surg repair artery; up extrem 35702 CPT 35702 | $999.89 | $3,378.00 | $506.70 – $2,736.18 | 5 |
| Expose art endoprosth iliac 34820 CPT 34820 | $5,458.24 | $18,440.00 | $2,766.00 – $14,936.40 | 6 |
| Expose endoprosth brachial 34834 CPT 34834 | $2,843.97 | $9,608.00 | $1,441.20 – $7,782.48 | 6 |
| External chromosome analysis 20-25 cells CPT 88264 | $194.77 | $658.00 | $144.61 – $299.27 | 12 |
| External tissue culture neoplastic disorders bone marrow/blood cells CPT 88237 | $193.29 | $653.00 | $124.21 – $303.28 | 12 |
| Extractable nuclear antigen/antibody any method each antibody centromere CPT 86235 | $138.53 | $468.00 | $17.93 – $43.05 | 12 |
| F-18 fdg pet diag HCPCS A9552 | $107.16 | $362.00 | $54.30 – $293.22 | 8 |
| Facial bones <3 CPT 70140 | $243.02 | $821.00 | $32.03 – $665.01 | 9 |
| Factor ix CPT 85250 | $160.14 | $541.00 | $19.04 – $45.71 | 12 |
| Factor ix recombinant nos HCPCS J7195 | $106.72 | $360.54 | $1.78 – $230.75 | 14 |
| Factor viii CPT 85240 | $34.34 | $116.00 | $17.90 – $43.00 | 12 |
| Fat/lipids feces qualitative CPT 82705 | $8.59 | $29.00 | $5.10 – $12.21 | 12 |
| Fatty acids nonesterified CPT 82725 | $25.16 | $85.00 | $18.73 – $32.10 | 12 |
| #fecal-sodium CPT 84302 | $6.52 | $22.00 | $4.86 – $11.69 | 12 |
| Femoral endovas graft add-on 34813 CPT 34813 | $3,313.72 | $11,195.00 | $1,679.25 – $9,067.95 | 6 |
| Fem/popl revasc w/stent CPT 37226 | $7,777.11 | $26,274.00 | $3,941.10 – $21,281.94 | 6 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $43.09 | $145.57 | $1.01 – $46.42 | 10 |
| Ferritin CPT 82728 | $96.50 | $326.00 | $13.63 – $32.72 | 12 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $279.79 | $945.23 | $0.33 – $559.10 | 11 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $44.40 | $150.00 | $3.40 – $18.59 | 12 |
| Fibrin degradation d dimer quantitative CPT 85379 | $161.62 | $546.00 | $10.18 – $24.45 | 12 |
| Fibrin degradation products CPT 85362 | $8.88 | $30.00 | $6.89 – $16.54 | 12 |
| Fibrinogen activity CPT 85384 | $121.66 | $411.00 | $9.72 – $20.38 | 12 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $13.32 | $45.00 | $7.27 – $26.47 | 12 |
| Fibrinolytic plasminogen CPT 85415 | $61.28 | $207.00 | $17.19 – $31.49 | 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.