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 |
|---|---|---|---|---|
| Ghs ppd (tb intradermal) CPT 86580 | $15.40 | $52.00 | $9.10 – $42.12 | 8 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $20.72 | $70.00 | $9.66 – $23.20 | 12 |
| Ghs protoporphyrins fract CPT 84202 | $23.98 | $81.00 | $14.35 – $34.44 | 12 |
| Ghs pr without cont pulse ox CPT 94625 | $68.38 | $231.00 | $34.65 – $285.00 | 6 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $303.70 | $1,026.00 | $121.00 – $831.06 | 9 |
| Ghs quinidine CPT 80194 | $91.17 | $308.00 | $14.60 – $35.06 | 12 |
| Ghs refill of implantable pump CPT 95990 | $378.00 | $1,277.00 | $191.55 – $3,642.00 | 7 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $19.24 | $65.00 | $15.89 – $30.94 | 12 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $16.28 | $55.00 | $13.91 – $27.49 | 12 |
| Ghs sedimentation rate CPT 85651 | $42.92 | $145.00 | $4.27 – $8.52 | 12 |
| Ghs sensitivity (per antimicro) CPT 87184 | $15.40 | $52.00 | $7.48 – $16.56 | 12 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $248.64 | $840.00 | $126.00 – $680.40 | 6 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $199.51 | $674.00 | $101.10 – $545.94 | 6 |
| Ghs sleep study unattended CPT 95800 | $170.20 | $575.00 | $86.25 – $711.00 | 7 |
| Ghs st - re-eval for alt comm CPT 92597 | $79.92 | $270.00 | $40.50 – $270.00 | 10 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $606.80 | $2,050.00 | $202.35 – $1,092.69 | 5 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $714.25 | $2,413.00 | $361.95 – $1,954.53 | 5 |
| Ghs urine, porphyrins quant CPT 84120 | $27.83 | $94.00 | $14.71 – $35.32 | 12 |
| Gi inhouse confirmation CPT 87045 | $24.57 | $83.00 | $9.44 – $22.67 | 12 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $129.24 | $436.60 | $65.48 – $353.59 | 11 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $261.33 | $882.85 | $79.45 – $429.01 | 10 |
| Glucagon plasma - sendout CPT 82943 | $18.65 | $63.00 | $14.29 – $34.30 | 12 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $23.68 | $80.00 | $3.28 – $5.63 | 12 |
| Glucose blood quantitative CPT 82947 | $10.07 | $34.00 | $3.93 – $9.43 | 12 |
| Glucose body fluid CPT 82945 | $59.80 | $202.00 | $3.93 – $9.43 | 12 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $17.17 | $58.00 | $12.87 – $22.01 | 12 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $21.32 | $72.00 | $3.92 – $9.42 | 12 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $4,236.56 | $14,312.70 | $11.59 – $11,593.29 | 11 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $106.27 | $359.00 | $18.58 – $44.62 | 12 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $34.04 | $115.00 | $18.52 – $44.46 | 12 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $4,665.26 | $15,761.01 | $620.50 – $4,751.70 | 11 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $23.68 | $80.00 | $12.00 – $64.80 | 10 |
| Graft axiofill 1000mg HCPCS J3590 | $2,017.20 | $6,814.85 | $440.61 – $2,379.30 | 10 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $3,705.04 | $12,517.00 | $1,743.60 – $9,415.44 | 10 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $131.43 | $444.00 | $42.75 – $230.85 | 10 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $330.93 | $1,118.00 | $46.35 – $250.29 | 10 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $150.96 | $510.00 | $41.85 – $75.33 | 10 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $220.23 | $744.00 | $46.80 – $252.72 | 10 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $128.47 | $434.00 | $45.90 – $247.86 | 10 |
| Granisetron 1 mg tab HCPCS Q0166 | $6.26 | $21.13 | $0.18 – $1.18 | 10 |
| Granisetron hcl injection HCPCS J1626 | $20.63 | $69.67 | $0.43 – $51.94 | 10 |
| G-tube reposition CPT 43761 | $352.24 | $1,190.00 | $178.50 – $963.90 | 5 |
| Gu dilat ureter/urethra s&i CPT 74485 | $381.25 | $1,288.00 | $112.43 – $1,043.28 | 9 |
| Guided cath fluid drainage 10030 CPT 10030 | $418.55 | $1,414.00 | $212.10 – $1,145.34 | 6 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $479.52 | $1,620.00 | $0.15 – $0.81 | 5 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $72.52 | $245.00 | $0.15 – $0.81 | 5 |
| Guid loc target vol rad tx CPT 77387 | $137.64 | $465.00 | $60.00 – $743.00 | 8 |
| Gw stiffened micro access kit HCPCS C1894 | $2,040.92 | $6,895.00 | $0.15 – $0.81 | 5 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $30.46 | $102.89 | $8.79 – $67.66 | 10 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $22.68 | $76.59 | $1.82 – $45.51 | 10 |
| Hand X-ray CPT 73130 | $212.53 | $718.00 | $38.83 – $581.58 | 9 |
| Haptoglobin quantitative CPT 83010 | $26.05 | $88.00 | $5.25 – $30.20 | 12 |
| Hbb full gene sequence CPT 81364 | $384.80 | $1,300.00 | $290.51 – $571.26 | 12 |
| Hbot, full body chamber, 30m HCPCS G0277 | $257.82 | $871.00 | $130.65 – $1,172.00 | 9 |
| Hcg qualitative CPT 84703 | $140.31 | $474.00 | $7.52 – $18.06 | 12 |
| Hcg quantitative CPT 84702 | $65.42 | $221.00 | $9.03 – $36.15 | 12 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $64.83 | $219.00 | $32.85 – $177.39 | 8 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $693.24 | $2,342.00 | $290.31 – $1,897.02 | 9 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $1,044.29 | $3,528.00 | $529.20 – $2,857.68 | 10 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $651.80 | $2,202.00 | $330.30 – $1,783.62 | 9 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $762.80 | $2,577.00 | $386.55 – $2,087.37 | 9 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $847.45 | $2,863.00 | $429.45 – $2,319.03 | 9 |
| Hdr rdncl skn surf brachytx CPT 77767 | $198.62 | $671.00 | $100.65 – $743.00 | 9 |
| Hdr rdncl skn surf brachytx CPT 77768 | $222.60 | $752.00 | $112.80 – $743.00 | 9 |
| Head CT scan (with and without contrast) CPT 70470 | $1,159.73 | $3,918.00 | $266.85 – $3,173.58 | 13 |
| Head CT scan (with contrast) CPT 70460 | $1,020.61 | $3,448.00 | $216.92 – $2,792.88 | 13 |
| Head CT scan (without contrast) CPT 70450 | $927.67 | $3,134.00 | $156.62 – $2,538.54 | 13 |
| Heart first pass add-on CPT 78496 | $326.49 | $1,103.00 | $32.60 – $1,067.00 | 9 |
| Helicobacter pylori antibody igm CPT 86677 | $14.21 | $48.00 | $16.85 – $34.85 | 12 |
| Hematocrit CPT 85014 | $49.44 | $167.00 | $2.37 – $5.68 | 12 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $11,715.46 | $39,579.24 | $31.94 – $32,059.19 | 11 |
| Hemodialysis one evaluation CPT 90935 | $612.43 | $2,069.00 | $310.35 – $1,675.89 | 5 |
| Hemoglobin CPT 85018 | $35.52 | $120.00 | $2.37 – $5.68 | 12 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $11.84 | $40.00 | $7.04 – $14.02 | 12 |
| Hemoglobin plasma CPT 83051 | $10.36 | $35.00 | $7.31 – $17.56 | 12 |
| Hemophilus influenza antibdy CPT 86684 | $58.32 | $197.00 | $15.84 – $35.89 | 12 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $933.00 | $3,152.00 | $472.80 – $2,553.12 | 6 |
| Heparin assay CPT 85520 | $54.76 | $185.00 | $13.09 – $31.43 | 12 |
| Heparin bolus from bag HCPCS J1644 | $36.74 | $124.10 | $0.04 – $0.25 | 10 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $24.39 | $82.38 | $0.02 – $45.66 | 10 |
| Hepatitis a antibody igm CPT 86709 | $52.40 | $177.00 | $11.26 – $27.03 | 12 |
| Hepatitis b core antibody igm CPT 86705 | $30.20 | $102.00 | $11.77 – $28.28 | 12 |
| Hepatitis b core antibody total CPT 86704 | $38.48 | $130.00 | $12.05 – $28.93 | 12 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $190.16 | $642.43 | $60.74 – $520.37 | 11 |
| Hepatitis b surface antibody CPT 86706 | $50.32 | $170.00 | $10.74 – $25.78 | 12 |
| Hepatitis c antibody CPT 86803 | $16.58 | $56.00 | $11.19 – $34.27 | 12 |
| Hepatobiliary system imaging CPT 78226 | $823.18 | $2,781.00 | $417.15 – $2,252.61 | 9 |
| Herpes simplex type 1 antibody igg CPT 86695 | $20.72 | $70.00 | $13.19 – $31.68 | 12 |
| Herpes simplex type 2 antibody igg CPT 86696 | $22.50 | $76.00 | $19.35 – $46.46 | 12 |
| Herpes simplex virus isolation CPT 87255 | $39.96 | $135.00 | $33.86 – $81.31 | 12 |
| Heterophile antibodies screening CPT 86308 | $123.44 | $417.00 | $5.18 – $12.43 | 12 |
| Hip X-ray CPT 73502 | $79.63 | $269.00 | $40.35 – $306.00 | 9 |
| Histamine CPT 83088 | $51.21 | $173.00 | $29.53 – $70.91 | 12 |
| Hla ii typing 1 loc hr CPT 81382 | $230.59 | $779.00 | $123.68 – $296.96 | 12 |
| Hla i low res one antigen equiv ea CPT 81374 | $113.37 | $383.00 | $74.33 – $174.68 | 12 |
| Hla i typing complete lr CPT 81372 | $573.36 | $1,937.00 | $110.09 – $690.14 | 12 |
| Hla i typing high res 1 allele grp ea CPT 81381 | $124.32 | $420.00 | $44.75 – $290.53 | 12 |
| Hla i typing low res one locus ea CPT 81373 | $906.65 | $3,063.00 | $110.09 – $267.40 | 12 |
| Hla typing a b or c CPT 86813 | $258.12 | $872.00 | $58.00 – $139.25 | 12 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | $3.91 | $13.20 | $0.26 – $10.70 | 10 |
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.