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 |
|---|---|---|---|---|
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $90.58 | $306.00 | $45.90 – $306.00 | 7 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $8,335.70 | $28,161.12 | $77.94 – $4,790.48 | 11 |
| Ivc venogram s&i CPT 75825 | $1,287.31 | $4,349.00 | $140.71 – $3,522.69 | 9 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $83.48 | $282.00 | $42.30 – $389.00 | 7 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $68.08 | $230.00 | $34.50 – $389.00 | 7 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $109.52 | $370.00 | $55.50 – $389.00 | 7 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $278.84 | $942.00 | $106.00 – $763.02 | 7 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $523.63 | $1,769.00 | $143.00 – $1,432.89 | 9 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $12,739.53 | $43,038.92 | $130.49 – $11,826.06 | 11 |
| John cunningham antibody CPT 86711 | $66.31 | $224.00 | $14.32 – $34.57 | 12 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $17.47 | $59.00 | $8.17 – $19.62 | 12 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $20.60 | $69.59 | $0.72 – $45.51 | 10 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $454.66 | $1,536.00 | $230.40 – $1,244.16 | 9 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $253.38 | $856.00 | $128.40 – $698.00 | 9 |
| Knee MRI (with and without contrast) CPT 73723 | $2,014.88 | $6,807.00 | $561.00 – $5,513.67 | 13 |
| Knee MRI (with contrast) CPT 73722 | $1,445.08 | $4,882.00 | $507.36 – $3,954.42 | 13 |
| Knee MRI (without contrast) CPT 73721 | $825.84 | $2,790.00 | $318.57 – $2,459.00 | 13 |
| Knee X-ray CPT 73564 | $122.25 | $413.00 | $50.72 – $334.53 | 9 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $29.89 | $100.95 | $8.29 – $44.76 | 10 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $93.34 | $315.32 | $0.04 – $0.25 | 10 |
| Lactate dehydrogenase (ldh) CPT 83615 | $42.04 | $142.00 | $6.04 – $14.48 | 12 |
| Lactated ringers intravenous solution HCPCS J7120 | $4.67 | $15.76 | $1.19 – $6.40 | 10 |
| Lactic acid CPT 83605 | $23.09 | $78.00 | $11.57 – $25.64 | 12 |
| Lactoferrin fecal qualitative CPT 83630 | $37.89 | $128.00 | $15.05 – $47.13 | 12 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $1,162.10 | $3,926.00 | $588.90 – $3,180.06 | 5 |
| Laryngoscopy w/bx & op scope CPT 31536 | $3,358.12 | $11,345.00 | $1,701.75 – $9,189.45 | 5 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $0.30 | $1.00 | $0.15 – $0.81 | 10 |
| Lead capillary CPT 83655 | $41.44 | $140.00 | $11.19 – $29.08 | 12 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $0.30 | $1.00 | $0.15 – $0.81 | 10 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $360.53 | $1,218.00 | $182.70 – $986.58 | 8 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $45.76 | $154.58 | $4.54 – $55.50 | 10 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $900.28 | $3,041.46 | $156.88 – $847.15 | 11 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $29.51 | $99.69 | $0.04 – $0.21 | 10 |
| Levetiracetam therapeutic drug level CPT 80177 | $21.32 | $72.00 | $13.25 – $31.84 | 12 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $23.28 | $78.64 | $0.04 – $0.25 | 10 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $136.57 | $461.36 | $47.47 – $256.33 | 10 |
| Lidocaine injection HCPCS J2001 | $21.83 | $73.73 | $0.02 – $46.03 | 10 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $23.74 | $80.17 | $8.49 – $45.83 | 10 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $26.77 | $90.43 | $11.99 – $64.72 | 10 |
| Lidocaine therapeutic drug level CPT 80176 | $71.04 | $240.00 | $14.69 – $35.27 | 12 |
| Ligate/strip long leg vein CPT 37722 | $1,846.16 | $6,237.00 | $935.55 – $5,051.97 | 5 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $1,194.96 | $4,037.00 | $605.55 – $3,269.97 | 5 |
| Ligation/divis of long saph vein 37700 CPT 37700 | $3,234.99 | $10,929.00 | $1,639.35 – $8,852.49 | 5 |
| Lig/band angioaccess av fistula CPT 37607 | $2,425.13 | $8,193.00 | $1,228.95 – $6,636.33 | 5 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $43.47 | $146.84 | $4.73 – $65.74 | 10 |
| Lipase CPT 83690 | $124.62 | $421.00 | $6.89 – $16.54 | 12 |
| Lipoprotein blood quant CPT 83704 | $61.87 | $209.00 | $34.19 – $75.75 | 12 |
| Lipoprotein direct measurement hdl CPT 83718 | $11.84 | $40.00 | $8.19 – $19.66 | 12 |
| Lipoprotein direct measurement ldl CPT 83721 | $18.36 | $62.00 | $10.50 – $22.92 | 12 |
| Lithium therapeutic drug level CPT 80178 | $59.20 | $200.00 | $6.61 – $15.88 | 12 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $5,621.64 | $18,992.00 | $712.20 – $3,845.88 | 7 |
| Litt icr 1 traj 1 smpl les CPT 61736 | $997.52 | $3,370.00 | $505.50 – $2,729.70 | 5 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | $1,186.96 | $4,010.00 | $601.50 – $3,248.10 | 5 |
| Liver Function Test CPT 80076 | $150.08 | $507.00 | $8.17 – $16.56 | 12 |
| Liver imaging CPT 78201 | $324.42 | $1,096.00 | $164.40 – $1,067.00 | 9 |
| Liver/spleen imag static only CPT 78215 | $510.31 | $1,724.00 | $258.60 – $1,396.44 | 9 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $479.52 | $1,620.00 | $153.86 – $1,312.20 | 9 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $31.03 | $104.82 | $1.07 – $46.21 | 10 |
| Low cost skin substitute app HCPCS C5271 | $606.80 | $2,050.00 | $307.50 – $1,660.50 | 5 |
| Low cost skin substitute app HCPCS C5273 | $1,981.72 | $6,695.00 | $1,004.25 – $5,422.95 | 5 |
| Low cost skin substitute app HCPCS C5275 | $606.80 | $2,050.00 | $307.50 – $1,660.50 | 5 |
| Low cost skin substitute app HCPCS C5277 | $606.80 | $2,050.00 | $307.50 – $1,660.50 | 5 |
| Low cost skin substitute app HCPCS C5272 | $464.72 | $1,570.00 | $158.85 – $857.79 | 5 |
| Low cost skin substitute app HCPCS C5274 | $1,022.39 | $3,454.00 | $518.10 – $2,797.74 | 5 |
| Low cost skin substitute app HCPCS C5276 | $313.47 | $1,059.00 | $158.85 – $857.79 | 5 |
| Low cost skin substitute app HCPCS C5278 | $313.47 | $1,059.00 | $158.85 – $857.79 | 5 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,256.23 | $4,244.00 | $302.00 – $3,437.64 | 13 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,158.84 | $3,915.00 | $272.90 – $3,171.15 | 13 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $884.75 | $2,989.00 | $216.03 – $2,421.09 | 13 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,177.08 | $7,355.00 | $511.65 – $5,957.55 | 13 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,565.25 | $5,288.00 | $432.02 – $4,283.28 | 13 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,422.88 | $4,807.00 | $303.54 – $2,884.20 | 13 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $248.35 | $839.00 | $38.83 – $679.59 | 9 |
| Lumbar diskogram s&i CPT 72295 | $629.60 | $2,127.00 | $89.78 – $1,722.87 | 9 |
| Lung Function Test (Spirometry) CPT 94010 | $222.00 | $750.00 | $83.53 – $607.50 | 6 |
| Lung perfusion imaging CPT 78580 | $326.79 | $1,104.00 | $165.60 – $1,067.00 | 9 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $17,393.41 | $58,761.52 | $203.79 – $47,596.84 | 11 |
| Lymphatics/lymph node imaging CPT 78195 | $814.89 | $2,753.00 | $412.95 – $2,229.93 | 9 |
| Macroscopic exam arthropod CPT 87168 | $4.44 | $15.00 | $4.27 – $9.87 | 12 |
| Macroscopic exam parasite CPT 87169 | $5.04 | $17.00 | $4.31 – $9.87 | 12 |
| Magnesium CPT 83735 | $15.40 | $52.00 | $6.70 – $16.09 | 12 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $24.78 | $83.69 | $0.04 – $0.25 | 10 |
| Mammosite ced HCPCS C1728 | $80.22 | $271.00 | $40.65 – $219.51 | 10 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $57.72 | $195.00 | $29.25 – $189.52 | 8 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $77.26 | $261.00 | $39.15 – $211.41 | 8 |
| Manipulation of hip joint CPT 27275 | $1,608.17 | $5,433.00 | $814.95 – $4,400.73 | 5 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $23.10 | $78.01 | $4.92 – $51.08 | 10 |
| Manual diff wbc count b-coat CPT 85009 | $33.75 | $114.00 | $5.07 – $8.94 | 12 |
| Map tachycard site(s) CPT 93609 | $612.72 | $2,070.00 | $310.50 – $1,676.70 | 7 |
| Marker biop eviva buckle ss HCPCS A4648 | $82.00 | $277.00 | $27.75 – $149.85 | 10 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $64.83 | $219.00 | $14.46 – $34.72 | 12 |
| Mayo aathr protein s free CPT 85306 | $27.24 | $92.00 | $15.32 – $34.30 | 12 |
| Mayo activated protein c resistance assay CPT 85307 | $20.13 | $68.00 | $15.32 – $34.30 | 12 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $23.98 | $81.00 | $14.78 – $33.51 | 12 |
| Mayo alpha 1 antitrypsin CPT 82103 | $68.97 | $233.00 | $13.44 – $32.26 | 12 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $21.91 | $74.00 | $15.08 – $36.19 | 12 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $214.01 | $723.00 | $121.63 – $291.60 | 12 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $128.76 | $435.00 | $80.55 – $220.11 | 12 |
| Mayo androstenedione CPT 82157 | $48.84 | $165.00 | $29.28 – $70.29 | 12 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $156.59 | $529.00 | $14.60 – $35.06 | 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.