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 |
|---|---|---|---|---|
| Sincalide 5 mcg solution for injection HCPCS J2805 | $142.54 | $481.53 | $72.23 – $390.04 | 10 |
| Sinus CT scan (with and without contrast) CPT 70488 | $974.14 | $3,291.00 | $283.85 – $2,665.71 | 13 |
| Sinus CT scan (with contrast) CPT 70487 | $880.90 | $2,976.00 | $233.27 – $2,410.56 | 13 |
| Sinus CT scan (without contrast) CPT 70486 | $667.19 | $2,254.00 | $193.83 – $1,825.74 | 13 |
| Sinus/juglr venogram s&i CPT 75860 | $612.72 | $2,070.00 | $154.90 – $1,676.70 | 9 |
| Sirolimus, oral HCPCS J7520 | $2,170.16 | $7,331.60 | $3.85 – $5,938.60 | 10 |
| Skin Biopsy CPT 11102 | $258.41 | $873.00 | $130.95 – $707.13 | 5 |
| Sleep Study (Polysomnography) CPT 95810 | $2,195.14 | $7,416.00 | $500.55 – $2,702.97 | 7 |
| Sleep study unattended CPT 95806 | $254.56 | $860.00 | $129.00 – $711.00 | 7 |
| Slp stdy unatnd w/anal CPT 95801 | $63.64 | $215.00 | $32.25 – $711.00 | 7 |
| Small bowel endoscopy CPT 44364 | $1,788.14 | $6,041.00 | $906.15 – $4,893.21 | 5 |
| Smallpox&monkeypox vac 0.5ml CPT 90611 | $0.08 | $0.25 | $0.04 – $0.21 | 10 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $93.54 | $316.00 | $5.39 – $11.16 | 12 |
| Smear gram stain CPT 87205 | $55.65 | $188.00 | $3.30 – $10.24 | 12 |
| Smear nasal eosinophil CPT 89190 | $30.49 | $103.00 | $5.79 – $9.90 | 12 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $8.00 | $27.00 | $5.99 – $14.40 | 12 |
| Smear wet mount CPT 87210 | $67.49 | $228.00 | $5.82 – $9.95 | 12 |
| Sodium 24 hour urine CPT 84300 | $13.03 | $44.00 | $4.87 – $11.69 | 12 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $6.22 | $21.00 | $1.58 – $8.52 | 10 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $6.16 | $20.78 | $0.80 – $4.27 | 10 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $5.45 | $18.38 | $0.76 – $5.33 | 10 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $7.77 | $26.24 | $0.09 – $10.64 | 10 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $52.95 | $178.87 | $2.19 – $70.17 | 10 |
| Sodium serum/plasma/whole blood CPT 84295 | $8.29 | $28.00 | $4.81 – $11.55 | 12 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $127.08 | $429.32 | $64.40 – $347.75 | 10 |
| Special physics consult CPT 77370 | $228.52 | $772.00 | $115.80 – $743.00 | 9 |
| Special radiation dosimetry CPT 77331 | $249.83 | $844.00 | $29.20 – $743.00 | 9 |
| Special radiation treatment CPT 77470 | $358.76 | $1,212.00 | $50.97 – $981.72 | 9 |
| Special teletx port plan CPT 77321 | $759.54 | $2,566.00 | $67.14 – $2,078.46 | 9 |
| Specific gravity body fluid CPT 84315 | $16.28 | $55.00 | $3.28 – $5.63 | 12 |
| Specimen fat stain CPT 89125 | $58.91 | $199.00 | $5.88 – $10.37 | 12 |
| Sperm antibody test CPT 89325 | $53.88 | $182.00 | $10.67 – $36.40 | 12 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $742.08 | $2,507.00 | $376.05 – $2,030.67 | 5 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $293.64 | $992.00 | $144.58 – $803.52 | 6 |
| Srs linear based CPT 77372 | $4,013.47 | $13,559.00 | $1,435.64 – $10,982.79 | 8 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $84.36 | $285.00 | $42.75 – $309.41 | 10 |
| Staph a dna amp probe CPT 87640 | $41.44 | $140.00 | $27.60 – $84.25 | 12 |
| Stent/athrectomy/fem/pop/unilat 37227 CPT 37227 | $15,942.86 | $53,861.00 | $8,079.15 – $43,627.41 | 6 |
| Stent axios caut enh 15x10mm electrocaut HCPCS C1874 | $2,399.97 | $8,108.00 | $883.65 – $4,771.71 | 10 |
| Stent bili dbl pgtl 10fx5cm HCPCS C2617 | $238.28 | $805.00 | $35.25 – $190.35 | 10 |
| Stent bili rx wallflx 10x80 uncvr HCPCS C1876 | $1,112.96 | $3,760.00 | $0.15 – $0.81 | 10 |
| Stent iliac/open or perc/uni/init 37221 CPT 37221 | $17,114.13 | $57,818.00 | $5,781.75 – $31,221.45 | 6 |
| Stent iliac/open/perc/ea ad/ipsila 37223 CPT 37223 | $4,563.73 | $15,418.00 | $2,312.70 – $12,488.58 | 7 |
| Stent placemt retro carotid CPT 37217 | $1,452.77 | $4,908.00 | $736.20 – $3,975.48 | 6 |
| Stent/tib/peroneal/unilat/initial 37230 CPT 37230 | $5,484.29 | $18,528.00 | $2,779.20 – $15,007.68 | 6 |
| St evaluate speech sound production CPT 92522 | $76.37 | $258.00 | $38.70 – $299.68 | 10 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $144.16 | $487.00 | $73.05 – $620.68 | 10 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $263.44 | $890.00 | $121.00 – $720.90 | 9 |
| St evaluation swallow function CPT 92610 | $156.29 | $528.00 | $79.20 – $427.68 | 9 |
| Strep b assay w/optic CPT 87802 | $26.35 | $89.00 | $12.73 – $27.49 | 12 |
| Strep b dna amp probe CPT 87653 | $30.79 | $104.00 | $27.60 – $84.25 | 12 |
| Stress test pulmonary CPT 94618 | $141.20 | $477.00 | $34.71 – $386.37 | 6 |
| St treatment speech individual CPT 92507 | $184.12 | $622.00 | $35.25 – $270.00 | 10 |
| St treatment swallow dysfunction/oral CPT 92526 | $149.19 | $504.00 | $75.60 – $408.24 | 10 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $20.83 | $70.34 | $0.17 – $45.72 | 7 |
| Sugars single quant CPT 84378 | $50.92 | $172.00 | $11.53 – $27.68 | 12 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $3,557.98 | $12,020.20 | $1,803.03 – $9,736.37 | 10 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $21.88 | $73.91 | $10.48 – $58.64 | 10 |
| Surgical pathology level 1 gross examination only CPT 88300 | $44.70 | $151.00 | $15.61 – $122.31 | 8 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $95.61 | $323.00 | $22.99 – $261.63 | 8 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $173.76 | $587.00 | $33.77 – $475.47 | 8 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $78.15 | $264.00 | $49.47 – $213.84 | 8 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $294.82 | $996.00 | $149.14 – $806.76 | 8 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $412.04 | $1,392.00 | $210.09 – $1,127.52 | 8 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $5.92 | $20.00 | $4.75 – $11.40 | 12 |
| Susceptibility mic per plate CPT 87186 | $21.91 | $74.00 | $8.65 – $20.77 | 12 |
| Suscept studies macrobroth dilution ea CPT 87188 | $8.00 | $27.00 | $6.64 – $15.95 | 12 |
| Svc venogram s&i CPT 75827 | $1,287.31 | $4,349.00 | $148.10 – $3,522.69 | 9 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $35.82 | $121.00 | $4.40 – $24.20 | 12 |
| System pcmkr dual chamber leadless micra av2 intrdcr cath HCPCS C1785 | $0.30 | $1.00 | $0.15 – $0.81 | 10 |
| T3 (triiodothyronine) free CPT 84481 | $33.75 | $114.00 | $16.94 – $40.67 | 12 |
| T3 (triiodothyronine) total CPT 84480 | $23.39 | $79.00 | $14.18 – $34.04 | 12 |
| T4 (thyroxine) free CPT 84439 | $52.10 | $176.00 | $9.02 – $21.65 | 12 |
| T4 (thyroxine) total CPT 84436 | $15.40 | $52.00 | $6.87 – $16.49 | 12 |
| Tacrolimus 1 mg capsule, immediate-release HCPCS J7507 | $138.72 | $468.63 | $0.35 – $9.59 | 10 |
| Tacrolimus 5 mg/ml intravenous solution HCPCS J7525 | $315.46 | $1,065.74 | $159.87 – $863.25 | 11 |
| Tacrolimus therapeutic drug level CPT 80197 | $206.32 | $697.00 | $13.73 – $32.96 | 12 |
| Tavr perq femoral CPT 33361 | $3,217.52 | $10,870.00 | $1,630.50 – $8,804.70 | 6 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $24.87 | $84.00 | $61.98 – $148.83 | 12 |
| Tc-99m exame autol wbc diag per dose HCPCS A9569 | $2,210.83 | $7,469.00 | $1,120.35 – $6,049.89 | 8 |
| Tc-99m exametazime diag HCPCS A9521 | $1,096.68 | $3,705.00 | $555.75 – $3,001.05 | 8 |
| Tc-99m labeled rbc HCPCS A9560 | $122.55 | $414.00 | $24.45 – $132.03 | 8 |
| Tc-99m maa HCPCS A9540 | $96.80 | $327.00 | $34.58 – $264.87 | 8 |
| Tc-99m mebrofenin HCPCS A9537 | $23.39 | $79.00 | $11.85 – $63.99 | 8 |
| Tc-99m mertiatide HCPCS A9562 | $218.16 | $737.00 | $110.55 – $596.97 | 8 |
| Tc-99m oxidronate HCPCS A9561 | $30.79 | $104.00 | $15.60 – $84.24 | 8 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $65.42 | $221.00 | $20.94 – $179.01 | 8 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $15.99 | $54.00 | $1.84 – $43.74 | 8 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $39.37 | $133.00 | $16.35 – $88.29 | 9 |
| Tc-99m succimer (dmsa) HCPCS A9551 | $1,038.96 | $3,510.00 | $526.50 – $2,843.10 | 8 |
| Tc-99m sulfur colloid HCPCS A9541 | $166.36 | $562.00 | $48.00 – $259.20 | 8 |
| Tc-99m tetrofosmin p study dose HCPCS A9502 | $70.45 | $238.00 | $35.70 – $192.78 | 8 |
| Tc-99m tilmanocept diag HCPCS A9520 | $502.32 | $1,697.00 | $254.55 – $1,374.57 | 8 |
| Tcd emboli detect w/inj CPT 93893 | $182.64 | $617.00 | $92.55 – $882.86 | 7 |
| Tcd emboli detect without inj CPT 93892 | $182.64 | $617.00 | $92.55 – $850.14 | 7 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $69.86 | $236.00 | $46.98 – $112.82 | 12 |
| T cells absolute cd 4 count CPT 86361 | $38.19 | $129.00 | $26.78 – $64.29 | 12 |
| T cells total count CPT 86359 | $44.40 | $150.00 | $33.14 – $90.57 | 12 |
| Telethx isodose plan cplx CPT 77307 | $894.52 | $3,022.00 | $211.76 – $2,447.82 | 9 |
| Telethx isodose plan simple CPT 77306 | $456.44 | $1,542.00 | $115.61 – $1,249.02 | 9 |
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.