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 |
|---|---|---|---|---|
| CT Angiogram of the Head CPT 70496 | $1,305.07 | $4,409.00 | $302.00 – $3,571.29 | 13 |
| CT angio hrt w/3d image CPT 75574 | $862.55 | $2,914.00 | $302.00 – $2,360.34 | 13 |
| CT angio pelvis CPT 72191 | $1,054.06 | $3,561.00 | $302.00 – $2,884.41 | 13 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $1,162.40 | $3,927.00 | $302.00 – $2,120.58 | 13 |
| CT colonography dx CPT 74261 | $368.82 | $1,246.00 | $186.90 – $1,467.00 | 13 |
| CT guidance for needle placement CPT 77012 | $109.52 | $370.00 | $55.50 – $1,467.00 | 12 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | $207.80 | $702.00 | $105.30 – $568.62 | 9 |
| CT guid parench tis ablat CPT 77013 | $907.24 | $3,065.00 | $404.79 – $2,482.65 | 12 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $20.43 | $69.00 | $10.35 – $1,467.00 | 13 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | $483.08 | $1,632.00 | $244.80 – $1,467.00 | 13 |
| CT hrt w/3d image CPT 75572 | $586.68 | $1,982.00 | $297.30 – $1,605.42 | 13 |
| CT limited or localized follow-up study CPT 76380 | $271.14 | $916.00 | $137.40 – $1,467.00 | 13 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $993.38 | $3,356.00 | $269.85 – $2,718.36 | 13 |
| CT lower extremity without contrast (both sides) CPT 73700 | $694.72 | $2,347.00 | $216.03 – $1,901.07 | 13 |
| CT lwr extremity w/o&w/dye CPT 73702 | $896.00 | $3,027.00 | $302.00 – $2,451.87 | 13 |
| CT neck soft tissue w/contrast CPT 70491 | $1,220.41 | $4,123.00 | $283.01 – $3,339.63 | 13 |
| CT neck soft tissue without contrast CPT 70490 | $1,012.92 | $3,422.00 | $230.49 – $2,771.82 | 13 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,281.39 | $4,329.00 | $302.00 – $3,506.49 | 13 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,044.29 | $3,528.00 | $302.00 – $2,857.68 | 13 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $856.33 | $2,893.00 | $302.00 – $2,343.33 | 13 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $751.25 | $2,538.00 | $279.54 – $2,055.78 | 13 |
| CT scan for therapy guide CPT 77014 | $330.64 | $1,117.00 | $152.51 – $904.77 | 9 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $807.20 | $2,727.00 | $302.00 – $2,208.87 | 13 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $714.55 | $2,414.00 | $302.00 – $1,955.34 | 13 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $607.40 | $2,052.00 | $248.44 – $1,662.12 | 13 |
| CT thoracic spine w/contrast CPT 72129 | $1,390.91 | $4,699.00 | $274.35 – $3,806.19 | 13 |
| CT thoracic spine without contrast CPT 72128 | $1,061.76 | $3,587.00 | $217.01 – $2,905.47 | 13 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $177.60 | $600.00 | $90.00 – $1,467.00 | 13 |
| CT t-spine w /wo contrast CPT 72130 | $1,507.83 | $5,094.00 | $302.00 – $4,126.14 | 13 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $1,028.01 | $3,473.00 | $302.00 – $2,813.13 | 13 |
| CT upper extremity without contrast (both sides) CPT 73200 | $694.72 | $2,347.00 | $248.57 – $1,901.07 | 13 |
| CT uppr extremity w/o&w/dye CPT 73202 | $1,028.01 | $3,473.00 | $302.00 – $2,813.13 | 13 |
| Culture aerobic additional method definitive id each CPT 87077 | $112.48 | $380.00 | $8.08 – $19.41 | 12 |
| Culture afb any source CPT 87116 | $137.64 | $465.00 | $10.80 – $93.00 | 12 |
| Culture anaerobic additional method definitive id each CPT 87076 | $93.54 | $316.00 | $8.08 – $19.41 | 12 |
| Culture anaerobic except blood CPT 87075 | $24.57 | $83.00 | $9.47 – $22.72 | 12 |
| Culture bact stool aero addl path ea CPT 87046 | $33.45 | $113.00 | $3.32 – $22.67 | 12 |
| Culture body fluid CPT 87070 | $21.91 | $74.00 | $8.62 – $20.68 | 12 |
| Culture fungi definitive id mold CPT 87107 | $31.68 | $107.00 | $10.32 – $24.80 | 12 |
| Culture fungi definitive id yeast CPT 87106 | $112.78 | $381.00 | $10.32 – $24.80 | 12 |
| Culture fungi other (except blood) CPT 87102 | $21.91 | $74.00 | $8.41 – $20.17 | 12 |
| Culture fungi skin/hair/nail CPT 87101 | $19.24 | $65.00 | $7.71 – $18.52 | 12 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $76.37 | $258.00 | $14.61 – $51.60 | 12 |
| Culture mycoplasma any source CPT 87109 | $116.33 | $393.00 | $15.39 – $34.85 | 12 |
| Culture quantitative aerobic other source CPT 87071 | $14.80 | $50.00 | $6.63 – $22.67 | 12 |
| Culture screening strep group a CPT 87081 | $21.61 | $73.00 | $6.63 – $15.93 | 12 |
| Culture typing added method CPT 87158 | $76.37 | $258.00 | $7.36 – $13.24 | 12 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $87.03 | $294.00 | $25.20 – $84.25 | 12 |
| Culture urine each isolate CPT 87088 | $18.36 | $62.00 | $8.09 – $19.45 | 12 |
| Cutter lead HCPCS C1773 | $534.28 | $1,805.00 | $64.35 – $347.49 | 5 |
| Cv line/pic reposition CPT 36597 | $1,898.55 | $6,414.00 | $962.10 – $5,195.34 | 6 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $18.96 | $64.04 | $0.04 – $0.25 | 10 |
| Cyclic citrullinated peptide antibody CPT 86200 | $167.24 | $565.00 | $12.95 – $31.08 | 12 |
| Cyclophosphamide 1 gram intravenous powder for solution HCPCS J9075 | $553.10 | $1,868.56 | $0.04 – $0.21 | 10 |
| Cyclophosphamide 25 mg capsule HCPCS J8530 | $268.13 | $905.82 | $0.66 – $408.76 | 10 |
| Cyclosporine 250 mg/5 ml intravenous solution HCPCS J7516 | $86.17 | $291.11 | $26.61 – $143.67 | 10 |
| Cyclosporine 2 hour CPT 80158 | $43.81 | $148.00 | $8.39 – $43.35 | 12 |
| Cyclosporine modified 25 mg capsule HCPCS J7515 | $25.22 | $85.20 | $0.08 – $0.48 | 10 |
| Cyclosporine oral 100 mg HCPCS J7502 | $226.38 | $764.79 | $0.20 – $1.29 | 10 |
| Cyp2d6 gene com variants CPT 81226 | $264.63 | $894.00 | $44.75 – $794.80 | 12 |
| Cystatin c CPT 82610 | $46.18 | $156.00 | $18.52 – $31.67 | 12 |
| Cystine urine quantitative CPT 82131 | $58.61 | $198.00 | $22.98 – $40.50 | 12 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $265.22 | $896.00 | $41.10 – $725.76 | 9 |
| Cystometrogram w/up 51727 CPT 51727 | $271.73 | $918.00 | $137.70 – $743.58 | 6 |
| Cystoscopy and treatment CPT 52234 | $1,381.73 | $4,668.00 | $700.20 – $3,781.08 | 5 |
| Cystoscopy (Bladder Scope) CPT 52000 | $520.37 | $1,758.00 | $263.70 – $1,423.98 | 5 |
| Cystoscopy chemodenervation CPT 52287 | $1,482.67 | $5,009.00 | $751.35 – $4,057.29 | 6 |
| Cystoscopy & ureter catheter CPT 52005 | $1,421.40 | $4,802.00 | $720.30 – $3,889.62 | 5 |
| Cysto/uretero w/lithotripsy CPT 52356 | $3,176.08 | $10,730.00 | $1,609.50 – $8,691.30 | 6 |
| Cystouretero w/lithotripsy CPT 52353 | $1,437.38 | $4,856.00 | $728.40 – $3,933.36 | 5 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $1,419.62 | $4,796.00 | $719.40 – $3,884.76 | 5 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $145.36 | $491.06 | $1.15 – $335.99 | 10 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $25.76 | $87.00 | $14.39 – $34.57 | 12 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $25.76 | $87.00 | $16.85 – $35.89 | 12 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $46.77 | $158.00 | $49.47 – $127.98 | 8 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $58.91 | $199.00 | $20.26 – $48.65 | 12 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $80.81 | $273.00 | $33.43 – $221.13 | 8 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $24.28 | $82.00 | $7.22 – $66.42 | 8 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $174.64 | $590.00 | $28.64 – $477.90 | 8 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $51.21 | $173.00 | $49.47 – $163.90 | 8 |
| Cytopath tbs c/v manual CPT 88164 | $42.04 | $142.00 | $14.86 – $31.10 | 12 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $130.69 | $441.49 | $4.61 – $342.86 | 10 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $5,000.58 | $16,893.82 | $405.01 – $13,684.00 | 11 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $3,401.41 | $11,491.25 | $15.58 – $9,307.92 | 11 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $973.35 | $3,288.34 | $0.05 – $359.34 | 10 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | $22,977.61 | $77,627.03 | $49.97 – $62,877.90 | 11 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $8,097.13 | $27,355.15 | $2.98 – $4,659.92 | 11 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $22,284.19 | $75,284.42 | $236.14 – $53,991.19 | 11 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $354.45 | $1,197.45 | $27.16 – $615.23 | 11 |
| Dch glucoscan CPT 82948 | $5.92 | $20.00 | $4.46 – $8.62 | 12 |
| Dch pulmonary stress test CPT 94621 | $305.77 | $1,033.00 | $154.95 – $836.73 | 6 |
| Dch validity tests CPT 81002 | $10.36 | $35.00 | $3.48 – $6.14 | 12 |
| Deamidated gliadin antibody iga CPT 86258 | $15.40 | $52.00 | $7.80 – $42.12 | 5 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $353.13 | $1,193.00 | $178.95 – $966.33 | 6 |
| Debridement (>20 cm) charge pt CPT 97598 | $116.04 | $392.00 | $57.75 – $311.85 | 6 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,228.70 | $4,151.00 | $622.65 – $3,362.31 | 5 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $185.30 | $626.00 | $93.90 – $507.06 | 6 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $823.48 | $2,782.00 | $417.30 – $2,253.42 | 6 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $686.43 | $2,319.00 | $347.85 – $1,878.39 | 5 |
| Debride nail1-5 11720 CPT 11720 | $37.30 | $126.00 | $18.90 – $102.06 | 6 |
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.