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 |
|---|---|---|---|---|
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | $1,096.98 | $3,706.00 | $555.90 – $3,001.86 | 6 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $185.30 | $626.00 | $93.90 – $507.06 | 6 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $960.82 | $3,246.00 | $486.90 – $2,629.26 | 5 |
| Decalcification CPT 88311 | $44.40 | $150.00 | $9.02 – $121.50 | 8 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $311.54 | $1,052.47 | $1.59 – $504.77 | 10 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $433.94 | $1,466.00 | $219.90 – $1,187.46 | 6 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | $1,625.64 | $5,492.00 | $823.80 – $4,448.52 | 5 |
| Decompression fasct forearm CPT 24495 | $6,983.24 | $23,592.00 | $3,538.80 – $19,109.52 | 5 |
| Decompression of lower leg CPT 27600 | $3,010.32 | $10,170.00 | $1,525.50 – $8,237.70 | 5 |
| Decompression of lower leg CPT 27601 | $3,214.86 | $10,861.00 | $1,629.15 – $8,797.41 | 5 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $63.16 | $213.37 | $8.96 – $73.77 | 10 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $1,145.81 | $3,870.95 | $4.27 – $3,135.47 | 11 |
| Delivery transcath fxtn dvc to endogrft w/s&i CPT 34712 | $1,664.71 | $5,624.00 | $843.60 – $4,555.44 | 5 |
| Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device CPT 94664 | $116.63 | $394.00 | $51.90 – $319.14 | 8 |
| Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution HCPCS J0897 | $6,709.74 | $22,668.03 | $25.44 – $10,113.14 | 11 |
| Depo-estradiol cypionate inj HCPCS J1000 | $49.14 | $166.00 | $24.90 – $134.46 | 10 |
| Dermagraft HCPCS Q4106 | $252.49 | $853.00 | $28.86 – $690.93 | 10 |
| Descend thora aorta rpr/lt sub art 33880 CPT 33880 | $3,379.73 | $11,418.00 | $1,712.70 – $9,248.58 | 6 |
| Design mlc device for imrt CPT 77338 | $178.49 | $603.00 | $90.45 – $743.00 | 9 |
| Desmopressin 4 mcg/ml injection solution HCPCS J2597 | $728.80 | $2,462.15 | $5.67 – $89.51 | 11 |
| Desoxycorticosterone CPT 82633 | $216.08 | $730.00 | $30.98 – $74.38 | 12 |
| Des thora aorta rpr without left sub art 33881 CPT 33881 | $3,068.64 | $10,367.00 | $1,555.05 – $8,397.27 | 6 |
| Des thor aorta/prox ext prosth/ini 33883 CPT 33883 | $2,113.44 | $7,140.00 | $1,071.00 – $5,783.40 | 6 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $84.96 | $287.00 | $26.38 – $306.00 | 9 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $29.12 | $98.35 | $0.04 – $0.21 | 10 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $21.26 | $71.81 | $0.04 – $0.21 | 10 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $187.21 | $632.45 | $91.55 – $494.35 | 11 |
| Dextran 40 infusion HCPCS J7100 | $41.92 | $141.60 | $20.08 – $114.70 | 10 |
| Dextrose 5 % and 0.9 % sodium chloride intravenous solution HCPCS J7042 | $6.22 | $21.00 | $1.07 – $8.52 | 10 |
| Dextrose 5 % and lactated ringers intravenous solution HCPCS J7121 | $4.67 | $15.76 | $1.58 – $8.52 | 10 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $22.16 | $74.85 | $0.87 – $4.69 | 10 |
| Dextrose 5 % IV bolus HCPCS J7070 | $7.77 | $26.24 | $0.83 – $4.48 | 10 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $35.82 | $121.00 | $22.23 – $53.38 | 12 |
| Diabetes (HbA1c) Test CPT 83036 | $24.57 | $83.00 | $9.71 – $23.30 | 12 |
| Diab manage trn ind/group HCPCS G0109 | $14.80 | $50.00 | $7.50 – $142.00 | 11 |
| Diag bronchoscope/catheter CPT 31643 | $1,647.84 | $5,567.00 | $835.05 – $4,509.27 | 5 |
| Diag laparo separate proc 49320 CPT 49320 | $5,630.22 | $19,021.00 | $2,853.15 – $15,407.01 | 5 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $166.95 | $564.00 | $84.60 – $456.84 | 6 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $737.93 | $2,493.00 | $373.95 – $2,019.33 | 6 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $126.99 | $429.00 | $64.35 – $347.49 | 9 |
| Diagnostic Mammogram (one breast) CPT 77065 | $97.68 | $330.00 | $49.50 – $285.00 | 9 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $4,064.38 | $13,731.00 | $2,059.65 – $11,122.11 | 6 |
| Dialysis one evaluation CPT 90945 | $570.99 | $1,929.00 | $289.35 – $1,562.49 | 6 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $55.63 | $187.93 | $0.04 – $0.25 | 10 |
| Dicyclomine injection HCPCS J0500 | $112.02 | $378.44 | $12.82 – $69.23 | 10 |
| Diffusing capacity CPT 94729 | $208.68 | $705.00 | $105.75 – $571.05 | 6 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $22.65 | $76.52 | $10.01 – $54.05 | 10 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $9,075.78 | $30,661.41 | $4,599.22 – $24,835.75 | 11 |
| Digoxin total therapeutic drug level CPT 80162 | $111.00 | $375.00 | $13.28 – $31.89 | 12 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $137.09 | $463.13 | $40.21 – $217.13 | 10 |
| Dilate biliary duct/ampulla CPT 47542 | $185.30 | $626.00 | $93.90 – $507.06 | 6 |
| Dilate ic vasospasm init CPT 61640 | $3,012.10 | $10,176.00 | $1,526.40 – $8,242.56 | 6 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $808.59 | $2,731.71 | $409.76 – $2,212.69 | 11 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $1.13 | $3.81 | $0.32 – $3.09 | 10 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $17.38 | $58.70 | $1.32 – $45.88 | 10 |
| Disaccharidases CPT 82657 | $30.49 | $103.00 | $8.45 – $43.35 | 12 |
| #d/lmeth-l-methamphetamine CPT 80374 | $150.08 | $507.00 | $76.05 – $410.67 | 5 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | $1,057.02 | $3,571.00 | $535.65 – $2,892.51 | 5 |
| Dmpk gene detc abnor allele CPT 81234 | $167.84 | $567.00 | $122.62 – $241.12 | 12 |
| Dna antibody native/double stranded CPT 86225 | $21.91 | $74.00 | $13.74 – $32.98 | 12 |
| Dna gardnerella CPT 87510 | $25.76 | $87.00 | $20.05 – $48.15 | 12 |
| Dna trichomonas CPT 87660 | $25.76 | $87.00 | $20.05 – $48.15 | 12 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $41.10 | $138.84 | $7.39 – $44.92 | 10 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $1,310.67 | $4,427.92 | $0.51 – $410.08 | 10 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $31.75 | $107.26 | $0.80 – $52.48 | 10 |
| Doppler echo complete CPT 93320 | $312.58 | $1,056.00 | $109.70 – $855.36 | 7 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $340.40 | $1,150.00 | $172.50 – $7,669.00 | 7 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $271.14 | $916.00 | $119.55 – $645.57 | 8 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $162.80 | $550.00 | $82.50 – $619.00 | 8 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $24,754.34 | $83,629.51 | $12,544.43 – $67,739.91 | 10 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $204.29 | $690.14 | $0.04 – $0.25 | 10 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,759.64 | $9,323.10 | $87.10 – $1,233.55 | 11 |
| Drainage of kidney lesion CPT 50390 | $700.34 | $2,366.00 | $354.90 – $1,916.46 | 5 |
| Drainage of pelvis lesion 26990 CPT 26990 | $3,344.51 | $11,299.00 | $1,694.85 – $9,152.19 | 5 |
| Drain cath image guided visceral pq CPT 49405 | $517.71 | $1,749.00 | $262.35 – $1,416.69 | 6 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $597.04 | $2,017.00 | $302.55 – $1,633.77 | 5 |
| Drain lower leg lesion 27603 CPT 27603 | $1,306.25 | $4,413.00 | $661.95 – $3,574.53 | 5 |
| Drain thigh/knee lesion 27301 CPT 27301 | $2,914.42 | $9,846.00 | $1,476.90 – $7,975.26 | 5 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $565.36 | $1,910.00 | $286.50 – $1,547.10 | 5 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $325.60 | $1,100.00 | $165.00 – $891.00 | 6 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | $243.02 | $821.00 | $123.15 – $665.01 | 5 |
| Dressing change not for burn w/anes 15852 CPT 15852 | $606.80 | $2,050.00 | $307.50 – $1,660.50 | 6 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | $338.33 | $1,143.00 | $171.45 – $925.83 | 6 |
| Drng of scrotum abscess 55100 CPT 55100 | $1,611.72 | $5,445.00 | $816.75 – $4,410.45 | 5 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $25.41 | $85.84 | $2.42 – $69.54 | 10 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $10.96 | $37.00 | $10.95 – $29.97 | 10 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $156.29 | $528.00 | $3.90 – $21.06 | 10 |
| Drug admin & hemodynmic meas CPT 93463 | $87.32 | $295.00 | $44.25 – $7,669.00 | 7 |
| Drug assay posaconazole CPT 80187 | $32.56 | $110.00 | $24.27 – $47.71 | 12 |
| Drug assay vedolizumab CPT 80280 | $49.73 | $168.00 | $34.53 – $67.88 | 12 |
| Drug assay voriconazole CPT 80285 | $35.23 | $119.00 | $24.27 – $47.71 | 12 |
| Drug of abuse screen urine CPT 80305 | $21.32 | $72.00 | $12.60 – $26.33 | 12 |
| Drug test def 1-7 classes HCPCS G0480 | $159.25 | $538.00 | $105.30 – $195.68 | 12 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $103.60 | $350.00 | $62.14 – $140.47 | 12 |
| Duplex scan bilateral study 93985 CPT 93985 | $285.35 | $964.00 | $144.60 – $780.84 | 8 |
| Duplex scan unilateral study 93986 CPT 93986 | $137.35 | $464.00 | $69.60 – $619.00 | 8 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $221.12 | $747.00 | $112.05 – $619.00 | 8 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $271.14 | $916.00 | $137.40 – $741.96 | 8 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $417.96 | $1,412.00 | $211.80 – $1,143.72 | 8 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $9,080.81 | $30,678.41 | $82.23 – $5,924.28 | 11 |
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.