SOUTHERN HILLS MEDICAL CENTER
2127 CENTURY FARMS PKWY, ANTIOCH, TN · Tristarhealth · · NPI 1720032345
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 |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | not published | not published | $13.18 – $87.84 | 23 |
| 17-hydroxypregnenolone CPT 84143 | not published | not published | $10.26 – $68.43 | 23 |
| 17-ketosteroids CPT 83586 | not published | not published | $5.76 – $38.40 | 23 |
| 1pc ost pch drain hgh output HCPCS A4435 | not published | not published | $5.91 – $12.07 | 20 |
| 1 pc ost pouch w filter HCPCS A5056 | not published | not published | $4.80 – $9.79 | 20 |
| 1 pc ost pou w built-in conv HCPCS A5057 | not published | not published | $9.85 – $20.11 | 20 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | not published | not published | $81.22 – $81.22 | 1 |
| 1st inpatient critical care pr day age 28 days/less than 99468 CPT 99468 | not published | not published | $1,253.02 – $1,253.02 | 1 |
| 2019-ncov diagnostic p HCPCS U0001 | not published | not published | $16.16 – $107.76 | 22 |
| 24 hr ambulatory b/p monitor CPT 93786 | not published | not published | $7.59 – $7.59 | 1 |
| 2vhpv vaccine 3 dose im CPT 90650 | not published | not published | $184.14 – $184.14 | 1 |
| 3d anat seg imaging preop HCPCS C8001 | not published | not published | $118.87 – $310.33 | 2 |
| 3d bn img algor drvd fr MRI HCPCS G0566 | not published | not published | $211.22 – $211.22 | 1 |
| 3d ech img cgen car anomal CPT 93319 | not published | not published | $84.56 – $3,807.00 | 2 |
| 3-d radiotherapy plan CPT 77295 | not published | not published | $230.24 – $867.20 | 4 |
| 3d recon without postprocess indpndt CPT 76376 | $1,097.70 | $1,097.70 | $16.58 – $459.25 | 3 |
| 4-bar link above knee w/swng HCPCS L5614 | not published | not published | $1,504.17 – $3,071.02 | 20 |
| 5% dextrose and 0.45% saline HCPCS S5010 | $69.40 | $69.40 | $9.99 – $9.99 | 1 |
| 5% dextrose with potassium HCPCS S5012 | $183.24 | $183.24 | $6.02 – $6.02 | 1 |
| 5' nucleotidase - sendout CPT 83915 | not published | not published | $5.02 – $33.45 | 23 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | not published | not published | $16.49 – $69.12 | 5 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | not published | not published | $57.95 – $57.95 | 1 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | not published | not published | $62.90 – $62.90 | 1 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | not published | not published | $65.46 – $65.46 | 1 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | not published | not published | $69.81 – $69.81 | 1 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | not published | not published | $74.48 – $74.48 | 1 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | not published | not published | $79.12 – $79.12 | 1 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | not published | not published | $65.55 – $65.55 | 1 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | not published | not published | $94.55 – $94.55 | 1 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | not published | not published | $53.03 – $118.64 | 3 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | not published | not published | $5.40 – $36.03 | 23 |
| Abciximab injection HCPCS J0130 | not published | not published | $1,528.60 – $1,772.05 | 2 |
| Abd aorta w/runoff s&i CPT 75630 | not published | not published | $84.04 – $3,365.20 | 5 |
| Abdominal CT scan (with and without contrast) CPT 74170 | not published | not published | $261.00 – $459.25 | 4 |
| Abdominal CT scan (with contrast) CPT 74160 | not published | not published | $237.36 – $459.25 | 4 |
| Abdominal CT scan (without contrast) CPT 74150 | not published | not published | $154.52 – $459.25 | 4 |
| Abdominal MRI (with and without contrast) CPT 74183 | $11,267.20 | $11,267.20 | $407.64 – $1,120.57 | 4 |
| Abdominal MRI (with contrast) CPT 74182 | $11,202.27 | $11,202.27 | $322.16 – $852.75 | 4 |
| Abdominal MRI (without contrast) CPT 74181 | $7,970.93 | $7,970.93 | $271.76 – $546.91 | 4 |
| Abdominal pad HCPCS L1270 | not published | not published | $81.82 – $167.05 | 20 |
| Abdominal Ultrasound (complete) CPT 76700 | not published | not published | $88.55 – $246.60 | 5 |
| Abdominal Ultrasound (limited) CPT 76705 | not published | not published | $63.73 – $188.38 | 5 |
| Abduct control hip semi-flex HCPCS L1630 | not published | not published | $142.74 – $291.43 | 20 |
| Abduction bar jointed adjust HCPCS L2300 | not published | not published | $226.72 – $462.89 | 20 |
| Abduction bar-straight HCPCS L2310 | not published | not published | $101.79 – $207.81 | 20 |
| Abduction rotation bar shoe HCPCS L3140 | not published | not published | $79.22 – $161.74 | 20 |
| Abduct rotation bar without shoe HCPCS L3150 | not published | not published | $72.42 – $147.85 | 20 |
| Abl1 gene CPT 81170 | not published | not published | $135.00 – $900.00 | 23 |
| Ablate arrhythmia add on CPT 93655 | not published | not published | $605.92 – $605.92 | 1 |
| Abobotulinumtoxina HCPCS J0586 | not published | not published | $10.89 – $23.32 | 3 |
| Above elbow prosth tiss shap HCPCS L6500 | not published | not published | $2,858.76 – $5,836.64 | 20 |
| Above knee cushion socket HCPCS L5648 | not published | not published | $580.33 – $1,184.83 | 20 |
| Above knee flex cover system HCPCS L5964 | not published | not published | $825.51 – $1,685.41 | 20 |
| Above knee hydracadence HCPCS L5610 | not published | not published | $1,824.96 – $3,725.95 | 20 |
| Above knee leather socket HCPCS L5642 | not published | not published | $546.12 – $1,114.99 | 20 |
| Above knee manual lock HCPCS L5925 | not published | not published | $394.91 – $806.27 | 20 |
| Above knee wood socket HCPCS L5644 | not published | not published | $520.62 – $1,062.94 | 20 |
| Absorpt drg >16<=48 in w/bdr HCPCS A6255 | not published | not published | $3.12 – $6.38 | 20 |
| Absorpt drg >16 <=48 without bdr HCPCS A6252 | not published | not published | $3.34 – $6.82 | 20 |
| Absorpt drg <=16 sq in w/bdr HCPCS A6254 | not published | not published | $1.22 – $2.50 | 20 |
| Absorpt drg <=16 sq in without b HCPCS A6251 | not published | not published | $2.04 – $4.17 | 20 |
| Absorpt drg > 48 sq in without b HCPCS A6253 | not published | not published | $6.50 – $13.27 | 20 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | not published | not published | $0.06 – $0.16 | 3 |
| Acetaminophen level CPT 80143 | not published | not published | $8.39 – $55.92 | 23 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $1,398.89 | $1,398.89 | $23.30 – $67.81 | 3 |
| Acetone qualitative CPT 82009 | not published | not published | $2.03 – $13.56 | 23 |
| Acetylcholine receptor modulating antibody CPT 86043 | $48.20 | $48.20 | $5.42 – $36.15 | 23 |
| Acetylcholinesterase assay CPT 82013 | not published | not published | $5.53 – $36.87 | 23 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $4,888.30 | $4,888.30 | $0.54 – $0.98 | 3 |
| Acetylcysteine non-comp unit HCPCS J7608 | not published | not published | $11.30 – $22.42 | 2 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $11.40 – $11.40 | 1 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $118.28 – $241.49 | 20 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $93.10 – $190.09 | 20 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | not published | not published | $70.62 – $70.62 | 1 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $110.65 | $110.65 | $9.86 – $20.14 | 20 |
| Acoustic immitance testing CPT 92570 | not published | not published | $44.17 – $44.17 | 1 |
| Acoustic refl threshold tst CPT 92568 | not published | not published | $19.68 – $19.68 | 1 |
| Acth stimulation panel CPT 80402 | not published | not published | $39.13 – $260.88 | 23 |
| Acth stimulation panel CPT 80406 | not published | not published | $35.22 – $234.78 | 23 |
| Actigraphy testing CPT 95803 | not published | not published | $136.53 – $136.53 | 1 |
| Actinotherapy uv light CPT 96900 | not published | not published | $20.98 – $20.98 | 1 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | not published | not published | $104.90 – $104.90 | 1 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | not published | not published | $58.93 – $58.93 | 1 |
| Acup 1/> without estim ea add 15 CPT 97811 | not published | not published | $52.54 – $52.54 | 1 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | not published | not published | $90.67 – $90.67 | 1 |
| Acute hepatitis panel CPT 80074 | not published | not published | $21.43 – $142.89 | 23 |
| Acute venous thrombus image CPT 78456 | not published | not published | $184.36 – $1,623.62 | 5 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $452.65 | $452.65 | $0.04 – $0.32 | 3 |
| #acylcarnitineprfl CPT 82017 | not published | not published | $7.59 – $50.61 | 23 |
| Acylcarnitines qual CPT 82016 | not published | not published | $7.42 – $49.47 | 23 |
| Adalimumab injection HCPCS J0135 | not published | not published | $1,127.43 – $1,127.43 | 1 |
| Adding walker to prev cast CPT 29440 | not published | not published | $86.59 – $86.59 | 1 |
| Additional switch, ext power HCPCS L6611 | not published | not published | $366.98 – $749.26 | 20 |
| Add le poly knee custom kafo HCPCS L2387 | not published | not published | $150.39 – $307.05 | 20 |
| Add ue prost a/e acrylic HCPCS L7404 | not published | not published | $495.41 – $1,011.46 | 20 |
| Add ue prost a/e ultlite mat HCPCS L7401 | not published | not published | $305.86 – $624.47 | 20 |
| Add ue prost b/e acrylic HCPCS L7403 | not published | not published | $328.28 – $670.23 | 20 |
| Add ue prost be/wd, ultlite HCPCS L7400 | not published | not published | $273.21 – $557.81 | 20 |
| Add ue prost s/d acrylic HCPCS L7405 | not published | not published | $647.96 – $1,322.91 | 20 |
| Add ue prost s/d ultlite mat HCPCS L7402 | not published | not published | $330.26 – $674.29 | 20 |
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.