Ascension Saint Thomas Hickman
135 E Swan St, Centerville, TN · Ascension · · NPI 1245275254
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 |
|---|---|---|---|---|
| Ghs respiratory syncytical virus igg/m CPT 86756 | not published | not published | $14.30 – $49.66 | 15 |
| Ghs reticulocyte count CPT 85044 | not published | not published | $3.88 – $16.95 | 15 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | not published | not published | $12.52 – $46.28 | 15 |
| Ghs sedimentation rate CPT 85651 | not published | not published | $3.84 – $13.54 | 15 |
| Ghs semen analysis fert CPT 89320 | not published | not published | $11.08 – $46.28 | 15 |
| Ghs semen analysis, post-vas CPT 89300 | not published | not published | $8.86 – $35.01 | 15 |
| Ghs sensitivity (per antimicro) CPT 87184 | not published | not published | $6.73 – $27.07 | 15 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | not published | not published | $45.00 – $2,225.50 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | not published | not published | $45.00 – $2,225.50 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | not published | not published | $45.00 – $2,225.50 | 3 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Ghs sleep study unattended CPT 95800 | not published | not published | $209.28 – $261.60 | 6 |
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $193.90 – $242.37 | 6 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $481.66 – $602.07 | 6 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | not published | not published | $43.05 – $115.64 | 8 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $15.73 – $19.67 | 6 |
| Ghs sp train/fitting sp device - kx CPT 92609 | not published | not published | $90.18 – $242.77 | 8 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $25.37 – $31.72 | 6 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $45.00 – $2,225.50 | 9 |
| Ghs st - re-eval for alt comm CPT 92597 | not published | not published | $61.91 – $160.10 | 8 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | not published | not published | $87.00 – $87.00 | 1 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | not published | not published | $87.00 – $87.00 | 1 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $6.57 – $28.22 | 15 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $45.00 – $2,225.50 | 3 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $45.00 – $2,225.50 | 3 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $21.87 – $93.68 | 15 |
| Ghs urine, porphyrins quant CPT 84120 | not published | not published | $13.24 – $56.45 | 15 |
| Ghs vaginal delivery only CPT 59409 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $893.52 – $1,116.90 | 6 |
| Ghs windowing of cast CPT 29730 | not published | not published | $45.00 – $2,225.50 | 9 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $13.25 – $56.45 | 15 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $64.48 – $456.86 | 12 |
| Gi inhouse confirmation CPT 87045 | not published | not published | $8.50 – $36.12 | 15 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Gi protein loss CPT 78282 | not published | not published | $127.13 – $748.47 | 12 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $1,162.84 – $1,453.55 | 6 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $1,393.01 – $1,741.26 | 5 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $1,127.33 – $1,409.16 | 6 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $1,601.46 – $2,001.83 | 6 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $91.01 – $317.17 | 15 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $55.37 – $261.99 | 15 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $31.50 – $261.99 | 15 |
| Glaucoma surgery CPT 66150 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Glaucoma surgery CPT 66155 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Glaucoma surgery CPT 66160 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Glaucoma surgery CPT 66170 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Glucagon plasma - sendout CPT 82943 | not published | not published | $12.86 – $55.30 | 15 |
| Glucose 1 hr post dose CPT 82950 | not published | not published | $4.28 – $18.06 | 15 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $5.45 – $23.70 | 15 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $2.95 – $10.16 | 15 |
| Glucose blood quantitative CPT 82947 | not published | not published | $3.54 – $14.69 | 15 |
| Glucose body fluid CPT 82945 | not published | not published | $3.54 – $14.69 | 15 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $92.35 – $115.44 | 6 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | not published | not published | $11.58 – $49.66 | 15 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | not published | not published | $3.53 – $14.69 | 15 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | not published | not published | $16.72 – $72.24 | 15 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | not published | not published | $16.67 – $72.24 | 15 |
| Gonioscopy CPT 92020 | not published | not published | $47.91 – $59.89 | 6 |
| Goniotomy CPT 65820 | not published | not published | $954.50 – $1,004.50 | 3 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $1,468.50 – $1,543.50 | 3 |
| Graft repair of spine defect 63710 CPT 63710 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $45.00 – $2,225.50 | 3 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Grfg autol fat lipo ea addl CPT 15772 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Growth hormone antibody CPT 86277 | not published | not published | $14.17 – $60.97 | 15 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $44.90 – $237.02 | 15 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Gstrst open wo constj tube CPT 43830 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| G-tube reposition CPT 43761 | not published | not published | $954.50 – $1,004.50 | 3 |
| Gu dilat ureter/urethra s&i CPT 74485 | not published | not published | $75.38 – $2,834.48 | 12 |
| Guided cath fluid drainage 10030 CPT 10030 | not published | not published | $45.00 – $2,225.50 | 3 |
| Guid loc target vol rad tx CPT 77387 | not published | not published | $40.23 – $204.59 | 11 |
| Gum graft CPT 41870 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Gynecomastia (males) 19300 CPT 19300 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Hair removal by electrolysis 17380 CPT 17380 | not published | not published | $45.00 – $2,225.50 | 3 |
| Hair trnspl 1-15 punch grfts CPT 15775 | not published | not published | $1,468.50 – $1,543.50 | 3 |
| Hair trnspl >15 punch grafts CPT 15776 | not published | not published | $1,468.50 – $1,543.50 | 3 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | not published | not published | $5.19 – $7.00 | 3 |
| Hand tendon/muscle transfer CPT 26494 | not published | not published | $1,468.50 – $1,543.50 | 3 |
| Hand tendon reconstruction CPT 26500 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Hand tendon reconstruction CPT 26502 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Hand X-ray CPT 73130 | not published | not published | $26.03 – $127.70 | 12 |
| Haptoglobin quantitative CPT 83010 | not published | not published | $11.32 – $48.55 | 15 |
| Harvest allogeneic stem cell CPT 38205 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Harvest auto stem cells CPT 38206 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Harvest cultured skin graft 15040 CPT 15040 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Harvest eye tissue alograft CPT 68371 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Harvest femoropopliteal vein 35572 CPT 35572 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Harvest stem cell concentrte CPT 38215 | not published | not published | $954.50 – $1,004.50 | 3 |
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.