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 |
|---|---|---|---|---|
| Unlstd hematop ret/endo lymp CPT 78199 | not published | not published | $589.01 – $938.21 | 4 |
| Unlstd laps px mat care&dlvr CPT 59898 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Unlstd laps px sprmatic cord CPT 55559 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Upgrade pm system CPT 33214 | not published | not published | $6,190.50 – $6,935.50 | 3 |
| Upper Back (Thoracic Spine) MRI (with and without contrast) CPT 72157 | not published | not published | $297.82 – $991.82 | 12 |
| Upper Back (Thoracic Spine) MRI (with contrast) CPT 72147 | not published | not published | $257.96 – $873.31 | 12 |
| Upper Back (Thoracic Spine) MRI (without contrast) CPT 72146 | not published | not published | $179.77 – $560.44 | 12 |
| Upper Endoscopy (EGD, diagnostic) CPT 43235 | not published | not published | $954.50 – $1,004.50 | 3 |
| Upper Endoscopy (EGD, with biopsy) CPT 43239 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Upper ext harvest for cabg1 seg 35600 CPT 35600 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Uppr gi scope w/submuc inj CPT 43236 | not published | not published | $1,185.00 – $1,246.50 | 3 |
| Urachal cyst/sinus excision 51500 CPT 51500 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Urea nitrogen CPT 84520 | not published | not published | $3.56 – $15.80 | 15 |
| Urea nitrogen 24 hour urine CPT 84540 | not published | not published | $5.00 – $18.06 | 15 |
| Urea nitrogen clearance CPT 84545 | not published | not published | $6.48 – $25.96 | 15 |
| Ureteral embolization/occl CPT 50705 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Ureteral reflux study CPT 78740 | not published | not published | $207.54 – $589.01 | 12 |
| Ureter endoscopy CPT 50970 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureter endoscopy & biopsy CPT 50955 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureter endoscopy & biopsy CPT 50974 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureter endoscopy & catheter CPT 50972 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureter endoscopy & treatment CPT 50957 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureter endoscopy & treatment CPT 50961 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureter endoscopy & treatment CPT 50976 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureter endoscopy & treatment CPT 50980 | not published | not published | $954.50 – $1,004.50 | 3 |
| Ureteroneocystostomy 50780 CPT 50780 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Ureteroureterostomy 50760 CPT 50760 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Urethrcystgrphy rtrgrde s&i CPT 74450 | not published | not published | $62.34 – $456.86 | 12 |
| Urethrlys transvag with scope CPT 53500 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Urethrocystography void s&i CPT 74455 | not published | not published | $72.72 – $372.86 | 12 |
| Uric acid blood CPT 84550 | not published | not published | $4.07 – $18.06 | 15 |
| Uric acid urine CPT 84560 | not published | not published | $4.57 – $18.06 | 15 |
| Urinalysis microscopic only CPT 81015 | not published | not published | $2.75 – $11.28 | 15 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $1.95 – $7.90 | 15 |
| Urinalysis (with microscopy) CPT 81001 | not published | not published | $2.85 – $12.42 | 15 |
| Urinalysis (without microscopy) CPT 81003 | not published | not published | $2.03 – $9.01 | 15 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $73.48 – $192.70 | 11 |
| Urinary reflex study CPT 51792 | not published | not published | $45.00 – $2,225.50 | 3 |
| Urine Culture Test CPT 87086 | not published | not published | $7.26 – $31.60 | 15 |
| Urine flow measurement 51736 CPT 51736 | not published | not published | $45.00 – $2,225.50 | 3 |
| Urine pregnancy test CPT 81025 | not published | not published | $7.75 – $27.07 | 15 |
| Urography, antegrade CPT 74425 | not published | not published | $55.90 – $610.96 | 12 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $93.98 – $291.55 | 12 |
| Use 1st target lesion CPT 76982 | not published | not published | $71.50 – $179.33 | 12 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $178.02 – $244.58 | 5 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $178.02 – $222.50 | 5 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $159.94 – $235.87 | 5 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $107.09 – $132.81 | 5 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $79.97 – $99.18 | 5 |
| Vaccine dtap < 7 years im CPT 90700 | not published | not published | $42.11 – $49.68 | 5 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $138.85 – $168.98 | 5 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $105.35 – $180.21 | 5 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $270.13 – $439.49 | 5 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $160.64 – $207.08 | 5 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $43.31 – $52.75 | 5 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | not published | not published | $18.64 – $20.79 | 5 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $85.88 – $140.26 | 5 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $157.78 – $217.66 | 5 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $50.81 – $65.56 | 5 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $36.55 – $36.55 | 2 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $66.56 – $118.69 | 6 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $65.04 – $118.69 | 6 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $94.61 – $254.64 | 6 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | not published | not published | $25.48 – $48.14 | 6 |
| Vaccine hpv types 6/11/16/18/31/33/45/52/58 nonvalent (9vhpv) 2 or 3 dose im CPT 90651 | not published | not published | $420.77 – $530.56 | 5 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $131.98 – $276.26 | 5 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | not published | not published | $50.56 – $126.53 | 6 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $51.80 – $127.99 | 5 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $16.25 – $33.29 | 5 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | not published | not published | $15.84 – $35.26 | 6 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $17.59 – $31.80 | 6 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $94.38 – $117.26 | 5 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $20.66 – $45.43 | 5 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | not published | not published | $18.92 – $34.03 | 6 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $8.76 – $15.91 | 6 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $25.46 – $42.26 | 6 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $50.56 – $111.27 | 6 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $19.58 – $55.96 | 4 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $5.71 – $16.65 | 6 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $303.96 – $385.92 | 5 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | not published | not published | $278.36 – $328.16 | 5 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | not published | not published | $244.28 – $296.62 | 5 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $221.78 – $271.39 | 5 |
| Vaccine mmr live subcutaneous CPT 90707 | not published | not published | $134.86 – $159.53 | 5 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $161.88 – $479.77 | 5 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | not published | not published | $109.24 – $201.94 | 6 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $207.19 – $390.54 | 6 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | not published | not published | $309.34 – $395.32 | 5 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $363.61 – $451.14 | 5 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $62.24 – $77.15 | 5 |
| Vaccine rabies im CPT 90675 | not published | not published | $412.96 – $713.91 | 10 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $431.88 – $508.82 | 5 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | not published | not published | $896.46 – $1,521.83 | 5 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $760.91 – $896.46 | 5 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $409.92 – $507.09 | 5 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $135.29 – $239.30 | 5 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $140.30 – $170.45 | 5 |
| Vaccine tdap >=7 years im CPT 90715 | not published | not published | $46.71 – $81.74 | 5 |
| Vaccine td preservative free >= 7 years im CPT 90714 | not published | not published | $33.94 – $69.53 | 5 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $138.57 – $252.81 | 5 |
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.