HORIZON MEDICAL CENTER
107 NATCHEZ PARK DR, DICKSON, TN · Tristarhealth · · NPI 1871530832
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 |
|---|---|---|---|---|
| Urinalysis microscopic only CPT 81015 | not published | not published | $1.37 – $9.15 | 22 |
| Urinalysis qual/semiquant excpt ia CPT 81005 | not published | not published | $0.98 – $6.51 | 22 |
| Urinalysis (with microscopy) CPT 81001 | $337.41 | $337.41 | $1.43 – $9.51 | 22 |
| Urinalysis (without microscopy) CPT 81003 | not published | not published | $1.01 – $6.75 | 22 |
| Urinary bldr retent nuc study CPT 78730 | not published | not published | $29.40 – $187.31 | 4 |
| Urinary pouch on barr w/flng HCPCS A5073 | not published | not published | $3.87 – $6.32 | 19 |
| Urinary pouch w/barrier HCPCS A5071 | not published | not published | $7.71 – $12.60 | 19 |
| Urinary suspensory HCPCS A5105 | not published | not published | $52.30 – $85.42 | 19 |
| Urine Culture Test CPT 87086 | $756.58 | $756.58 | $3.63 – $24.21 | 22 |
| Urine ost pouch w faucet/tap HCPCS A4428 | not published | not published | $8.36 – $13.66 | 19 |
| Urine pregnancy test CPT 81025 | not published | not published | $3.87 – $25.83 | 22 |
| Urine screen for bacteria CPT 81007 | not published | not published | $3.50 – $89.94 | 22 |
| Urine specimen collect mult HCPCS P9615 | not published | not published | $2.39 – $28.02 | 21 |
| Urofollitropin, 75 iu HCPCS J3355 | not published | not published | $78.66 – $78.66 | 1 |
| Urography, antegrade CPT 74425 | not published | not published | $46.42 – $349.42 | 5 |
| Urography inf drip &/or bolus CPT 74410 | not published | not published | $78.05 – $370.32 | 5 |
| Urokinase 250,000 iu inj HCPCS J3365 | not published | not published | $567.59 – $567.59 | 1 |
| Urokinase 5000 iu injection HCPCS J3364 | not published | not published | $11.36 – $11.36 | 1 |
| Use 1st target lesion CPT 76982 | not published | not published | $59.38 – $205.42 | 5 |
| User adjustable heel height HCPCS L5990 | not published | not published | $2,021.44 – $3,301.68 | 19 |
| Ustekinumab 130 mg/26 ml intravenous solution HCPCS J3358 | not published | not published | $15.66 – $33.10 | 3 |
| Ustekinumab 45 mg/0.5 ml subcutaneous solution HCPCS J3357 | not published | not published | $196.12 – $1,080.43 | 3 |
| Vaccine covid-19 moderna >=12yrs 50mcg/0.5ml CPT 91322 | not published | not published | $171.52 – $428.37 | 3 |
| Vaccine covid-19 moderna 6mos-11yrs 25mcg/0.25ml CPT 91321 | not published | not published | $156.04 – $389.71 | 3 |
| Vaccine covid-19 pfizer tris-sucrose >=12yrs 30mcg/0.3ml im CPT 91320 | not published | not published | $159.71 – $446.18 | 3 |
| Vaccine covid-19 pfizer tris-sucrose 5yrs-11yrs 10mcg/0.3ml im CPT 91319 | not published | not published | $93.14 – $251.22 | 3 |
| Vaccine covid-19 pfizer tris-sucrose 6mos-4yrs 3mcg/0.3ml im CPT 91318 | not published | not published | $69.55 – $173.50 | 3 |
| Vaccine dtap < 7 years im CPT 90700 | $182.36 | $182.36 | $36.31 – $98.16 | 3 |
| Vaccine dtap-hep b-ipv im CPT 90723 | not published | not published | $136.07 – $351.66 | 2 |
| Vaccine dtap-ipv 4-6 years im CPT 90696 | not published | not published | $77.51 – $208.53 | 3 |
| Vaccine dtap-ipv-hib-hepb im CPT 90697 | not published | not published | $209.50 – $529.81 | 2 |
| Vaccine dtap-ipv/hib im CPT 90698 | not published | not published | $144.47 – $374.37 | 3 |
| Vaccine haemophilus influenzae type b (hib) prp-omp 3 dose im CPT 90647 | not published | not published | $36.83 – $99.69 | 3 |
| Vaccine haemophilus influenzae type b (hib) prp-t 4 dose im CPT 90648 | $61.62 | $61.62 | $15.78 – $43.25 | 3 |
| Vaccine hepatitis a (hepa) adult im CPT 90632 | not published | not published | $104.05 – $194.88 | 3 |
| Vaccine hepatitis a (hepa) hepatitis b (hepb) adult im CPT 90636 | not published | not published | $159.89 – $449.49 | 3 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 2 dose im CPT 90633 | not published | not published | $47.17 – $113.98 | 3 |
| Vaccine hepatitis a (hepa) pediatric/adolescent 3 dose im CPT 90634 | not published | not published | $83.21 – $83.21 | 1 |
| Vaccine hepatitis b (hepb) adolescent 2 dose im CPT 90743 | not published | not published | $83.08 – $199.15 | 3 |
| Vaccine hepatitis b (hepb) adult 3 dose im CPT 90746 | not published | not published | $87.23 – $199.15 | 3 |
| Vaccine hepatitis b (hepb) adult dosage 2 dose schedule im CPT 90739 | not published | not published | $188.40 – $470.53 | 3 |
| Vaccine hepatitis b (hepb) pediatric/adolescent 3 dose im CPT 90744 | $175.22 | $175.22 | $35.23 – $87.98 | 3 |
| 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 | $399.33 – $1,046.11 | 2 |
| Vaccine hpv types 6/11/16/18 quadrivalent (4vhpv) 3 dose im CPT 90649 | not published | not published | $222.44 – $300.06 | 2 |
| Vaccine influenza (iiv) preservative free antigen content im CPT 90662 | $82.29 | $82.29 | $88.60 – $260.12 | 3 |
| Vaccine influenza inactivated adjuvant im CPT 90653 | not published | not published | $72.69 – $260.12 | 3 |
| Vaccine influenza nos 0.5ml dose im CPT 90658 | not published | not published | $22.38 – $58.49 | 2 |
| Vaccine influenza preservative free trivalent (iiv3) 0.5ml dose im CPT 90656 | $33.39 | $33.39 | $24.26 – $61.53 | 3 |
| Vaccine influenza quadrivalent (iiv4) 0.5ml dose im CPT 90688 | not published | not published | $25.61 – $25.61 | 1 |
| Vaccine influenza quadrivalent (iiv4) inactivated adjuvanted preservative free 0.5ml dose im CPT 90694 | not published | not published | $94.42 – $94.42 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.25ml dose im CPT 90685 | not published | not published | $26.53 – $26.53 | 1 |
| Vaccine influenza quadrivalent (iiv4) preservative free 0.5ml dose im CPT 90686 | $110.86 | $110.86 | $27.40 – $27.40 | 1 |
| Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im CPT 90687 | not published | not published | $12.81 – $12.81 | 1 |
| Vaccine influenza quadrivalent live (laiv4) intranasal CPT 90672 | not published | not published | $34.03 – $34.03 | 1 |
| Vaccine influenza quadrivalent (riv4) rdna antibiotic/preservative free im CPT 90682 | not published | not published | $89.59 – $89.59 | 1 |
| Vaccine influenza trivalent (cciiv3) cell cultures subunit antibiotic free 0.5 ml im CPT 90661 | not published | not published | $27.33 – $131.18 | 3 |
| Vaccine influenza trivalent (iiv3) 0.25ml dose im CPT 90657 | not published | not published | $7.43 – $29.23 | 2 |
| Vaccine mengingoccocal serogroup b 2 dose im CPT 90620 | not published | not published | $310.75 – $798.76 | 2 |
| Vaccine mengingoccocal serogroup b 2 or 3 dose im CPT 90621 | $407.20 | $407.20 | $264.23 – $717.99 | 2 |
| Vaccine menigococcal serogroups a/c/w/y quadrivalent tetanus toxoid(menacwy-tt) im CPT 90619 | $353.69 | $353.69 | $231.91 – $562.81 | 2 |
| Vaccine meningococcal serogroups a/c/w/y quadrivalent diphtheria toxoid(menacwy-d/menacwy-crm) im CPT 90734 | not published | not published | $218.52 – $561.54 | 2 |
| Vaccine mmr live subcutaneous CPT 90707 | $384.64 | $384.64 | $86.59 – $310.42 | 3 |
| Vaccine mmrv live subcutaneous CPT 90710 | not published | not published | $209.98 – $917.96 | 3 |
| Vaccine pneumococcal 23 valent (ppsv23) subcutaneous/im CPT 90732 | $310.71 | $310.71 | $32.48 – $353.70 | 3 |
| Vaccine pneumococcal conjugate 13 valent (pcv13) im CPT 90670 | not published | not published | $314.47 – $683.30 | 2 |
| Vaccine pneumonococcal conjugate 15 valent (pcv15) im CPT 90671 | $466.99 | $466.99 | $285.74 – $713.67 | 3 |
| Vaccine pneumonococcal conjugate 20 valent (pcv20) im CPT 90677 | not published | not published | $342.42 – $829.19 | 3 |
| Vaccine polio (ipv) subcutaneous/im CPT 90713 | not published | not published | $53.96 – $151.63 | 3 |
| Vaccine rabies im CPT 90675 | $1,056.52 | $1,056.52 | $545.72 – $847.34 | 3 |
| Vaccine respiratory syncytial virus bivalent subunit/preservative free im CPT 90678 | not published | not published | $409.69 – $1,014.63 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 0.5 ml im CPT 90380 | $1,010.39 | $1,010.39 | $721.83 – $1,892.29 | 2 |
| Vaccine respiratory syncytial virus monoclonal antibody seasonal dose 1 ml im CPT 90381 | not published | not published | $721.83 – $1,892.29 | 2 |
| Vaccine respiratory syncytial virus recombinant subunit adjuvanted/preservative free im CPT 90679 | not published | not published | $388.87 – $974.19 | 2 |
| Vaccine rotavirus attenuated (rv1) live 2 dose oral CPT 90681 | not published | not published | $192.68 – $495.05 | 2 |
| Vaccine rotavirus pentavalent (rv5) live 3 dose oral CPT 90680 | not published | not published | $133.28 – $326.32 | 2 |
| Vaccine tdap >=7 years im CPT 90715 | $298.93 | $298.93 | $59.06 – $105.18 | 3 |
| Vaccine td preservative free >= 7 years im CPT 90714 | $175.51 | $175.51 | $38.62 – $103.27 | 3 |
| Vaccine typhoid vicps im CPT 90691 | not published | not published | $177.29 – $440.93 | 3 |
| Vaccine varicella live subcutaneous CPT 90716 | $489.62 | $489.62 | $123.39 – $610.53 | 3 |
| Vaccine yellow fever live subcutaneous CPT 90717 | not published | not published | $82.96 – $815.14 | 3 |
| Vaccinia vrs vac 0.3 ml perq CPT 90622 | not published | not published | $0.01 – $0.03 | 2 |
| Vacuum drain bottle/tube kit HCPCS A7048 | not published | not published | $54.57 – $89.13 | 19 |
| Vad battery clip set hmii 14-v li-ion HCPCS Q0497 | not published | not published | $521.59 – $851.92 | 19 |
| Vad cable power module dc input HCPCS Q0478 | not published | not published | $204.75 – $334.43 | 19 |
| Vad univ batt charger hm 1440 HCPCS Q0495 | not published | not published | $4,654.24 – $7,601.93 | 19 |
| Vag inser rectal control sys HCPCS A4563 | not published | not published | $1,520.76 – $2,483.90 | 19 |
| Valproate in ns IV syringe 10 mg/ml (pediatric) - cnr HCPCS J3379 | $171.12 | $171.12 | $0.13 – $0.13 | 1 |
| Valproic acid total therapeutic drug level CPT 80164 | $1,138.61 | $1,138.61 | $6.09 – $40.62 | 22 |
| Valrubicin injection HCPCS J9357 | not published | not published | $1,766.16 – $3,453.85 | 3 |
| Vancomycin 1,000 mg intravenous injection HCPCS J3373 | not published | not published | $0.04 – $0.08 | 2 |
| Vancomycin 750 mg intravenous solution HCPCS J3374 | not published | not published | $0.14 – $0.27 | 2 |
| Vancomycin hcl injection HCPCS J3370 | not published | not published | $2.48 – $2.48 | 1 |
| Vancomycin peak therapeutic drug level CPT 80202 | not published | not published | $6.09 – $40.62 | 22 |
| Vanomycin dna amp probe CPT 87500 | not published | not published | $15.79 – $105.27 | 22 |
| Vantas implant HCPCS J9225 | not published | not published | $6,164.46 – $12,480.25 | 2 |
| Variable concentration mask HCPCS A4620 | not published | not published | $0.82 – $1.34 | 19 |
| Varicella zoster antibody igg CPT 86787 | not published | not published | $5.80 – $38.64 | 22 |
| Varicella-zoster immue globin im CPT 90396 | not published | not published | $3,031.16 – $6,262.98 | 2 |
| Varus/valgus strap padded/li HCPCS L2270 | not published | not published | $55.54 – $90.71 | 19 |
| Vasopressin 20 unit/ml intravenous solution HCPCS J2598 | $593.92 | $593.92 | $1.40 – $2.39 | 2 |
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.