CHI Memorial Hospital Hixson
2051 Hamill Road, Hixson, TN · CommonSpirit Health · · NPI 1083778633
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 inf midline insertion CPT 36140 | $693.24 | $2,342.00 | $468.40 – $5,206.00 | 4 |
| Ghs inhibitor screen CPT 85335 | $112.19 | $379.00 | $7.14 – $265.30 | 10 |
| Ghs inj neurolytic other perph nerve CPT 64640 | not published | not published | $102.69 – $102.69 | 1 |
| Ghs inj transforaminal cerv ea add bil CPT 64480 | $700.64 | $2,367.00 | $315.80 – $1,105.30 | 3 |
| Ghs inj transforaminal cerv single bil CPT 64479 | $1,406.60 | $4,752.00 | $638.20 – $2,233.70 | 2 |
| Ghs insertion of needle - bone CPT 36680 | $427.13 | $1,443.00 | $288.60 – $1,010.10 | 3 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $375.33 | $1,268.00 | $253.60 – $824.20 | 2 |
| Ghs intro needle/intracath vein - 36000 CPT 36000 | not published | not published | $42.18 – $42.18 | 1 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $359.94 | $1,216.00 | $243.00 – $850.50 | 3 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $95.91 | $324.00 | $64.80 – $226.80 | 4 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | not published | not published | $78.54 – $78.54 | 1 |
| Ghs layer closure 2.5cm or less - 12051 CPT 12051 | not published | not published | $84.58 – $84.58 | 1 |
| Ghs layer closure 7.6 - 12.5 cm - 12034 CPT 12034 | $246.57 | $833.00 | $166.60 – $541.45 | 2 |
| Ghs leukocyte alkaline phos (mayo) CPT 85540 | $31.38 | $106.00 | $7.60 – $74.20 | 10 |
| Ghs mbp CPT 83873 | $30.20 | $102.00 | $15.28 – $71.40 | 10 |
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $8.00 | $27.00 | $5.40 – $18.90 | 2 |
| Ghs musc test done w/n test comp CPT 95886 | $992.49 | $3,353.00 | $46.60 – $2,347.10 | 4 |
| Ghs musc tst done w/nerv tst lim CPT 95885 | $357.28 | $1,207.00 | $44.23 – $844.90 | 4 |
| Ghs musc tst done w/n tst non ext CPT 95887 | $59.80 | $202.00 | $40.40 – $757.00 | 4 |
| Ghs myocardial strain img spckl track CPT 93356 | $19.84 | $67.00 | $13.40 – $989.00 | 4 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | not published | not published | $72.50 – $72.50 | 1 |
| Ghs nerve blk intercostal, single level CPT 64420 | not published | not published | $52.36 – $52.36 | 1 |
| Ghs nerve block brachial plexus CPT 64415 | $964.96 | $3,260.00 | $652.00 – $2,282.00 | 2 |
| Ghs nerve block celiac plexus CPT 64530 | $648.84 | $2,192.00 | $438.40 – $1,534.40 | 2 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $872.91 | $2,949.00 | $589.80 – $2,064.30 | 2 |
| Ghs ng placement w fluoro guidance CPT 43752 | $376.52 | $1,272.00 | $254.40 – $890.40 | 3 |
| Ghs o2 saturation CPT 82810 | $12.14 | $41.00 | $7.76 – $28.70 | 10 |
| Ghs opcc repair cvp without subq port CPT 36575 | $436.31 | $1,474.00 | $294.80 – $1,031.80 | 2 |
| Ghs ot prosthetic training/15 min CPT 97761 | $58.61 | $198.00 | $34.83 – $189.52 | 6 |
| Ghs ot work hardening-additional hours CPT 97546 | $121.66 | $411.00 | $70.00 – $287.70 | 6 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $217.86 | $736.00 | $147.20 – $515.20 | 3 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $234.44 | $792.00 | $158.40 – $554.40 | 3 |
| Ghs peritonsillar abscess i andd CPT 42700 | $236.80 | $800.00 | $160.00 – $560.00 | 2 |
| Ghs ppd (tb intradermal) CPT 86580 | $15.40 | $52.00 | $8.13 – $36.40 | 6 |
| Ghs prostatic acid phosphatase (mayo) CPT 84066 | $20.72 | $70.00 | $8.58 – $49.00 | 10 |
| Ghs protoporphyrins fract CPT 84202 | $23.98 | $81.00 | $12.74 – $56.70 | 10 |
| Ghs pr without cont pulse ox CPT 94625 | $68.38 | $231.00 | $46.20 – $419.00 | 3 |
| Ghs pt - work hardening/int 2hrs CPT 97545 | $303.70 | $1,026.00 | $70.00 – $718.20 | 6 |
| Ghs quinidine CPT 80194 | $91.17 | $308.00 | $12.97 – $215.60 | 10 |
| Ghs refill of implantable pump CPT 95990 | $378.00 | $1,277.00 | $65.38 – $3,642.00 | 4 |
| Ghs removal intranasal foreign body CPT 30300 | not published | not published | $36.24 – $36.24 | 1 |
| Ghs respiratory syncytical virus igg/m CPT 86756 | $19.24 | $65.00 | $11.45 – $45.50 | 10 |
| Ghs rsv eia (respir synctial vrs) CPT 87420 | $16.28 | $55.00 | $10.65 – $38.50 | 10 |
| Ghs sedimentation rate CPT 85651 | $42.92 | $145.00 | $3.14 – $101.50 | 10 |
| Ghs sensitivity (per antimicro) CPT 87184 | $15.40 | $52.00 | $6.13 – $36.40 | 10 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $248.64 | $840.00 | $168.00 – $588.00 | 3 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $199.51 | $674.00 | $134.80 – $471.80 | 3 |
| Ghs sleep study unattended CPT 95800 | $170.20 | $575.00 | $115.00 – $402.50 | 4 |
| Ghs st - re-eval for alt comm CPT 92597 | $79.92 | $270.00 | $50.81 – $189.52 | 6 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $606.80 | $2,050.00 | $92.63 – $876.85 | 3 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $60.41 – $60.41 | 1 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $714.25 | $2,413.00 | $482.60 – $1,568.45 | 2 |
| Ghs urine, porphyrins quant CPT 84120 | $27.83 | $94.00 | $13.07 – $65.80 | 10 |
| Ghs windowing of cast CPT 29730 | not published | not published | $54.43 – $54.43 | 1 |
| Gi inhouse confirmation CPT 87045 | $24.57 | $83.00 | $8.39 – $58.10 | 10 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $129.24 | $436.60 | $64.80 – $305.58 | 9 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $261.33 | $882.85 | $105.93 – $370.75 | 8 |
| Glucagon plasma - sendout CPT 82943 | $18.65 | $63.00 | $12.69 – $44.10 | 10 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $23.68 | $80.00 | $2.08 – $56.00 | 10 |
| Glucose blood quantitative CPT 82947 | $10.07 | $34.00 | $3.49 – $23.80 | 10 |
| Glucose body fluid CPT 82945 | $59.80 | $202.00 | $3.49 – $141.40 | 10 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $17.17 | $58.00 | $11.44 – $40.60 | 10 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $21.32 | $72.00 | $3.49 – $50.40 | 10 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $4,236.56 | $14,312.70 | $11.59 – $10,018.89 | 9 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $106.27 | $359.00 | $16.51 – $251.30 | 10 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $34.04 | $115.00 | $16.45 – $80.50 | 10 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $4,665.26 | $15,761.01 | $161.01 – $4,106.41 | 9 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $23.68 | $80.00 | $16.00 – $80.00 | 10 |
| Graft axiofill 1000mg HCPCS J3590 | $2,017.20 | $6,814.85 | $587.48 – $2,056.18 | 8 |
| Graft patch felt ptfe 2x2 HCPCS C1768 | $3,705.04 | $12,517.00 | $2,324.80 – $11,624.00 | 9 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $131.43 | $444.00 | $57.00 – $285.00 | 9 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $330.93 | $1,118.00 | $61.80 – $309.00 | 10 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $150.96 | $510.00 | $25.44 – $65.10 | 9 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $220.23 | $744.00 | $62.40 – $312.00 | 10 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $128.47 | $434.00 | $61.20 – $306.00 | 9 |
| Granisetron 1 mg tab HCPCS Q0166 | $6.26 | $21.13 | $0.24 – $1.18 | 8 |
| Granisetron hcl injection HCPCS J1626 | $20.63 | $69.67 | $0.43 – $44.89 | 9 |
| Ground mileage HCPCS A0425 | $10.07 | $34.00 | $2.84 – $468.00 | 9 |
| G-tube reposition CPT 43761 | $352.24 | $1,190.00 | $238.00 – $833.00 | 2 |
| Gu dilat ureter/urethra s&i CPT 74485 | $381.25 | $1,288.00 | $112.43 – $901.60 | 6 |
| Guided cath fluid drainage 10030 CPT 10030 | $418.55 | $1,414.00 | $282.80 – $989.80 | 3 |
| Guide wire threaded 1.4x150mm HCPCS C1769 | $479.52 | $1,620.00 | $0.20 – $0.70 | 2 |
| Guide worley csg 9fx50cm std HCPCS C1892 | $72.52 | $245.00 | $0.20 – $0.70 | 2 |
| Guid loc target vol rad tx CPT 77387 | $137.64 | $465.00 | $41.23 – $800.00 | 5 |
| Gw stiffened micro access kit HCPCS C1894 | $2,040.92 | $6,895.00 | $0.20 – $0.70 | 2 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $30.46 | $102.89 | $8.79 – $58.47 | 9 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $22.68 | $76.59 | $1.82 – $39.33 | 9 |
| Hand X-ray CPT 73130 | $212.53 | $718.00 | $22.82 – $502.60 | 6 |
| Haptoglobin quantitative CPT 83010 | $26.05 | $88.00 | $4.69 – $61.60 | 10 |
| Hbb full gene sequence CPT 81364 | $384.80 | $1,300.00 | $211.87 – $910.00 | 10 |
| Hbot, full body chamber, 30m HCPCS G0277 | $257.82 | $871.00 | $54.61 – $1,172.00 | 6 |
| Hcg qualitative CPT 84703 | $140.31 | $474.00 | $6.68 – $331.80 | 10 |
| Hcg quantitative CPT 84702 | $65.42 | $221.00 | $8.07 – $154.70 | 10 |
| Hc i-131 sodium iodide cap dx per mci HCPCS A9528 | $64.83 | $219.00 | $43.80 – $153.30 | 6 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | $693.24 | $2,342.00 | $220.61 – $1,639.40 | 6 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | $1,044.29 | $3,528.00 | $705.60 – $2,469.60 | 7 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | $651.80 | $2,202.00 | $240.78 – $1,541.40 | 6 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | $762.80 | $2,577.00 | $438.56 – $1,803.90 | 6 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | $847.45 | $2,863.00 | $454.45 – $2,004.10 | 6 |
| Hdr rdncl skn surf brachytx CPT 77767 | $198.62 | $671.00 | $126.86 – $469.70 | 6 |
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.