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 |
|---|---|---|---|---|
| Intracranial angioplasty CPT 61630 | $3,012.10 | $10,176.00 | $2,035.20 – $7,123.20 | 3 |
| Intracranial complete study CPT 93886 | $262.56 | $887.00 | $132.73 – $620.90 | 5 |
| Intracranial limited study CPT 93888 | $125.80 | $425.00 | $85.00 – $297.50 | 5 |
| Intraoral i+d tongue/floor lingual 41000 CPT 41000 | not published | not published | $50.35 – $50.35 | 1 |
| Intraventricular pacing CPT 93612 | $1,597.52 | $5,397.00 | $73.58 – $3,777.90 | 4 |
| Intrinsic factor antibody CPT 86340 | $111.00 | $375.00 | $13.39 – $262.50 | 10 |
| Intro cath dialysis circuit CPT 36901 | $612.13 | $2,068.00 | $413.60 – $1,447.60 | 2 |
| Intro cath dialysis circuit w/pta CPT 36902 | $4,370.44 | $14,765.00 | $2,953.00 – $10,335.50 | 2 |
| Intro cath dialysis circuit w/stent plcmnt CPT 36903 | $8,828.20 | $29,825.00 | $5,965.00 – $20,877.50 | 2 |
| Intro catheter aorta CPT 36200 | $434.53 | $1,468.00 | $293.60 – $5,206.00 | 4 |
| Intro cath svc/ivc CPT 36010 | $552.64 | $1,867.00 | $373.40 – $5,206.00 | 4 |
| Intro long gi tube CPT 44500 | $333.60 | $1,127.00 | $225.40 – $788.90 | 3 |
| Intro long gi tube w/mult fluo CPT 74340 | $127.88 | $432.00 | $86.40 – $302.40 | 4 |
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $2,388.43 | $8,069.00 | $1,613.80 – $5,648.30 | 3 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $1,194.36 | $4,035.00 | $807.00 – $5,206.00 | 3 |
| Intubation endotracheal emergency procedure CPT 31500 | $174.05 | $588.00 | $117.60 – $411.60 | 3 |
| Iodine i-123 sod iodide mil HCPCS A9509 | $2,725.87 | $9,209.00 | $150.00 – $525.00 | 6 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $14.80 | $50.00 | $0.12 – $17.50 | 9 |
| Ipilimumab 5 mg/ml intravenous solution (wrapper) HCPCS J9228 | $74,300.07 | $251,013.73 | $93.56 – $44,127.33 | 9 |
| Irinotecan 20 mg/ml intravenous solution (wrapper) HCPCS J9206 | $158.97 | $537.03 | $0.05 – $0.25 | 9 |
| Iron CPT 83540 | $15.40 | $52.00 | $5.75 – $36.40 | 10 |
| Iron binding capacity CPT 83550 | $95.91 | $324.00 | $7.77 – $226.80 | 10 |
| Iron dextran 50 mg/ml injection solution HCPCS J1750 | $56.64 | $191.35 | $8.48 – $122.57 | 9 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $93.53 | $315.95 | $0.23 – $129.71 | 9 |
| Irradiation of blood product each unit reference CPT 86945 | $85.55 | $289.00 | $32.28 – $202.30 | 6 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $90.58 | $306.00 | $32.09 – $214.20 | 4 |
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | $8,335.70 | $28,161.12 | $46.46 – $4,139.92 | 9 |
| Ivc venogram s&i CPT 75825 | $1,287.31 | $4,349.00 | $140.71 – $3,044.30 | 6 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $83.48 | $282.00 | $37.48 – $197.40 | 4 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $68.08 | $230.00 | $24.05 – $368.00 | 4 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $109.52 | $370.00 | $22.81 – $259.00 | 4 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $278.84 | $942.00 | $79.58 – $659.40 | 4 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $523.63 | $1,769.00 | $70.95 – $1,238.30 | 6 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | $12,739.53 | $43,038.92 | $49.94 – $10,220.05 | 9 |
| John cunningham antibody CPT 86711 | $66.31 | $224.00 | $12.78 – $156.80 | 10 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $17.47 | $59.00 | $7.26 – $41.30 | 10 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $20.60 | $69.59 | $0.72 – $39.33 | 9 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $454.66 | $1,536.00 | $188.57 – $1,075.20 | 6 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $253.38 | $856.00 | $82.88 – $599.20 | 6 |
| Knee MRI (with and without contrast) CPT 73723 | $2,014.88 | $6,807.00 | $315.33 – $4,764.90 | 10 |
| Knee MRI (with contrast) CPT 73722 | $1,445.08 | $4,882.00 | $278.75 – $3,417.40 | 10 |
| Knee MRI (without contrast) CPT 73721 | $825.84 | $2,790.00 | $186.96 – $2,459.00 | 10 |
| Knee X-ray CPT 73564 | $122.25 | $413.00 | $26.36 – $289.10 | 6 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $29.89 | $100.95 | $11.05 – $38.68 | 8 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $93.34 | $315.32 | $0.05 – $0.25 | 8 |
| Lactate dehydrogenase (ldh) CPT 83615 | $42.04 | $142.00 | $5.36 – $99.40 | 10 |
| Lactated ringers intravenous solution HCPCS J7120 | $4.67 | $15.76 | $1.58 – $7.89 | 9 |
| Lactic acid CPT 83605 | $23.09 | $78.00 | $9.49 – $54.60 | 10 |
| Lactoferrin fecal qualitative CPT 83630 | $37.89 | $128.00 | $13.45 – $89.60 | 10 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $1,162.10 | $3,926.00 | $785.20 – $2,748.20 | 2 |
| Laryngoscopy w/bx & op scope CPT 31536 | $3,358.12 | $11,345.00 | $2,269.00 – $7,941.50 | 2 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $62.42 – $62.42 | 1 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $0.30 | $1.00 | $0.20 – $1.00 | 9 |
| Lead capillary CPT 83655 | $41.44 | $140.00 | $10.00 – $98.00 | 10 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $0.30 | $1.00 | $0.20 – $1.00 | 9 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $360.53 | $1,218.00 | $132.73 – $852.60 | 5 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $45.76 | $154.58 | $4.54 – $47.96 | 9 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $900.28 | $3,041.46 | $166.01 – $732.11 | 9 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $29.51 | $99.69 | $0.05 – $0.18 | 8 |
| Levetiracetam therapeutic drug level CPT 80177 | $21.32 | $72.00 | $11.77 – $50.40 | 10 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $23.28 | $78.64 | $0.05 – $0.25 | 8 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $136.57 | $461.36 | $63.29 – $221.52 | 8 |
| Lidocaine injection HCPCS J2001 | $21.83 | $73.73 | $0.02 – $39.78 | 8 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $23.74 | $80.17 | $11.32 – $39.61 | 8 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $26.77 | $90.43 | $15.98 – $55.93 | 8 |
| Lidocaine therapeutic drug level CPT 80176 | $71.04 | $240.00 | $13.05 – $168.00 | 10 |
| Ligate/strip long leg vein CPT 37722 | $1,846.16 | $6,237.00 | $1,247.40 – $4,365.90 | 2 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $1,194.96 | $4,037.00 | $807.40 – $2,825.90 | 2 |
| Ligation/divis of long saph vein 37700 CPT 37700 | $3,234.99 | $10,929.00 | $2,185.80 – $7,650.30 | 2 |
| Lig/band angioaccess av fistula CPT 37607 | $2,425.13 | $8,193.00 | $1,638.60 – $5,735.10 | 2 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $43.47 | $146.84 | $4.73 – $56.82 | 9 |
| Lipase CPT 83690 | $124.62 | $421.00 | $6.13 – $294.70 | 10 |
| Lipoprotein blood quant CPT 83704 | $61.87 | $209.00 | $28.02 – $146.30 | 10 |
| Lipoprotein direct measurement hdl CPT 83718 | $11.84 | $40.00 | $7.27 – $28.00 | 10 |
| Lipoprotein direct measurement ldl CPT 83721 | $18.36 | $62.00 | $8.48 – $43.40 | 10 |
| Lithium therapeutic drug level CPT 80178 | $59.20 | $200.00 | $5.87 – $140.00 | 10 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $5,621.64 | $18,992.00 | $750.00 – $3,323.60 | 4 |
| Litt icr 1 traj 1 smpl les CPT 61736 | $997.52 | $3,370.00 | $674.00 – $2,359.00 | 2 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | $1,186.96 | $4,010.00 | $802.00 – $2,807.00 | 2 |
| Liver Function Test CPT 80076 | $150.08 | $507.00 | $7.25 – $354.90 | 10 |
| Liver imaging CPT 78201 | $324.42 | $1,096.00 | $99.40 – $767.20 | 6 |
| Liver/spleen imag static only CPT 78215 | $510.31 | $1,724.00 | $123.69 – $1,206.80 | 6 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $479.52 | $1,620.00 | $146.70 – $1,134.00 | 6 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $31.03 | $104.82 | $1.07 – $39.93 | 9 |
| Low cost skin substitute app HCPCS C5271 | $606.80 | $2,050.00 | $410.00 – $1,435.00 | 2 |
| Low cost skin substitute app HCPCS C5273 | $1,981.72 | $6,695.00 | $1,339.00 – $4,686.50 | 2 |
| Low cost skin substitute app HCPCS C5275 | $606.80 | $2,050.00 | $410.00 – $1,435.00 | 2 |
| Low cost skin substitute app HCPCS C5277 | $606.80 | $2,050.00 | $410.00 – $1,435.00 | 2 |
| Low cost skin substitute app HCPCS C5272 | $464.72 | $1,570.00 | $211.80 – $741.30 | 2 |
| Low cost skin substitute app HCPCS C5274 | $1,022.39 | $3,454.00 | $690.80 – $2,417.80 | 2 |
| Low cost skin substitute app HCPCS C5276 | $313.47 | $1,059.00 | $211.80 – $741.30 | 2 |
| Low cost skin substitute app HCPCS C5278 | $313.47 | $1,059.00 | $211.80 – $741.30 | 2 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,256.23 | $4,244.00 | $176.05 – $2,970.80 | 10 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $1,158.84 | $3,915.00 | $157.26 – $2,740.50 | 10 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $884.75 | $2,989.00 | $78.34 – $2,092.30 | 10 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,177.08 | $7,355.00 | $315.33 – $5,148.50 | 10 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,565.25 | $5,288.00 | $278.75 – $3,701.60 | 10 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,422.88 | $4,807.00 | $186.96 – $2,884.20 | 10 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $248.35 | $839.00 | $28.47 – $587.30 | 6 |
| Lumbar diskogram s&i CPT 72295 | $629.60 | $2,127.00 | $89.78 – $2,175.45 | 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.