Fort Loudoun Medical Center
550 Fort Loudoun Medical Center Dr, Lenoir City, TN · Fsregional · · NPI 1609860659
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 |
|---|---|---|---|---|
| Diabetic shoe with wedge HCPCS A5504 | not published | not published | $45.79 – $48.08 | 12 |
| Diabetic shoe w/off set heel HCPCS A5506 | not published | not published | $45.79 – $48.08 | 12 |
| Diabetic shoe w/roller/rockr HCPCS A5503 | not published | not published | $45.79 – $48.08 | 12 |
| Diab manage trn ind/group HCPCS G0109 | not published | not published | $7.36 – $17.66 | 2 |
| Diab shoe for density insert HCPCS A5500 | not published | not published | $90.63 – $95.16 | 12 |
| Diab shoe w/metatarsal bar HCPCS A5505 | not published | not published | $45.79 – $48.08 | 12 |
| Diag bronchoscope/catheter CPT 31643 | not published | not published | $1,614.86 – $1,695.60 | 12 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $5,484.95 – $5,759.20 | 12 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $405.30 – $425.57 | 12 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $1,085.68 – $1,139.96 | 12 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $120.71 – $126.75 | 12 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $56.73 – $164.17 | 4 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $44.35 – $163.00 | 4 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $181.10 – $190.16 | 12 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $181.10 – $190.16 | 12 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $114.84 | $348.00 | $56.73 – $495.83 | 17 |
| Diagnostic Mammogram (one breast) CPT 77065 | $89.43 | $271.00 | $44.35 – $392.60 | 5 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $27.91 – $216.00 | 13 |
| Dialysis one evaluation CPT 90945 | not published | not published | $125.00 – $397.50 | 14 |
| Dialysis repeated eval CPT 90947 | not published | not published | $268.00 – $389.07 | 2 |
| Dialysis training complete CPT 90989 | not published | not published | $125.00 – $125.00 | 1 |
| Dialysis training incompl CPT 90993 | not published | not published | $125.00 – $125.00 | 1 |
| Diathermy eg microwave CPT 97024 | not published | not published | $7.88 – $161.00 | 5 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $127.83 | $387.35 | $0.07 – $189.21 | 17 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $64.52 | $195.50 | $7.02 – $30.09 | 17 |
| Dicyclomine injection HCPCS J0500 | $47.15 | $142.88 | $10.58 – $128.59 | 17 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.14 – $0.27 | 4 |
| Diffusing capacity CPT 94729 | $84.81 | $257.00 | $50.50 – $268.00 | 17 |
| Digital analysis of eeg CPT 95957 | not published | not published | $181.49 – $332.00 | 2 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | not published | not published | $10.14 – $11.72 | 2 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | $5,593.96 | $16,951.39 | $1,519.77 – $15,256.25 | 26 |
| Digoxin total therapeutic drug level CPT 80162 | $44.22 | $134.00 | $5.98 – $120.60 | 26 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $118.09 | $357.84 | $60.50 – $322.05 | 17 |
| Dilate esophagus CPT 43453 | not published | not published | $1,740.98 – $1,828.03 | 12 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $822.88 – $864.02 | 12 |
| Dilate tear duct opening CPT 68801 | not published | not published | $405.30 – $425.57 | 12 |
| Dilate urethra stricture CPT 53600 | not published | not published | $226.68 – $238.01 | 12 |
| Dilate urethra stricture CPT 53601 | not published | not published | $120.71 – $126.75 | 12 |
| Dilate urethra stricture CPT 53605 | not published | not published | $3,198.13 – $3,358.04 | 12 |
| Dilate urethra stricture CPT 53621 | not published | not published | $226.68 – $238.01 | 12 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $116.74 – $122.58 | 12 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $1,085.68 – $1,139.96 | 12 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $2,936.96 – $3,083.81 | 12 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,085.68 – $1,139.96 | 12 |
| Dilation of salivary duct CPT 42660 | not published | not published | $489.32 – $513.79 | 12 |
| Dilation of urethra CPT 53661 | not published | not published | $120.71 – $126.75 | 12 |
| Dilation of urethra CPT 53665 | not published | not published | $1,896.55 – $1,991.38 | 12 |
| Dilation of vagina CPT 57400 | not published | not published | $2,936.96 – $3,083.81 | 12 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,407.71 – $1,478.10 | 12 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $632.64 – $664.27 | 12 |
| Dilator fascial 10fx20cm HCPCS C2627 | $415.80 | $1,260.00 | $172.21 – $738.07 | 14 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $3,198.13 – $3,358.04 | 12 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $3,198.13 – $3,358.04 | 12 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | not published | not published | $0.03 – $0.05 | 3 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $18.91 – $61.64 | 2 |
| Dimenhydrinate injection HCPCS J1240 | not published | not published | $0.98 – $8.72 | 2 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,398.63 | $4,238.27 | $248.90 – $3,814.44 | 26 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | not published | not published | $0.02 – $1.51 | 2 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $25.71 | $77.91 | $0.75 – $15.07 | 17 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $83.64 – $83.64 | 1 |
| Dipyridamole injection HCPCS J1245 | not published | not published | $8.91 – $9.50 | 2 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $14.19 – $35.58 | 12 |
| Disability dlco CPT 94727 | $109.23 | $331.00 | $34.13 – $297.90 | 26 |
| Disaccharidases CPT 82657 | not published | not published | $9.98 – $40.13 | 14 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,871.96 – $1,965.56 | 12 |
| Disarticulation shoulder CPT 23920 | not published | not published | $11,648.21 – $12,230.62 | 12 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $98.91 – $1,860.24 | 14 |
| Disconnect insert locking wr HCPCS L6616 | not published | not published | $86.93 – $91.28 | 12 |
| Disconnect locking wrist uni HCPCS L6615 | not published | not published | $234.61 – $246.34 | 12 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $1,614.86 – $1,695.60 | 12 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $26.87 – $26.87 | 1 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $5,048.52 – $5,300.95 | 12 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $5,370.91 – $5,639.46 | 12 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.02 – $49.26 | 2 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $65.80 – $504.99 | 14 |
| Dmpk gene charac alleles CPT 81239 | not published | not published | $123.67 – $497.44 | 14 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $61.65 – $247.97 | 14 |
| Dna antibody native/double stranded CPT 86225 | $7.92 | $24.00 | $6.18 – $24.87 | 26 |
| Dna gardnerella CPT 87510 | not published | not published | $9.02 – $36.29 | 14 |
| Dna probe chlamydia CPT 87490 | not published | not published | $10.24 – $41.18 | 14 |
| Dna probe gc CPT 87590 | not published | not published | $12.10 – $48.65 | 14 |
| Dna trichomonas CPT 87660 | not published | not published | $9.02 – $36.29 | 14 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $92.38 | $279.94 | $8.50 – $58.55 | 17 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $5,475.50 | $16,592.42 | $0.69 – $364.77 | 18 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $29.70 – $54.24 | 13 |
| Dolasetron mesylate HCPCS J1260 | $44.65 | $135.29 | $3.89 – $121.76 | 17 |
| Dolasetron mesylate oral HCPCS Q0180 | not published | not published | $60.55 – $69.52 | 2 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $20.63 | $62.50 | $0.85 – $42.07 | 17 |
| Doppler echo complete CPT 93320 | $76.23 | $231.00 | $38.58 – $450.00 | 17 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $6,139.00 – $6,139.00 | 1 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $155.43 | $471.00 | $63.55 – $423.90 | 26 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $87.45 | $265.00 | $50.01 – $251.57 | 26 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $0.45 – $1.07 | 2 |
| Dornase alfa non-comp unit HCPCS J7639 | not published | not published | $58.47 – $62.34 | 2 |
| Dornhoffer fixed part w/window HCPCS L8614 | not published | not published | $23,437.87 – $24,609.76 | 12 |
| Dorsi & plantar flex ass/res HCPCS L2220 | not published | not published | $101.79 – $106.88 | 12 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $13,529.72 | $40,999.16 | $107.56 – $36,899.24 | 26 |
| Double transfer toe-hand CPT 26554 | not published | not published | $6,583.38 – $6,912.55 | 12 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $295.82 | $896.42 | $2.95 – $64.01 | 17 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | $2,724.53 | $8,256.16 | $96.33 – $2,352.24 | 26 |
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.