Ascension Saint Thomas River Park
1559 Sparta Rd, McMinnville, TN · Ascension · · NPI 1518346469
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 |
|---|---|---|---|---|
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $1,610.43 – $2,225.50 | 4 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $634.35 | $2,114.50 | $76.07 – $433.25 | 31 |
| Leishmania antibody CPT 86717 | not published | not published | $8.59 – $72.39 | 36 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $614.17 – $1,004.50 | 4 |
| Lengthening of palate CPT 42227 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $1,468.50 – $1,881.50 | 4 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $1,105.06 – $1,543.50 | 4 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $1,881.50 – $1,985.50 | 4 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $1,881.50 – $1,985.50 | 4 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $21.50 | $71.65 | $5.40 – $26.12 | 9 |
| Leukacyte transfusion CPT 86950 | not published | not published | $7.40 – $251.71 | 35 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $5.60 – $32.75 | 36 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $0.18 | $0.60 | $0.07 – $0.13 | 7 |
| Levetiracetam therapeutic drug level CPT 80177 | $148.74 | $495.80 | $8.96 – $50.81 | 36 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $11.82 | $39.40 | $0.84 – $2.91 | 7 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $20.46 | $68.20 | $8.30 – $26.47 | 9 |
| Lidocaine therapeutic drug level CPT 80176 | $77.45 | $258.15 | $10.30 – $56.45 | 36 |
| Ligate leg veins open CPT 37761 | not published | not published | $1,085.86 – $1,246.50 | 4 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $1,085.86 – $1,543.50 | 4 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $1,085.86 – $1,543.50 | 4 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $1,085.86 – $1,543.50 | 4 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $923.10 – $2,298.50 | 4 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $670.71 – $1,246.50 | 4 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $1,085.86 – $1,246.50 | 4 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $1,250.59 – $2,225.50 | 4 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $1,085.86 – $2,225.50 | 4 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $1,250.59 – $2,225.50 | 4 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Ligation major artery neck CPT 37615 | not published | not published | $1,085.86 – $2,225.50 | 4 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $1,085.86 – $1,246.50 | 4 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Ligation of femoral vein CPT 37650 | not published | not published | $1,085.86 – $1,246.50 | 4 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $1,085.86 – $2,225.50 | 4 |
| Ligation of neck artery CPT 37606 | not published | not published | $1,085.86 – $2,225.50 | 4 |
| Ligation of salivary duct CPT 42665 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $1,085.86 – $1,543.50 | 4 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $1,085.86 – $1,543.50 | 4 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $1,085.86 – $1,543.50 | 4 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $1,085.86 – $1,543.50 | 4 |
| Limb exercise test CPT 95875 | not published | not published | $18.86 – $206.75 | 28 |
| Limited visual field xm CPT 92081 | not published | not published | $6.78 – $78.50 | 28 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $46.65 | $155.50 | $3.20 – $19.42 | 10 |
| Lipase CPT 83690 | $41.90 | $139.65 | $4.83 – $27.07 | 36 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $973.10 – $1,246.50 | 4 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $17.40 – $106.11 | 36 |
| Lipoprotein blood quant CPT 83704 | $28.82 | $96.05 | $22.13 – $121.90 | 36 |
| Lipoprotein direct measurement hdl CPT 83718 | $53.36 | $177.85 | $5.74 – $31.60 | 36 |
| Lipoprotein direct measurement ldl CPT 83721 | $81.65 | $272.15 | $6.69 – $37.24 | 36 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $30.77 – $109.63 | 36 |
| Lip surgery procedure CPT 40799 | not published | not published | $64.86 – $2,225.50 | 23 |
| Listeria monocytogenes CPT 86723 | not published | not published | $9.25 – $52.27 | 36 |
| Lithium therapeutic drug level CPT 80178 | $50.33 | $167.75 | $4.63 – $25.96 | 36 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | not published | not published | $10,471.00 – $16,047.00 | 5 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $158.57 – $371.76 | 29 |
| Liver elastography 91200 CPT 91200 | not published | not published | $22.57 – $206.75 | 28 |
| Liver Function Test CPT 80076 | $105.26 | $350.85 | $5.73 – $31.60 | 36 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Liver imaging CPT 78201 | not published | not published | $99.79 – $2,035.50 | 34 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $122.08 – $2,035.50 | 34 |
| Liver/spleen imag static only CPT 78215 | $540.83 | $1,802.75 | $124.17 – $589.01 | 34 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $103.16 – $589.01 | 34 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $88.24 – $767.34 | 9 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $6.12 | $20.40 | $1.55 – $14.01 | 9 |
| Loudness balance test CPT 92562 | not published | not published | $17.18 – $411.50 | 28 |
| Low back disk surgery CPT 63030 | not published | not published | $2,056.59 – $6,089.00 | 2 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $861.47 | $2,871.55 | $151.23 – $764.58 | 34 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $961.67 | $3,205.55 | $148.75 – $619.72 | 34 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $889.92 | $2,966.40 | $90.33 – $562.76 | 34 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,356.98 | $4,523.25 | $264.35 – $1,339.35 | 34 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $965.33 | $3,217.75 | $215.74 – $865.43 | 34 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $930.30 | $3,101.00 | $167.52 – $669.56 | 34 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $172.35 | $574.50 | $22.18 – $179.33 | 35 |
| Lower jaw bone graft CPT 21215 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $168.80 – $262.57 | 25 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $2,739.57 – $3,160.00 | 4 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $2,739.57 – $3,160.00 | 4 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $2,739.57 – $3,160.00 | 4 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $2,739.57 – $3,160.00 | 4 |
| L/s ratio fetal lung CPT 83661 | $136.35 | $454.50 | $15.41 – $84.67 | 36 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $60.19 – $2,750.96 | 15 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $2,118.00 – $5,112.00 | 4 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $11.27 – $78.50 | 28 |
| Lung Function Test (Spirometry) CPT 94010 | $161.93 | $539.75 | $19.14 – $206.75 | 28 |
| Lung perfusion imaging CPT 78580 | $657.60 | $2,192.00 | $100.20 – $589.01 | 34 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $20.81 – $2,225.50 | 23 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Lymphatics/lymph node imaging CPT 78195 | $718.80 | $2,396.00 | $126.65 – $820.53 | 34 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $32.90 – $210.63 | 36 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $34.37 – $189.63 | 36 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $36.66 – $593.72 | 36 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $210.40 – $1,074.72 | 34 |
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.