SUMMIT MEDICAL CENTER
100 SUMMIT BLVD, MT JULIET, TN · Tristarhealth · · NPI 1982650024
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 |
|---|---|---|---|---|
| Eo, adj lock joint prefab ot HCPCS L3761 | not published | not published | $506.12 – $826.65 | 20 |
| Eo elas w/metal jnts pre ots HCPCS L3710 | not published | not published | $146.75 – $239.70 | 20 |
| Epcoritamab-bysp 48 mg/0.8 ml subcutaneous solution HCPCS J9321 | not published | not published | $67.08 – $150.55 | 3 |
| Epidurography CPT 72275 | not published | not published | $147.40 – $147.40 | 1 |
| Epilepsy gen seq alys panel CPT 81419 | not published | not published | $1,101.85 – $7,345.68 | 23 |
| Ep induct arrhy by elect pacing CPT 93618 | $32,397.95 | $32,397.95 | $194.35 – $194.35 | 1 |
| Epinephrine 0.1 mg/ml injection syringe HCPCS J0168 | not published | not published | $2.65 – $7.95 | 2 |
| Epinephrine 1 mg/ml im kit - adult HCPCS J0169 | not published | not published | $2.77 – $3.66 | 2 |
| Epinephrine 1 mg/ml im kit - pediatric HCPCS J0165 | not published | not published | $0.86 – $1.14 | 2 |
| Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution HCPCS J0166 | not published | not published | $2.78 – $2.94 | 2 |
| Epirubicin 200 mg/100 ml intravenous solution HCPCS J9178 | not published | not published | $1.85 – $5.22 | 3 |
| Epoetin alfa, 100 units esrd HCPCS Q4081 | not published | not published | $1.00 – $2.04 | 2 |
| Epoetin alfa-epbx 40,000 unit/ml injection solution HCPCS Q5106 | not published | not published | $8.46 – $20.06 | 3 |
| Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr HCPCS J0885 | not published | not published | $8.65 – $20.51 | 3 |
| Epoetin beta esrd use HCPCS J0887 | not published | not published | $1.34 – $3.23 | 2 |
| Epoetin beta non esrd HCPCS J0888 | not published | not published | $1.34 – $3.23 | 3 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | not published | not published | $19.66 – $41.47 | 3 |
| Epstein barr early antigen antibody CPT 86663 | $48.18 | $48.18 | $5.90 – $39.36 | 23 |
| Epstein barr nuclear antigen antibody CPT 86664 | $159.55 | $159.55 | $6.88 – $45.87 | 23 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | not published | not published | $8.16 – $54.42 | 23 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | not published | not published | $9.33 – $15.02 | 3 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | not published | not published | $23.14 – $54.33 | 3 |
| Ercp biliary & pancreas CPT 74330 | $4,456.22 | $4,456.22 | $112.00 – $175.73 | 3 |
| Ergonovine 0.2 mg/ml inj HCPCS J1330 | not published | not published | $6.04 – $6.04 | 1 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | not published | not published | $145.19 – $192.42 | 3 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $184.80 | $184.80 | $11.22 – $24.27 | 3 |
| Erwinaze injection HCPCS J9019 | not published | not published | $509.82 – $509.82 | 1 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | $589.14 | $589.14 | $53.42 – $86.54 | 3 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | not published | not published | $0.49 – $1.09 | 2 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | not published | not published | $0.33 – $0.56 | 2 |
| Esophageal dilat s&i CPT 74360 | not published | not published | $104.64 – $148.75 | 3 |
| Esophageal motility CPT 78258 | not published | not published | $116.85 – $520.94 | 5 |
| Esophageal recording CPT 93615 | not published | not published | $13.44 – $13.44 | 1 |
| Esophageal recording CPT 93616 | not published | not published | $14.49 – $14.49 | 1 |
| Esophagus motility study CPT 91010 | not published | not published | $38.78 – $38.78 | 1 |
| Esoph balloon distension tst CPT 91040 | not published | not published | $493.40 – $493.40 | 1 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $16.72 – $16.72 | 1 |
| Esoph imped function test CPT 91037 | not published | not published | $119.91 – $119.91 | 1 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $85.28 – $85.28 | 1 |
| Esrd home pt serv p mo 12-19 CPT 90965 | not published | not published | $521.79 – $521.79 | 1 |
| Esrd home pt serv p mo 20+ CPT 90966 | not published | not published | $271.23 – $271.23 | 1 |
| Esrd home pt serv p mo 2-11 CPT 90964 | not published | not published | $548.59 – $548.59 | 1 |
| Esrd home pt serv p mo <2yrs CPT 90963 | not published | not published | $656.72 – $656.72 | 1 |
| Esrd serv 1 visit p mo 20+ CPT 90962 | not published | not published | $212.66 – $212.66 | 1 |
| Esrd serv 1 visit p mo <2yrs CPT 90953 | not published | not published | $585.85 – $585.85 | 1 |
| Esrd serv 1 vst p mo 12-19 CPT 90959 | not published | not published | $363.85 – $363.85 | 1 |
| Esrd serv 2-3 vsts p mo <2yr CPT 90952 | not published | not published | $878.99 – $878.99 | 1 |
| Esrd serv 4 visits p mo <2yr CPT 90951 | not published | not published | $1,246.25 – $1,246.25 | 1 |
| Esrd serv 4 vsts p mo 2-11 CPT 90954 | not published | not published | $1,024.81 – $1,024.81 | 1 |
| Esrd srv 1 visit p mo 2-11 CPT 90956 | not published | not published | $392.71 – $392.71 | 1 |
| Esrd srv 2-3 vsts p mo 12-19 CPT 90958 | not published | not published | $554.36 – $554.36 | 1 |
| Esrd srv 2-3 vsts p mo 20+ CPT 90961 | not published | not published | $293.90 – $293.90 | 1 |
| Esrd srv 2-3 vsts p mo 2-11 CPT 90955 | not published | not published | $579.76 – $579.76 | 1 |
| Esrd srv 4 visits p mo 20+ CPT 90960 | not published | not published | $363.85 – $363.85 | 1 |
| Esrd srv 4 vsts p mo 12-19 CPT 90957 | not published | not published | $821.98 – $821.98 | 1 |
| Esrd svc pr day pt 12-19 CPT 90969 | not published | not published | $17.89 – $17.89 | 1 |
| Esrd svc pr day pt <2 CPT 90967 | not published | not published | $23.44 – $23.44 | 1 |
| Esrd svc pr day pt 20+ CPT 90970 | not published | not published | $9.46 – $9.46 | 1 |
| Esrd svc pr day pt 2-11 CPT 90968 | not published | not published | $18.34 – $18.34 | 1 |
| Established Patient Office Visit (level 1) CPT 99211 | not published | not published | $37.74 – $37.74 | 1 |
| Established Patient Office Visit (level 2) CPT 99212 | not published | not published | $50.33 – $50.33 | 1 |
| Established Patient Office Visit (level 3) CPT 99213 | not published | not published | $58.71 – $58.71 | 1 |
| Established Patient Office Visit (level 4) CPT 99214 | not published | not published | $75.38 – $75.38 | 1 |
| Established Patient Office Visit (level 5) CPT 99215 | not published | not published | $118.11 – $118.11 | 1 |
| Estradiol total CPT 82670 | $197.00 | $197.00 | $12.57 – $83.82 | 23 |
| Estradiol valerate 10 mg inj HCPCS J1380 | not published | not published | $8.93 – $19.74 | 3 |
| Estrogens total-sendout CPT 82672 | $1,975.00 | $1,975.00 | $9.77 – $65.10 | 23 |
| Etanercept injection HCPCS J1438 | not published | not published | $1,114.51 – $3,242.65 | 3 |
| Ethanolamine oleate 100 mg HCPCS J1430 | $875.55 | $875.55 | $608.51 – $1,370.26 | 3 |
| Eth estr and eton monthly HCPCS J7295 | not published | not published | $155.21 – $495.82 | 2 |
| Ethylene glycol -sendout CPT 82693 | $537.00 | $537.00 | $6.71 – $44.70 | 23 |
| Etonogestrel implant system HCPCS J7307 | not published | not published | $1,462.47 – $4,055.64 | 2 |
| Etoposide 20 mg/ml intravenous solution HCPCS J9181 | not published | not published | $1.31 – $2.76 | 3 |
| Etoposide 50 mg cap HCPCS J8560 | not published | not published | $93.94 – $229.99 | 2 |
| Euflexxa inj per dose HCPCS J7323 | not published | not published | $151.25 – $279.47 | 3 |
| Euglobulin lysis CPT 85360 | not published | not published | $3.78 – $25.23 | 23 |
| Eval aud funcj ea addl 15 CPT 92627 | not published | not published | $25.39 – $25.39 | 1 |
| Eval aud rehab status/first hr 92626 CPT 92626 | not published | not published | $100.91 – $100.91 | 1 |
| Eval/fit voice prosthesis iii, st CPT 92607 | not published | not published | $104.96 – $171.43 | 20 |
| Evaluation cervical mucus CPT 89330 | not published | not published | $4.67 – $31.14 | 23 |
| Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen CPT 84112 | $388.00 | $388.00 | $44.15 – $294.33 | 23 |
| Evaluation heart device CPT 93640 | not published | not published | $359.72 – $359.72 | 1 |
| Evaluation of speech fluency 92521 CPT 92521 | $852.99 | $852.99 | $115.05 – $187.91 | 20 |
| Event monitor CPT 93270 | not published | not published | $57.64 – $3,807.00 | 2 |
| Evoked auditory tst complete CPT 92588 | not published | not published | $9.22 – $9.22 | 1 |
| Evoked oa emissions ltd CPT 92587 | not published | not published | $6.69 – $6.69 | 1 |
| Evoked potentials auditory screening automated analysis CPT 92650 | not published | not published | $35.79 – $35.79 | 1 |
| Evoked potentials upper limbs CPT 95925 | not published | not published | $65.61 – $65.61 | 1 |
| Evoked potential visual not glaucoma CPT 95930 | not published | not published | $12.00 – $12.00 | 1 |
| Evok oa screening qual CPT 92558 | not published | not published | $11.38 – $11.38 | 1 |
| Ewhfo w/joint(s) cf HCPCS L3766 | not published | not published | $1,374.20 – $2,244.53 | 20 |
| Ewho w/joint(s) cf HCPCS L3764 | not published | not published | $801.34 – $1,308.86 | 20 |
| Excimer lsr psriasis 250-500 CPT 96921 | not published | not published | $191.66 – $191.66 | 1 |
| Excimer lsr psriasis<250sqcm CPT 96920 | not published | not published | $187.10 – $187.10 | 1 |
| Excimer lsr psriasis>500sqcm CPT 96922 | not published | not published | $265.58 – $265.58 | 1 |
| Excursion amplifier lever ty HCPCS L6642 | not published | not published | $239.59 – $391.33 | 20 |
| Excursion amplifier pulley t HCPCS L6641 | not published | not published | $176.76 – $288.71 | 20 |
| Exemestane, 25 mg HCPCS S0156 | not published | not published | $2.95 – $2.95 | 1 |
| Exercise tst brncspsm w/ecg CPT 94617 | not published | not published | $76.29 – $76.29 | 1 |
| Exercise tst brncspsm wo ecg CPT 94619 | not published | not published | $60.57 – $60.57 | 1 |
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.