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 |
|---|---|---|---|---|
| Mayo hemosiderin qualitative urine CPT 83070 | not published | not published | $2.14 – $14.25 | 23 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative CPT 87535 | $581.00 | $581.00 | $15.79 – $105.27 | 23 |
| Mayo hip12 infectious agent nucleic acid amplified probe hiv-2 CPT 87538 | $96.55 | $96.55 | $15.79 – $105.27 | 23 |
| Mayo hiser histoplasma antibodies immunodiffusion CPT 86698 | $224.60 | $224.60 | $6.21 – $41.37 | 23 |
| Mayo hla typing a/b/c single antigen CPT 86812 | not published | not published | $11.61 – $77.43 | 23 |
| Mayo hvdip HIV 1 antibody CPT 86701 | $96.55 | $96.55 | $4.00 – $26.67 | 23 |
| Mayo hvdip HIV 2 antibody CPT 86702 | $96.55 | $96.55 | $6.08 – $40.56 | 23 |
| Mayo hydroxyprogesterone 17-d CPT 83498 | $159.00 | $159.00 | $12.23 – $81.51 | 23 |
| Mayo immunoassay c1 esterase inhibitor antibody quantitative CPT 83520 | not published | not published | $7.77 – $51.81 | 23 |
| Mayo immunoassay infectious agent antibody quantitative diptheria igg CPT 86317 | not published | not published | $6.75 – $44.97 | 23 |
| Mayo immunoassay tumor antigen quantitative ca 27.29 CPT 86300 | not published | not published | $9.36 – $62.43 | 23 |
| Mayo immunoassay tumor antigen quantitative chromogranin a CPT 86316 | not published | not published | $9.36 – $62.43 | 23 |
| Mayo inf agt nucleic acid amp prb helicobacter pylori clarithromycin resistance CPT 87513 | not published | not published | $31.58 – $105.27 | 22 |
| Mayo infectious agent antigen immunoassay direct optical observation cryptococcus CPT 87899 | not published | not published | $7.23 – $48.21 | 23 |
| Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal CPT 87305 | $472.00 | $472.00 | $5.39 – $35.94 | 23 |
| Mayo infectious agent nucleic acid amplified probe enterovirus CPT 87498 | $302.27 | $302.27 | $15.79 – $105.27 | 23 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma genitalium urine CPT 87563 | not published | not published | $15.79 – $105.27 | 23 |
| Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae CPT 87581 | $752.00 | $752.00 | $15.79 – $105.27 | 23 |
| Mayo infectious agent nucleic acid amplified probe pneumocystis jirovecii CPT 87594 | not published | not published | $31.58 – $105.27 | 22 |
| Mayo infectious agent nucleic acid quantification cytomegalovirus CPT 87497 | $2,577.95 | $2,577.95 | $19.28 – $128.52 | 23 |
| Mayo infectious disease hepatitis c chronic six biochemical assays CPT 81596 | $244.89 | $244.89 | $32.49 – $216.57 | 23 |
| Mayo infliximab therapeutic drug level CPT 80230 | $801.91 | $801.91 | $17.36 – $115.71 | 23 |
| Mayo inhab inhibin a CPT 86336 | $293.00 | $293.00 | $7.02 – $46.77 | 23 |
| Mayo insft insulin free CPT 83527 | not published | not published | $5.83 – $38.85 | 23 |
| Mayo insulin antibodies CPT 86337 | $132.00 | $132.00 | $9.63 – $64.23 | 23 |
| Mayo iodine CPT 83789 | $365.00 | $365.00 | $10.85 – $72.33 | 23 |
| Mayo itraconazole therapeutic drug level CPT 80189 | not published | not published | $12.20 – $81.33 | 23 |
| Mayo lacosamide therapeutic drug level CPT 80235 | $413.55 | $413.55 | $12.20 – $81.33 | 23 |
| Mayo lamotrigine therapeutic drug level CPT 80175 | $896.00 | $896.00 | $5.96 – $39.75 | 23 |
| Mayo ld_i lactate dehydrogenase isoenzymes CPT 83625 | $457.00 | $457.00 | $5.76 – $38.37 | 23 |
| Mayo legionella antibody CPT 86713 | $54.00 | $54.00 | $6.89 – $45.90 | 23 |
| Mayo leptospira antibody igm CPT 86720 | $340.00 | $340.00 | $7.29 – $48.60 | 23 |
| Mayo lipoprotein electrophoresis CPT 83700 | $418.00 | $418.00 | $5.07 – $33.78 | 23 |
| Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory CPT 86617 | not published | not published | $6.97 – $46.47 | 23 |
| Mayo manganese CPT 83785 | $752.00 | $752.00 | $11.99 – $79.95 | 23 |
| Mayo metanephrines plasma CPT 83835 | $1,162.00 | $1,162.00 | $7.62 – $50.82 | 23 |
| Mayo methadone definitive assay confirmation urine CPT 80358 | not published | not published | $0.01 – $86.44 | 2 |
| Mayo mgle voltage-gated calcium channel antibody each CPT 86596 | $283.44 | $283.44 | $5.42 – $36.15 | 23 |
| Mayo mgrm acetylcholine receptor binding antibody CPT 86041 | $139.97 | $139.97 | $8.28 – $55.20 | 23 |
| Mayo microsomal antibody liver-kidney CPT 86376 | not published | not published | $6.55 – $43.65 | 23 |
| Mayo mitotane (lysodren) therapeutic drug level CPT 80299 | not published | not published | $8.39 – $55.92 | 23 |
| Mayo molecular pathology procedure level 2 apoe genotype CPT 81401 | $463.36 | $463.36 | $61.65 – $411.00 | 23 |
| Mayo mpl sequence analysis exon 10 CPT 81339 | not published | not published | $83.34 – $555.60 | 23 |
| Mayo muramidase CPT 85549 | $299.00 | $299.00 | $8.44 – $56.25 | 23 |
| Mayo muscle-specific kinase (musk) antibody CPT 86366 | $1,458.00 | $1,458.00 | $8.28 – $55.20 | 23 |
| Mayo mycophenolic acid therapeutic drug level CPT 80180 | not published | not published | $8.12 – $54.15 | 23 |
| Mayo myoglobin CPT 83874 | not published | not published | $5.81 – $38.76 | 23 |
| Mayo nickel CPT 83885 | not published | not published | $11.03 – $73.53 | 23 |
| Mayo opatu opiates definitive assay >=1 CPT 80361 | not published | not published | $0.01 – $86.44 | 2 |
| Mayo opatu opioid/analogs definitive assay 1 or 2 CPT 80362 | not published | not published | $0.01 – $86.44 | 2 |
| Mayo opatu oxycodone definitive assay CPT 80365 | not published | not published | $0.01 – $86.44 | 2 |
| Mayo organic acid methylmalonic single quantitative CPT 83921 | $325.00 | $325.00 | $9.54 – $63.63 | 23 |
| Mayo organic acids qualitative each specimen CPT 83919 | not published | not published | $7.40 – $49.35 | 23 |
| Mayo oxalate 24 hour urine CPT 83945 | $225.00 | $225.00 | $6.50 – $43.35 | 23 |
| Mayo pancreatic elastase fecal qualitative or semi quantitative CPT 82656 | not published | not published | $5.19 – $34.59 | 23 |
| Mayo parvs parvovirus b19 antibody igg CPT 86747 | not published | not published | $6.76 – $45.09 | 23 |
| Mayo paval fluorescent antibody screen agna type 1 CPT 86255 | not published | not published | $5.42 – $36.15 | 23 |
| Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme) CPT 87476 | $1,952.00 | $1,952.00 | $15.79 – $105.27 | 23 |
| Mayo phospholipid neutralization hexagonal lupus anticoagulant CPT 85598 | $210.00 | $210.00 | $8.09 – $53.94 | 23 |
| Mayo pntft phenytoin free therapeutic drug level CPT 80186 | $341.00 | $341.00 | $6.19 – $41.28 | 23 |
| Mayo pqnu porphobilinogen urine quantitative 24 hour urine CPT 84110 | $190.00 | $190.00 | $3.80 – $25.32 | 23 |
| Mayo pregnenolone CPT 84140 | $111.00 | $111.00 | $9.30 – $62.01 | 23 |
| Mayo prmb primidone therapeutic drug level CPT 80188 | $228.00 | $228.00 | $7.47 – $49.77 | 23 |
| Mayo proinsulin CPT 84206 | $1,211.00 | $1,211.00 | $12.01 – $80.07 | 23 |
| Mayo psaft prostate specific antigen free CPT 84154 | $608.00 | $608.00 | $8.28 – $55.17 | 23 |
| Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative CPT 83519 | not published | not published | $8.28 – $55.20 | 23 |
| Mayo rbcme osmotic fragility rbc incubated CPT 85557 | not published | not published | $6.01 – $40.08 | 23 |
| Mayo receptor assay transferrin soluble CPT 84238 | $833.00 | $833.00 | $16.46 – $109.71 | 23 |
| Mayo renin CPT 84244 | $148.00 | $148.00 | $9.90 – $65.97 | 23 |
| Mayo repu protein electrophoresis urine CPT 84166 | not published | not published | $8.02 – $53.49 | 23 |
| Mayo selenium CPT 84255 | $804.00 | $804.00 | $11.49 – $76.59 | 23 |
| Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria CPT 89322 | not published | not published | $6.98 – $46.50 | 23 |
| Mayo serotonin CPT 84260 | $678.08 | $678.08 | $13.94 – $92.94 | 23 |
| Mayo sfgp rickettsia rickettsii antibody igg CPT 86757 | not published | not published | $8.71 – $58.05 | 23 |
| Mayo sirolimus therapeutic drug level CPT 80195 | $863.00 | $863.00 | $6.18 – $41.19 | 23 |
| Mayo streptococcus pneumoniae antibody igg 23 serotypes multiplex immunoassay quantitative CPT 86581 | not published | not published | $82.83 – $276.09 | 21 |
| Mayo syphilis test non-treponemal antibody qualitative vdrl CPT 86592 | not published | not published | $1.92 – $12.81 | 23 |
| Mayo tau phosphorylated 217 each CPT 84393 | $1,012.50 | $1,012.50 | $116.03 – $386.76 | 21 |
| Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification CPT 81340 | not published | not published | $62.96 – $626.76 | 23 |
| Mayo tgrp testosterone free CPT 84402 | $148.00 | $148.00 | $11.46 – $76.41 | 23 |
| Mayo tgrp testosterone total CPT 84403 | $501.00 | $501.00 | $11.61 – $77.43 | 23 |
| Mayo thiopurine s-methyltransferase CPT 84433 | $503.84 | $503.84 | $9.98 – $66.51 | 23 |
| Mayo thyroglobulin CPT 84432 | not published | not published | $7.23 – $48.18 | 23 |
| Mayo ticks anaplasma phagocytophilum antibody igg CPT 86666 | not published | not published | $4.58 – $30.54 | 23 |
| Mayo ticks babesia microti antibody igg CPT 86753 | not published | not published | $5.58 – $37.17 | 23 |
| Mayo tramadol definitive assay w metabolite quantitative urine CPT 80373 | not published | not published | $0.01 – $86.44 | 2 |
| Mayo ttfb testosterone bioavailable direct CPT 84410 | $155.00 | $155.00 | $23.08 – $153.84 | 23 |
| Mayo tulab francisella tularensis antibody igg CPT 86668 | $86.40 | $86.40 | $6.37 – $42.48 | 23 |
| Mayo valpg valproic acid free therapeutic drug level CPT 80165 | $488.00 | $488.00 | $6.09 – $40.62 | 23 |
| Mayo vasoactive intestinal peptide CPT 84586 | $1,763.00 | $1,763.00 | $14.09 – $105.99 | 23 |
| Mayo vitamin b-2 (riboflavin) CPT 84252 | $1,549.00 | $1,549.00 | $9.11 – $60.72 | 23 |
| Mayo vitamin b3 (niacin) CPT 84591 | $1,410.00 | $1,410.00 | $7.68 – $51.18 | 23 |
| Mayo vitamin k CPT 84597 | $2,257.00 | $2,257.00 | $6.17 – $41.16 | 23 |
| Mayo zonisamide therapeutic drug level CPT 80203 | $294.00 | $294.00 | $5.96 – $39.75 | 23 |
| Mcoln1 gene CPT 81290 | not published | not published | $17.69 – $117.93 | 23 |
| Mcrscp xm hair pluck/clipped CPT 96902 | not published | not published | $20.74 – $33.39 | 2 |
| Meas lung vol thru 2 yrs CPT 94013 | not published | not published | $26.30 – $26.30 | 1 |
| Mecasermin injection HCPCS J2170 | not published | not published | $185.99 – $1,226.92 | 3 |
| Mech hip extension assist HCPCS L5855 | not published | not published | $378.75 – $618.62 | 20 |
| Mechlorethamine hcl inj HCPCS J9230 | not published | not published | $346.96 – $398.94 | 2 |
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.