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 |
|---|---|---|---|---|
| Radiation treatment aid(s) CPT 77332 | $1,805.30 | $1,805.30 | $45.89 – $64.90 | 4 |
| Radiation treatment aid(s) CPT 77333 | not published | not published | $8.07 – $309.97 | 4 |
| Radiation treatment aid(s) CPT 77334 | $4,950.03 | $4,950.03 | $75.84 – $231.60 | 4 |
| Radiation treatment delivery CPT 77401 | not published | not published | $17.52 – $150.08 | 2 |
| Radiation treatment delivery CPT 77402 | $6,543.39 | $6,543.39 | $71.79 – $482.24 | 4 |
| Radiation treatment delivery CPT 77412 | $3,009.60 | $3,009.60 | $94.32 – $926.84 | 4 |
| Radiation tx management x5 CPT 77427 | not published | not published | $212.78 – $724.28 | 3 |
| Radiesse injection HCPCS Q2026 | not published | not published | $925.35 – $925.35 | 1 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $5,847.03 – $9,550.15 | 20 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $767.83 – $1,254.12 | 20 |
| Radiology port images(s) CPT 77417 | $1,013.26 | $1,013.26 | $12.16 – $45.12 | 3 |
| Radiotherapy dose plan imrt CPT 77301 | $8,858.87 | $8,858.87 | $1,034.88 – $4,557.24 | 4 |
| Radium ra223 dichl ther/uci HCPCS A9606 | not published | not published | $201.50 – $455.59 | 3 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | not published | not published | $145.56 – $1,623.62 | 5 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $12,974.02 | $12,974.02 | $175.45 – $1,672.19 | 5 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $327.76 – $1,752.20 | 5 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $5,972.10 | $5,972.10 | $195.60 – $921.95 | 5 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $119.16 – $630.79 | 5 |
| Radphm quant measure sgl area add-on CPT 78835 | not published | not published | $73.15 – $137.62 | 3 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $88.37 – $200.29 | 3 |
| Range of motion measurements CPT 95852 | not published | not published | $17.10 – $28.87 | 20 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $110.54 – $173.42 | 3 |
| Rapid desensitization CPT 95180 | not published | not published | $111.21 – $111.21 | 1 |
| Rapid Strep Test CPT 87880 | not published | not published | $7.44 – $49.59 | 23 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $452.94 – $1,015.93 | 3 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $269.38 – $595.72 | 3 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $482.48 – $1,417.96 | 2 |
| Rbc count only automated CPT 85041 | $176.00 | $176.00 | $1.36 – $9.06 | 23 |
| Rbc deglycerolized each unit HCPCS P9039 | $1,977.00 | $1,977.00 | $263.63 – $263.63 | 1 |
| Rbc irradiated each unit HCPCS P9038 | not published | not published | $17.27 – $17.27 | 1 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $3.87 – $25.80 | 23 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $3.36 – $22.41 | 23 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $9.78 – $270.22 | 5 |
| Recon, cta for surg plan HCPCS G0288 | not published | not published | $34.38 – $34.38 | 1 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $18,503.74 – $25,232.37 | 5 |
| Reconstruct elbow joint CPT 24360 | not published | not published | $7,657.61 – $10,442.19 | 5 |
| Reconstruct elbow joint CPT 24361 | not published | not published | $18,503.74 – $25,232.37 | 5 |
| Reconstruct elbow joint CPT 24362 | not published | not published | $13,548.88 – $18,475.74 | 5 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | $13,548.88 – $18,475.74 | 5 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $18,503.74 – $25,232.37 | 5 |
| Rectal sensation test CPT 91120 | not published | not published | $485.94 – $485.94 | 1 |
| Red blood cells each unit HCPCS P9021 | $462.81 | $462.81 | $85.45 – $85.45 | 1 |
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | not published | not published | $573.42 – $573.42 | 1 |
| Red blood cells leukocytes reduced cmv negative irradiated each unit HCPCS P9058 | not published | not published | $184.55 – $184.55 | 1 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $499.00 | $499.00 | $336.66 – $336.66 | 1 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | not published | not published | $311.00 – $311.00 | 1 |
| Red blood cells washed each unit HCPCS P9022 | $700.00 | $700.00 | $181.42 – $181.42 | 1 |
| Red cell mass multiple CPT 78121 | not published | not published | $52.40 – $611.66 | 5 |
| Red cell mass single CPT 78120 | not published | not published | $37.44 – $471.74 | 5 |
| Red cell sequestration CPT 78140 | not published | not published | $93.86 – $471.74 | 5 |
| Red cell survival kinetics CPT 78135 | not published | not published | $107.36 – $107.36 | 1 |
| Red cell survival study CPT 78130 | not published | not published | $98.72 – $471.74 | 5 |
| Refill maint impl spine pump CPT 95991 | not published | not published | $210.26 – $210.26 | 1 |
| Refill/maint pump/resvr syst CPT 96522 | not published | not published | $131.91 – $131.91 | 1 |
| Regadenoson 0.4 mg/5 ml intravenous syringe HCPCS J2785 | $3,074.91 | $3,074.91 | $4.20 – $7.10 | 3 |
| Reinforced solid stirrup HCPCS L2260 | not published | not published | $207.31 – $338.61 | 20 |
| Rem/biv cast full arm/leg CPT 29705 | not published | not published | $126.81 – $126.81 | 1 |
| Rem/biv cast shldr/hip spica CPT 29710 | not published | not published | $244.23 – $244.23 | 1 |
| Remdesivir 100 mg intravenous powder for solution HCPCS J0248 | $2,806.82 | $2,806.82 | $7.76 – $18.29 | 3 |
| Rem interrog dev eval icpms CPT 93297 | not published | not published | $33.28 – $3,807.00 | 2 |
| Rem interrog dev eval scrms CPT 93298 | not published | not published | $38.04 – $3,807.00 | 2 |
| Rem interrog evl pm/ids CPT 93296 | not published | not published | $43.59 – $3,807.00 | 2 |
| Rem interrog evl pm/ldls pm CPT 93294 | not published | not published | $47.26 – $3,807.00 | 2 |
| Rem mntr wrls p-art prs snr CPT 93264 | not published | not published | $3,807.00 – $3,807.00 | 1 |
| Remote 30 day ecg rev/report CPT 93228 | not published | not published | $33.28 – $3,807.00 | 2 |
| Remote 30 day ecg tech supp CPT 93229 | not published | not published | $873.72 – $3,807.00 | 2 |
| Remot img sub by pt, non e/m HCPCS G2250 | not published | not published | $11.03 – $18.02 | 20 |
| Removable insert each HCPCS L6691 | not published | not published | $381.74 – $623.50 | 20 |
| Removable soft interface le HCPCS K0672 | not published | not published | $94.28 – $154.00 | 20 |
| Removal devitalized tissue non-selective debridement without anesthesia per session CPT 97602 | not published | not published | $14.88 – $14.88 | 1 |
| Remove cva lumen obstruct CPT 75902 | not published | not published | $49.36 – $123.21 | 3 |
| Remove esophagus obstruction CPT 74235 | not published | not published | $94.19 – $222.60 | 3 |
| Renal cyst study s&i CPT 74470 | not published | not published | $44.71 – $634.33 | 5 |
| Renal function panel CPT 80069 | not published | not published | $3.91 – $26.04 | 23 |
| Renal venogram bil s&i CPT 75833 | not published | not published | $96.97 – $3,365.20 | 5 |
| Renin stimulation panel CPT 80416 | not published | not published | $94.19 – $627.96 | 23 |
| Renin stimulation panel CPT 80417 | not published | not published | $19.80 – $131.97 | 23 |
| Repair of body cast CPT 29720 | not published | not published | $172.48 – $172.48 | 1 |
| Repair prosthesis per 15 min HCPCS L7520 | not published | not published | $36.60 – $59.78 | 20 |
| Replace afo soft interface HCPCS L4392 | not published | not published | $26.19 – $42.78 | 20 |
| Replace elbow joint CPT 24363 | not published | not published | $18,503.74 – $25,232.37 | 5 |
| Replace foot drop spint HCPCS L4394 | not published | not published | $19.12 – $31.22 | 20 |
| Replace high roll cuff HCPCS L4060 | not published | not published | $328.67 – $536.83 | 20 |
| Replacement of contact lens CPT 92326 | not published | not published | $76.28 – $76.28 | 1 |
| Replacemnt lithium ionbatter HCPCS L7367 | not published | not published | $433.77 – $708.50 | 20 |
| Replace molded calf lacer HCPCS L4050 | not published | not published | $426.96 – $697.37 | 20 |
| Replace molded thigh lacer HCPCS L4040 | not published | not published | $422.16 – $689.53 | 20 |
| Replace non-molded calf lace HCPCS L4055 | not published | not published | $276.48 – $451.58 | 20 |
| Replace non-molded thigh lac HCPCS L4045 | not published | not published | $339.25 – $554.10 | 20 |
| Replace pretibial shell HCPCS L4130 | not published | not published | $603.61 – $985.90 | 20 |
| Replace prox & dist upright HCPCS L4070 | not published | not published | $313.56 – $512.15 | 20 |
| Replace quadlat socket brim HCPCS L4020 | not published | not published | $948.34 – $1,548.95 | 20 |
| Replace socket above knee HCPCS L5701 | not published | not published | $3,791.24 – $6,192.36 | 20 |
| Replace socket below knee HCPCS L5700 | not published | not published | $3,156.93 – $5,156.32 | 20 |
| Replace socket brim cust fit HCPCS L4030 | not published | not published | $522.15 – $852.85 | 20 |
| Replace socket hip HCPCS L5702 | not published | not published | $4,796.46 – $7,834.22 | 20 |
| Replace trilateral socket br HCPCS L4010 | not published | not published | $759.22 – $1,240.06 | 20 |
| Repl alkaline battery HCPCS L8622 | not published | not published | $0.36 – $0.59 | 20 |
| Replc sockt above elbow disa HCPCS L6884 | not published | not published | $2,595.10 – $4,238.66 | 20 |
| Replc sockt below e/w disa HCPCS L6883 | not published | not published | $1,748.46 – $2,855.81 | 20 |
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.