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 |
|---|---|---|---|---|
| Specimen fat stain CPT 89125 | not published | not published | $2.65 – $17.64 | 23 |
| Speech audiometry complete CPT 92556 | not published | not published | $27.53 – $27.53 | 1 |
| Speech evaluation complex CPT 70371 | not published | not published | $44.64 – $313.62 | 5 |
| Speech recep thresh CPT 92555 | not published | not published | $17.73 – $17.73 | 1 |
| Sperm antibody test CPT 89325 | not published | not published | $4.80 – $32.01 | 23 |
| Sperm evaluation test CPT 89329 | not published | not published | $8.82 – $58.77 | 23 |
| Sperm identification CPT 89257 | not published | not published | $49.76 – $334.36 | 3 |
| Sperm isolation complex CPT 89261 | not published | not published | $49.76 – $96.44 | 3 |
| Sperm isolation simple CPT 89260 | not published | not published | $49.76 – $103.41 | 3 |
| Sperm washing 58323 CPT 58323 | not published | not published | $10.98 – $10.98 | 1 |
| Spirmtry w/brnchdil inf-2 yr CPT 94012 | not published | not published | $193.92 – $193.92 | 1 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $1,905.98 | $1,905.98 | $43.94 – $43.94 | 1 |
| Spirometry up to 2 yrs old CPT 94011 | not published | not published | $120.33 – $120.33 | 1 |
| Spleen imaging CPT 78185 | not published | not published | $64.68 – $471.74 | 5 |
| Splint dorsal bloc wh med perf 3.2mm lf polyflex ii HCPCS L3906 | not published | not published | $426.94 – $697.34 | 20 |
| Splint extn xsm w sof-stretch rolyan HCPCS L3925 | not published | not published | $53.45 – $87.30 | 20 |
| Splint finger fold over sm HCPCS L3924 | not published | not published | $88.03 – $143.78 | 20 |
| Splint finger frog med HCPCS L3927 | not published | not published | $35.41 – $57.83 | 20 |
| Splint fing stax assort 1-7in HCPCS Q4049 | not published | not published | $2.41 – $3.94 | 20 |
| Splint rstrc wrst/cmc right med HCPCS L3923 | not published | not published | $88.03 – $143.78 | 20 |
| Split blood or products CPT 86985 | not published | not published | $9.78 – $149.16 | 5 |
| Split flat caliper stirr & p HCPCS L2230 | not published | not published | $79.35 – $129.61 | 20 |
| Spontaneous nystagmus study CPT 92531 | not published | not published | $25.17 – $25.17 | 1 |
| Spring-ass rot wrst with latch HCPCS L6623 | not published | not published | $942.37 – $1,539.21 | 20 |
| Sputum specimen collection CPT 89220 | not published | not published | $13.25 – $149.16 | 5 |
| Sr-89 stront chlor ther / mci HCPCS A9600 | not published | not published | $4,500.00 – $10,987.80 | 3 |
| Srsf2 gene common variants CPT 81348 | not published | not published | $78.93 – $526.20 | 23 |
| Srs linear based CPT 77372 | $35,047.03 | $35,047.03 | $893.01 – $1,579.92 | 2 |
| Srs multisource CPT 77371 | not published | not published | $1,173.90 – $1,755.64 | 2 |
| Staggered spondaic word test CPT 92572 | not published | not published | $3.97 – $3.97 | 1 |
| Stainless steel any wrist HCPCS L6630 | not published | not published | $237.47 – $387.86 | 20 |
| St analysis behavior qualitative voice/resonance CPT 92524 | $852.99 | $852.99 | $94.55 – $154.42 | 20 |
| Stance phase only HCPCS L5858 | not published | not published | $20,708.10 – $33,823.23 | 20 |
| Standard control cable extra HCPCS L6655 | not published | not published | $90.23 – $147.38 | 20 |
| Staph a dna amp probe CPT 87640 | not published | not published | $15.79 – $105.27 | 23 |
| Static or dynami afo pre ots HCPCS L4397 | not published | not published | $186.67 – $304.89 | 20 |
| Stationary o2 contents, gas HCPCS E0441 | not published | not published | $61.45 – $100.37 | 20 |
| Stationary o2 contents, liq HCPCS E0442 | not published | not published | $61.45 – $100.37 | 20 |
| St cognitve performance testing healthcare professional each hour CPT 96125 | not published | not published | $88.36 – $144.32 | 20 |
| Stem cells total count CPT 86367 | not published | not published | $35.00 – $233.34 | 23 |
| Stenger test pure tone CPT 92565 | not published | not published | $18.66 – $18.66 | 1 |
| Stenger test speech CPT 92577 | not published | not published | $34.52 – $34.52 | 1 |
| Stereoscopic x-ray guidance HCPCS G6002 | not published | not published | $50.72 – $175.57 | 2 |
| Stereotactic radiation trmt CPT 77432 | not published | not published | $558.37 – $1,619.96 | 3 |
| Sterile gauze <= 16 sq in HCPCS A6402 | not published | not published | $0.14 – $0.22 | 20 |
| Sterile water/saline, 10 ml HCPCS A4216 | not published | not published | $0.49 – $0.79 | 20 |
| Sterile water/saline, 500 ml HCPCS A4217 | not published | not published | $3.42 – $5.59 | 20 |
| Sternal pad HCPCS L1050 | not published | not published | $91.40 – $149.29 | 20 |
| St evaluate speech sound production CPT 92522 | $877.73 | $877.73 | $96.34 – $157.36 | 20 |
| St evaluate speech sound production comprehensive/expressive CPT 92523 | $1,071.40 | $1,071.40 | $195.66 – $319.58 | 20 |
| St evaluation motion fluoroscopic swallow function cine/video CPT 92611 | $1,425.82 | $1,425.82 | $54.81 – $127.23 | 20 |
| St evaluation swallow function CPT 92610 | $852.99 | $852.99 | $50.34 – $119.00 | 20 |
| Stimulants synthetic CPT 80371 | not published | not published | $0.01 – $86.44 | 2 |
| Stocking sup grips 4 pre ots HCPCS L0982 | not published | not published | $19.68 – $32.15 | 20 |
| Stoma absorptive cover HCPCS A5083 | not published | not published | $0.83 – $1.35 | 20 |
| Storage/year embryo(s) CPT 89342 | not published | not published | $149.16 – $206.89 | 3 |
| Storage/year oocyte(s) CPT 89346 | not published | not published | $183.69 – $291.26 | 3 |
| Storage/year reprod tissue CPT 89344 | not published | not published | $84.80 – $183.69 | 3 |
| Storage/year sperm/semen CPT 89343 | not published | not published | $54.28 – $230.51 | 3 |
| Straight knee joint heavy du HCPCS L2385 | not published | not published | $138.53 – $226.26 | 20 |
| Strap chin dlx f/cpap HCPCS A7036 | not published | not published | $11.99 – $19.58 | 20 |
| Strap montgmry ns 8 hl sht 7.25 x 11.25in HCPCS A4461 | not published | not published | $4.23 – $6.91 | 20 |
| Strapping of ankle and/or ft 29540 CPT 29540 | not published | not published | $55.83 – $55.83 | 1 |
| Strapping of chest CPT 29200 | not published | not published | $62.00 – $62.00 | 1 |
| Strapping of elbow or wrist 29260 CPT 29260 | not published | not published | $57.09 – $57.09 | 1 |
| Strapping of hand or finger CPT 29280 | not published | not published | $58.10 – $58.10 | 1 |
| Strapping of hip CPT 29520 | not published | not published | $67.45 – $67.45 | 1 |
| Strapping of knee CPT 29530 | not published | not published | $57.97 – $57.97 | 1 |
| Strapping of toes 29550 CPT 29550 | not published | not published | $38.61 – $38.61 | 1 |
| Strep a ag ia CPT 87430 | not published | not published | $7.56 – $50.43 | 23 |
| Strep a dna dir probe CPT 87650 | not published | not published | $9.02 – $60.15 | 23 |
| Strep a dna quant CPT 87652 | not published | not published | $18.79 – $125.28 | 23 |
| Strep b assay w/optic CPT 87802 | not published | not published | $5.73 – $38.19 | 23 |
| Strep b dna amp probe CPT 87653 | not published | not published | $15.79 – $105.27 | 23 |
| Streptokinase 1.5 m-units inj HCPCS J2995 | not published | not published | $98.58 – $98.58 | 1 |
| Streptokinase antibody CPT 86590 | not published | not published | $5.70 – $37.98 | 23 |
| Streptomycin injection HCPCS J3000 | not published | not published | $31.28 – $89.78 | 3 |
| Streptozocin injection HCPCS J9320 | not published | not published | $419.08 – $464.68 | 3 |
| Stress test pulmonary CPT 94618 | not published | not published | $13.83 – $13.83 | 1 |
| Stress tte complete CPT 93351 | not published | not published | $337.48 – $3,807.00 | 2 |
| Str markers spec anal addl CPT 81266 | not published | not published | $123.00 – $914.43 | 23 |
| Str markers specimen anal CPT 81265 | not published | not published | $104.88 – $699.21 | 23 |
| St treatment speech individual CPT 92507 | $632.52 | $632.52 | $43.48 – $107.38 | 20 |
| St treatment swallow dysfunction/oral CPT 92526 | $632.52 | $632.52 | $49.74 – $118.28 | 20 |
| Subq i/p critical care pr day age 28 days/less than 99469 CPT 99469 | not published | not published | $494.33 – $494.33 | 1 |
| Succinylcholine chloride 20 mg/ml injection solution (wrapper) HCPCS J0330 | $20.58 | $20.58 | $0.96 – $4.11 | 3 |
| Suction socket HCPCS L6686 | not published | not published | $867.30 – $1,416.59 | 20 |
| Suction susp ak/knee disart HCPCS L5652 | not published | not published | $480.38 – $784.61 | 20 |
| Sugars multiple quant CPT 84379 | not published | not published | $5.19 – $34.59 | 23 |
| Sugars single quant CPT 84378 | not published | not published | $5.19 – $34.59 | 23 |
| Sulfamethoxazole 400 mg-trimethoprim 80 mg/5 ml intravenous solution HCPCS J2865 | $182.27 | $182.27 | $0.06 – $0.11 | 2 |
| Sulfonylurea screen qn-sendout CPT 80377 | not published | not published | $0.01 – $86.44 | 2 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $1,655.15 | $1,655.15 | $44.40 – $502.18 | 3 |
| Sup/ext non-ins inf pump syr HCPCS K0552 | not published | not published | $3.12 – $5.10 | 20 |
| Sup of prep of antigen # of vials 95144 CPT 95144 | not published | not published | $31.47 – $31.47 | 1 |
| Supp non-insulin inf cath/wk HCPCS A4221 | not published | not published | $23.28 – $38.03 | 20 |
| Support clav 29.6-40.5in med HCPCS L3650 | not published | not published | $60.58 – $98.95 | 20 |
| Supprelin la implant HCPCS J9226 | not published | not published | $54,756.23 – $114,441.15 | 3 |
| Surgical pathology level 1 gross examination only CPT 88300 | $71.38 | $71.38 | $4.37 – $24.67 | 5 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $144.84 | $144.84 | $10.43 – $45.91 | 5 |
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.