Hawkins County Memorial Hospital
851 LOCUST ST, ROGERSVILLE, TN · Balladhealth · · NPI 1174553598
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 |
|---|---|---|---|---|
| IV inj ra drug dx study CPT 78808 | $452.25 | $3,015.00 | $37.46 – $790.69 | 17 |
| Ivp w/nephrotomography CPT 74415 | $105.90 | $706.00 | $69.65 – $346.92 | 17 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $119.55 | $797.00 | $55.30 – $346.92 | 17 |
| Jak2 targeted sequence analysis CPT 81279 | $121.05 | $807.00 | $92.60 – $403.74 | 17 |
| John cunningham antibody CPT 86711 | $25.20 | $168.00 | $8.45 – $36.82 | 17 |
| J-tube placement CPT 44015 | $73.50 | $490.00 | $490.00 – $5,855.44 | 5 |
| Ketamine and metabolite screen - quest CPT 80357 | $20.25 | $135.00 | $16.20 – $16.52 | 5 |
| Ketogenic steroids fract CPT 83582 | $24.15 | $161.00 | $7.74 – $33.72 | 17 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $14.40 | $96.00 | $4.09 – $17.81 | 17 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $9.17 | $61.14 | $0.30 – $0.73 | 16 |
| Kidney imaging morphology CPT 78700 | $452.25 | $3,015.00 | $99.84 – $790.69 | 17 |
| Kidney imag w/bld flow multi CPT 78709 | $452.25 | $3,015.00 | $145.14 – $1,073.92 | 17 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $452.25 | $3,015.00 | $146.97 – $1,073.92 | 17 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $101.55 | $677.00 | $48.16 – $234.44 | 17 |
| Kit gene analys d816 variant CPT 81273 | $108.15 | $721.00 | $50.93 – $272.22 | 17 |
| Knee MRI (with and without contrast) CPT 73723 | $668.55 | $4,457.00 | $267.02 – $690.02 | 17 |
| Knee MRI (with contrast) CPT 73722 | $636.75 | $4,245.00 | $217.92 – $1,550.48 | 17 |
| Knee MRI (without contrast) CPT 73721 | $614.85 | $4,099.00 | $169.21 – $471.92 | 17 |
| Knee X-ray CPT 73564 | $80.10 | $534.00 | $20.54 – $206.78 | 17 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $213.59 | $1,423.90 | $0.08 – $0.35 | 2 |
| Lactate dehydrogenase (ldh) CPT 83615 | $10.50 | $70.00 | $3.02 – $13.17 | 17 |
| Lactated ringers intravenous solution HCPCS J7120 | $7.26 | $48.38 | $12.61 – $14.85 | 2 |
| Lactic acid CPT 83605 | $18.75 | $125.00 | $5.79 – $25.22 | 17 |
| Lactoferrin fecal qualitative CPT 83630 | $34.35 | $229.00 | $9.85 – $42.95 | 17 |
| Lactoferrin fecal quant CPT 83631 | $21.00 | $140.00 | $9.82 – $42.79 | 17 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $398.85 | $2,659.00 | $203.94 – $3,520.39 | 17 |
| Laryngoscopy w/fb removal CPT 31530 | $599.25 | $3,995.00 | $298.66 – $3,520.39 | 17 |
| Lb with mastopexy 15839 CPT 15839 | $1,223.85 | $8,159.00 | $490.40 – $5,745.12 | 17 |
| Lead capillary CPT 83655 | $21.15 | $141.00 | $6.06 – $26.40 | 17 |
| Legion pneumo dna dir prob CPT 87540 | $35.10 | $234.00 | $10.03 – $43.71 | 17 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $344.25 | $2,295.00 | $76.07 – $471.92 | 17 |
| Leishmania antibody CPT 86717 | $20.70 | $138.00 | $6.13 – $26.71 | 17 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | $113.74 | $758.28 | $5.67 – $18.76 | 2 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $6,163.15 | $41,087.66 | $105.49 – $487.85 | 17 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $81.24 | $541.59 | $0.07 – $0.48 | 2 |
| Levetiracetam therapeutic drug level CPT 80177 | $23.10 | $154.00 | $6.63 – $28.89 | 17 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $386.10 | $2,573.98 | $4.47 – $21.00 | 2 |
| Lidocaine therapeutic drug level CPT 80176 | $25.80 | $172.00 | $7.35 – $32.02 | 17 |
| Ligation/major artery/extremity 37618 CPT 37618 | $644.55 | $4,297.00 | $1,385.82 – $3,075.56 | 5 |
| Ligation of inf vena cava CPT 37619 | $1,690.80 | $11,272.00 | $5,048.52 – $11,005.77 | 17 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $1,070.70 | $7,138.00 | $2,864.70 – $6,245.05 | 17 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $28.90 | $192.67 | $3.99 – $17.68 | 3 |
| Lipase CPT 83690 | $12.15 | $81.00 | $3.45 – $15.02 | 17 |
| Lipoprotein blood high res frac & quant CPT 83701 | $43.50 | $290.00 | $16.93 – $73.81 | 17 |
| Lipoprotein blood quant CPT 83704 | $55.35 | $369.00 | $17.10 – $74.53 | 17 |
| Lipoprotein direct measurement hdl CPT 83718 | $14.40 | $96.00 | $4.10 – $17.85 | 17 |
| Lipoprotein direct measurement ldl CPT 83721 | $16.65 | $111.00 | $5.25 – $22.89 | 17 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $45.00 | $300.00 | $17.10 – $74.53 | 17 |
| Listeria monocytogenes CPT 86723 | $15.00 | $100.00 | $6.60 – $28.75 | 17 |
| Lithium therapeutic drug level CPT 80178 | $11.70 | $78.00 | $3.31 – $14.41 | 17 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $2,285.10 | $15,234.00 | $12,116.94 – $12,352.22 | 5 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $79.65 | $531.00 | $88.10 – $384.09 | 17 |
| Liver elastography 91200 CPT 91200 | $91.65 | $611.00 | $19.34 – $254.50 | 17 |
| Liver Function Test CPT 80076 | $13.65 | $91.00 | $4.09 – $17.81 | 17 |
| Liver imaging CPT 78201 | $452.25 | $3,015.00 | $77.48 – $1,291.39 | 17 |
| Liver imag w/vasclr flow CPT 78202 | $474.90 | $3,166.00 | $94.78 – $1,291.39 | 17 |
| Liver/spleen imag static only CPT 78215 | $474.90 | $3,166.00 | $96.41 – $1,291.39 | 17 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $498.60 | $3,324.00 | $114.34 – $1,291.39 | 17 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $7.25 | $48.34 | $2.43 – $10.46 | 2 |
| Low cost skin substitute app HCPCS C5271 | $267.00 | $1,780.00 | $215.06 – $2,800.70 | 5 |
| Low cost skin substitute app HCPCS C5275 | $267.00 | $1,780.00 | $215.06 – $2,800.70 | 5 |
| Low cost skin substitute app HCPCS C5272 | $112.05 | $747.00 | $229.33 – $2,800.70 | 5 |
| Low cost skin substitute app HCPCS C5276 | $112.05 | $747.00 | $229.33 – $2,800.70 | 5 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $587.70 | $3,918.00 | $159.14 – $455.25 | 17 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $559.65 | $3,731.00 | $150.25 – $690.02 | 17 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $531.75 | $3,545.00 | $94.85 – $206.78 | 17 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $668.55 | $4,457.00 | $267.02 – $690.02 | 17 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $636.75 | $4,245.00 | $217.92 – $690.02 | 17 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $604.95 | $4,033.00 | $169.21 – $471.92 | 17 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $65.85 | $439.00 | $22.19 – $206.78 | 17 |
| L/s ratio fetal lung CPT 83661 | $38.55 | $257.00 | $11.00 – $47.94 | 17 |
| Lumbar diskogram s&i CPT 72295 | $1,040.40 | $6,936.00 | $135.67 – $3,862.21 | 17 |
| Lung function test (mbc/mvv) CPT 94200 | $28.95 | $193.00 | $8.75 – $116.68 | 17 |
| Lung Function Test (Spirometry) CPT 94010 | $86.40 | $576.00 | $14.86 – $427.07 | 17 |
| Lung perfusion imaging CPT 78580 | $452.25 | $3,015.00 | $101.21 – $1,291.39 | 17 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $150.15 | $1,001.00 | $125.88 – $51,278.63 | 17 |
| Lymphatics/lymph node imaging CPT 78195 | $452.25 | $3,015.00 | $127.93 – $1,291.39 | 17 |
| Lymphocyte transformation mitogen CPT 86353 | $83.85 | $559.00 | $24.52 – $106.89 | 17 |
| Lymph vessel x-ray arm/leg CPT 75801 | $276.60 | $1,844.00 | $177.96 – $1,602.15 | 17 |
| Lymph vessel x-ray arms/legs CPT 75803 | $414.75 | $2,765.00 | $177.96 – $3,113.45 | 17 |
| Lymph vessel x-ray trunk CPT 75805 | $452.10 | $3,014.00 | $200.16 – $6,245.05 | 17 |
| Lymph vessel x-ray trunk CPT 75807 | $492.60 | $3,284.00 | $200.16 – $6,245.05 | 17 |
| Lysis of labial adhesions CPT 56441 | $1,140.00 | $7,600.00 | $187.12 – $6,402.58 | 17 |
| Macroscopic exam arthropod CPT 87168 | $7.20 | $48.00 | $2.14 – $11.56 | 17 |
| Macroscopic exam parasite CPT 87169 | $7.20 | $48.00 | $2.16 – $11.56 | 17 |
| Magnesium CPT 83735 | $11.85 | $79.00 | $2.31 – $14.61 | 17 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $19.27 | $128.47 | $0.49 – $0.84 | 2 |
| Magnetic image bone marrow CPT 77084 | $537.15 | $3,581.00 | $169.21 – $471.92 | 17 |
| Malaria antibody CPT 86750 | $23.10 | $154.00 | $6.60 – $28.75 | 17 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $28.95 | $193.00 | $12.40 – $263.15 | 17 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $38.85 | $259.00 | $14.86 – $263.15 | 17 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $236.10 | $1,574.00 | $45.82 – $538.39 | 5 |
| Map tachycard site(s) CPT 93609 | $513.90 | $3,426.00 | $97.49 – $24,590.07 | 5 |
| Marker biop eviva buckle ss HCPCS A4648 | $130.20 | $868.00 | $119.73 – $119.73 | 1 |
| Mastoids complete CPT 70130 | $69.30 | $462.00 | $22.40 – $206.78 | 17 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $1,835.67 | $12,237.78 | $31.66 – $246.13 | 16 |
| M.avium-intra dna dir prob CPT 87560 | $18.75 | $125.00 | $11.55 – $59.49 | 17 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $25.35 | $169.00 | $7.23 – $31.52 | 17 |
| Mayo aathr protein s free CPT 85306 | $25.95 | $173.00 | $5.17 – $33.40 | 17 |
| Mayo activated protein c resistance assay CPT 85307 | $25.95 | $173.00 | $6.98 – $33.40 | 17 |
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.