Ascension Saint Thomas DeKalb
520 W Main St, Smithville, TN · Ascension · · NPI 1649659582
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 |
|---|---|---|---|---|
| Destruction vag lesions simple 57061 CPT 57061 | not published | not published | $33.83 – $2,225.50 | 6 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | not published | not published | $29.77 – $2,225.50 | 6 |
| Detect agent nos dna dir CPT 87797 | not published | not published | $14.06 – $93.68 | 36 |
| Detect agnt mult dna direc CPT 87800 | $166.77 | $555.90 | $22.51 – $155.76 | 36 |
| Developmental screen/score/document 96110 CPT 96110 | $199.26 | $664.20 | $4.94 – $71.97 | 3 |
| Devel tst phys/qhp 1st hr CPT 96112 | not published | not published | $114.67 – $206.75 | 20 |
| Device hemospray 7frx220cm endo hemostat min access HCPCS C1052 | $3,996.00 | $13,320.00 | $36.50 – $36.50 | 1 |
| Dev tst admin phys/qhp ea addl 30 min CPT 96113 | not published | not published | $51.16 – $68.09 | 2 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | not published | not published | $15.90 – $127.70 | 34 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $1.61 | $5.35 | $0.13 – $0.69 | 9 |
| Dexrazoxane hcl 250 mg intravenous solution HCPCS J1190 | $504.81 | $1,682.70 | $89.14 – $429.85 | 14 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $46.35 | $154.50 | $2.05 – $13.82 | 9 |
| Dextrose 5 % IV bolus HCPCS J7070 | $46.35 | $154.50 | $4.10 – $17.27 | 9 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $71.87 | $239.55 | $15.59 – $85.78 | 36 |
| Diabetes (HbA1c) Test CPT 83036 | $41.96 | $139.85 | $6.81 – $37.24 | 36 |
| Diag bronchoscope/catheter CPT 31643 | $1,345.43 | $4,484.75 | $527.56 – $1,246.50 | 4 |
| Diag laparo separate proc 49320 CPT 49320 | not published | not published | $1,468.50 – $1,543.50 | 4 |
| Diagnostic anoscopy CPT 46601 | not published | not published | $65.88 – $1,004.50 | 22 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $413.71 – $1,985.50 | 4 |
| Diagnostic anoscopy spx 46600 CPT 46600 | not published | not published | $13.53 – $2,225.50 | 24 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | not published | not published | $46.61 – $313.06 | 15 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | not published | not published | $59.55 – $244.53 | 15 |
| Diagnostic laryngoscopy 31505 CPT 31505 | $132.84 | $442.80 | $17.59 – $2,225.50 | 24 |
| Diagnostic laryngoscopy 31575 CPT 31575 | not published | not published | $45.00 – $2,225.50 | 22 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $244.26 | $814.20 | $87.17 – $319.26 | 35 |
| Diagnostic Mammogram (one breast) CPT 77065 | $215.58 | $718.60 | $68.40 – $249.90 | 35 |
| Diagnostic radio unlisted proc CPT 76499 | not published | not published | $22.18 – $166.77 | 24 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Dialysis one evaluation CPT 90945 | $753.99 | $2,513.30 | $80.11 – $562.70 | 21 |
| Diathermy eg microwave CPT 97024 | not published | not published | $5.81 – $13.52 | 28 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $10.77 | $35.90 | $1.60 – $13.17 | 9 |
| Diffusing capacity CPT 94729 | $263.46 | $878.20 | $31.15 – $92.92 | 9 |
| Digital analysis of eeg CPT 95957 | not published | not published | $51.15 – $692.97 | 8 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $11.82 | $39.40 | $1.40 – $15.62 | 9 |
| Digoxin total therapeutic drug level CPT 80162 | $44.45 | $148.15 | $9.31 – $51.92 | 36 |
| Dilate biliary duct/ampulla CPT 47542 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Dilate esophagus CPT 43453 | not published | not published | $532.43 – $1,004.50 | 4 |
| Dilate esophagus 1/mult pass CPT 43450 | $840.86 | $2,802.85 | $372.80 – $1,238.94 | 22 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | not published | not published | $224.54 – $1,246.50 | 4 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | not published | not published | $112.45 – $1,246.50 | 4 |
| Dilate ic vasospasm init CPT 61640 | not published | not published | $319.11 – $1,543.50 | 4 |
| Dilate tear duct opening CPT 68801 | not published | not published | $21.65 – $2,225.50 | 24 |
| Dilate urethra stricture CPT 53600 | not published | not published | $106.89 – $1,004.50 | 22 |
| Dilate urethra stricture CPT 53601 | not published | not published | $56.62 – $1,004.50 | 22 |
| Dilate urethra stricture CPT 53605 | not published | not published | $613.48 – $1,246.50 | 4 |
| Dilate urethra stricture CPT 53621 | not published | not published | $106.89 – $1,004.50 | 22 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $45.00 – $2,225.50 | 22 |
| Dilation of anal sphincter CPT 45905 | not published | not published | $727.58 – $1,004.50 | 4 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $923.10 – $1,004.50 | 4 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $727.58 – $1,004.50 | 4 |
| Dilation of salivary duct CPT 42660 | not published | not published | $45.00 – $2,225.50 | 22 |
| Dilation of urethra CPT 53661 | not published | not published | $45.00 – $2,225.50 | 22 |
| Dilation of urethra CPT 53665 | not published | not published | $814.38 – $1,004.50 | 4 |
| Dilation of vagina CPT 57400 | not published | not published | $923.10 – $1,246.50 | 4 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $633.43 – $1,004.50 | 4 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $274.47 – $2,225.50 | 22 |
| Dilat xst trc ndurlgc px CPT 50436 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Dilat xst trc new access rcs CPT 50437 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,493.66 | $4,978.85 | $42.33 – $1,538.74 | 14 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $4.64 | $15.45 | $0.90 – $1.98 | 9 |
| Diphtheria-tetanus toxoids 0.5 ml (peds) CPT 90702 | not published | not published | $8.12 – $113.99 | 7 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $5.89 – $51.87 | 21 |
| Disability dlco CPT 94727 | $237.62 | $792.05 | $23.32 – $206.75 | 27 |
| Disaccharidases CPT 82657 | $247.73 | $825.75 | $12.66 – $69.98 | 36 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,150.77 – $1,543.50 | 4 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Discography cerv/thor spine CPT 72285 | not published | not published | $57.91 – $2,750.96 | 16 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $45.00 – $2,225.50 | 3 |
| Dissolve clot heart vessel CPT 92975 | not published | not published | $312.32 – $7,684.00 | 3 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $1,610.43 – $2,225.50 | 4 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| #d/lmeth-l-methamphetamine CPT 80374 | not published | not published | $0.02 – $0.02 | 2 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Dmd dup/delet analysis CPT 81161 | not published | not published | $69.37 – $874.80 | 36 |
| Dmpk gene detc abnor allele CPT 81234 | not published | not published | $111.30 – $429.41 | 35 |
| Dna antibody native/double stranded CPT 86225 | $36.84 | $122.80 | $9.63 – $53.04 | 36 |
| Dna gardnerella CPT 87510 | not published | not published | $14.06 – $77.88 | 36 |
| Dna probe chlamydia CPT 87490 | not published | not published | $14.06 – $77.88 | 36 |
| Dna probe gc CPT 87590 | not published | not published | $14.06 – $84.67 | 36 |
| Dna trichomonas CPT 87660 | not published | not published | $14.06 – $77.88 | 36 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $16.53 | $55.10 | $9.25 – $41.25 | 9 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $2.97 | $9.90 | $0.44 – $1.72 | 9 |
| Doppler echo complete CPT 93320 | $689.00 | $2,296.65 | $52.30 – $74.43 | 8 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | not published | not published | $58.64 – $78.05 | 2 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $272.97 | $909.90 | $53.33 – $304.81 | 31 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $272.97 | $909.90 | $32.70 – $201.15 | 31 |
| Dpyd gene common variants CPT 81232 | not published | not published | $142.02 – $548.59 | 36 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $31.12 – $2,225.50 | 24 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $45.00 – $2,225.50 | 22 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $432.98 – $2,225.50 | 4 |
| Drainage external ear simple 69000 CPT 69000 | not published | not published | $28.41 – $2,225.50 | 24 |
| Drainage lymph node lesion 38300 CPT 38300 | not published | not published | $35.18 – $1,004.50 | 6 |
| Drainage lymph node lesion 38305 CPT 38305 | not published | not published | $817.89 – $1,246.50 | 4 |
| Drainage mouth roof lesion CPT 42000 | not published | not published | $181.65 – $1,246.50 | 22 |
| Drainage of arm bursa 23931 CPT 23931 | not published | not published | $39.24 – $1,246.50 | 6 |
| Drainage of bladder abscess CPT 51080 | not published | not published | $817.89 – $1,004.50 | 4 |
| Drainage of eye CPT 65800 | not published | not published | $157.21 – $1,004.50 | 4 |
| Drainage of eye CPT 65810 | not published | not published | $876.31 – $1,543.50 | 4 |
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.