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 |
|---|---|---|---|---|
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $703.71 – $1,543.50 | 4 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $0.65 | $2.15 | $0.35 – $0.85 | 7 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $133.11 | $443.70 | $17.41 – $94.05 | 27 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $199.67 | $665.55 | $36.35 – $128.85 | 27 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $263.97 | $879.90 | $103.89 – $438.31 | 27 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $133.11 | $443.70 | $63.32 – $438.31 | 27 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $85.77 | $285.90 | $17.41 – $94.05 | 27 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $96.89 | $322.95 | $17.41 – $152.95 | 27 |
| Administration immunization 1 vaccine CPT 90471 | $43.88 | $146.25 | $4.06 – $94.05 | 27 |
| Administration immunization each additional component CPT 90461 | not published | not published | $9.64 – $26.84 | 8 |
| Administration immunization each additional vaccine CPT 90472 | $43.89 | $146.30 | $4.57 – $26.84 | 9 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $19.18 – $52.92 | 8 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | not published | not published | $3.13 – $94.05 | 27 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $3.13 – $26.84 | 9 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $38.00 – $47.49 | 5 |
| Administration vaccine influenza virus HCPCS G0008 | $43.88 | $146.25 | $4.06 – $52.92 | 9 |
| Administration vaccine pneumococcal HCPCS G0009 | $43.88 | $146.25 | $4.06 – $52.92 | 9 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $32.70 – $40.87 | 5 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $153.69 – $2,035.50 | 16 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $155.70 – $411.50 | 23 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $149.74 – $411.50 | 23 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $204.52 – $411.50 | 23 |
| _afb id by dna probe rflx ast CPT 87149 | not published | not published | $14.06 – $77.88 | 36 |
| #afb mycobacteria suscep. #1 CPT 87190 | not published | not published | $1.22 – $22.59 | 36 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $80.88 – $447.01 | 36 |
| After cataract laser surgery CPT 66821 | not published | not published | $221.82 – $1,246.50 | 22 |
| Air conduction bilat CPT 92552 | not published | not published | $13.55 – $170.34 | 27 |
| Air injection into abdomen 49400 CPT 49400 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $23.32 – $206.75 | 27 |
| Albumin body fluid quantitative each specimen CPT 82042 | $42.81 | $142.70 | $3.63 – $24.85 | 36 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $123.36 | $411.20 | $34.02 – $112.77 | 12 |
| Albumin ischemia modified CPT 82045 | not published | not published | $23.80 – $130.95 | 36 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $71.75 | $239.15 | $4.06 – $48.82 | 36 |
| Albumin serum plasma or whole blood CPT 82040 | $27.45 | $91.50 | $3.47 – $19.17 | 36 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $14.03 – $50.19 | 34 |
| Alkaline phosphatase CPT 84075 | $27.60 | $92.00 | $3.63 – $20.32 | 36 |
| Allergen alpha lactalbumin ige CPT 86008 | $152.36 | $507.85 | $16.14 – $69.98 | 36 |
| Allergen egg white ige CPT 86003 | $127.83 | $426.10 | $3.66 – $28.71 | 36 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $10.88 | $36.25 | $5.59 – $30.48 | 36 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $12.41 – $60.97 | 27 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $12.41 – $60.97 | 27 |
| Allergy Skin Testing CPT 95004 | not published | not published | $2.85 – $1,344.43 | 21 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $5.89 – $1,344.43 | 21 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $2,118.00 – $2,225.50 | 4 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $12.40 – $51.87 | 21 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $7.02 – $32.37 | 21 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $45.16 – $249.45 | 36 |
| Alpha-fetoprotein amniotic CPT 82106 | not published | not published | $11.76 – $65.46 | 36 |
| Alpha-fetoprotein tumor marker CPT 82105 | $80.12 | $267.05 | $11.76 – $65.46 | 36 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $189.51 | $631.70 | $22.41 – $199.03 | 14 |
| Alt/sgpt CPT 84460 | $71.16 | $237.20 | $3.71 – $20.32 | 36 |
| Aluminum - quest CPT 82108 | $75.56 | $251.85 | $17.86 – $98.21 | 36 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $633.43 – $2,225.50 | 4 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | not published | not published | $56.04 – $235.75 | 27 |
| Amantadine (symmetrel)-sendout CPT 80375 | $315.47 | $1,051.55 | $0.02 – $0.02 | 2 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $8.63 – $180.08 | 27 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $3.08 | $10.25 | $0.83 – $2.28 | 7 |
| Amino acid screen, urine CPT 82128 | not published | not published | $9.72 – $54.18 | 36 |
| Amino acid single qual CPT 82127 | not published | not published | $9.72 – $54.18 | 36 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $10.23 – $65.46 | 36 |
| Aminolevulinic acid delta CPT 82135 | $129.15 | $430.50 | $11.54 – $63.20 | 36 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $35.52 | $118.40 | $1.42 – $28.72 | 9 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $0.86 | $2.85 | $0.79 – $1.68 | 5 |
| Amitriptyline (elavil) -sendout CPT 80335 | not published | not published | $0.02 – $0.02 | 2 |
| Ammonia CPT 82140 | $48.83 | $162.75 | $10.22 – $56.45 | 36 |
| Amniocentesisdiagnostic 59000 CPT 59000 | not published | not published | $243.63 – $2,225.50 | 22 |
| Amniocentesis therapeutic CPT 59001 | not published | not published | $113.08 – $2,225.50 | 22 |
| Amniotic fluid scan CPT 82143 | $181.43 | $604.75 | $4.82 – $29.34 | 36 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | not published | not published | $614.17 – $1,985.50 | 4 |
| Amphetamine confirm urine -sendout CPT 80324 | not published | not published | $0.02 – $0.02 | 2 |
| Amphetamines 5 or more CPT 80326 | not published | not published | $0.02 – $0.02 | 2 |
| Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr HCPCS J0285 | $107.46 | $358.20 | $57.22 – $119.97 | 9 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $7.35 | $24.50 | $1.07 – $2.48 | 9 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $9.24 | $30.80 | $2.37 – $8.79 | 9 |
| Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis CPT 81515 | not published | not published | $236.69 – $554.91 | 23 |
| Amp metatarsal w/toe single 28810 CPT 28810 | not published | not published | $871.76 – $1,246.50 | 4 |
| Amp thigh through femur re-amp 27596 CPT 27596 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Amputate hand at wrist CPT 25922 | not published | not published | $830.42 – $1,543.50 | 4 |
| Amputate metacarpal bone 26910 CPT 26910 | not published | not published | $1,105.06 – $1,543.50 | 4 |
| Amputate thigh through femur 27590 CPT 27590 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Amputation follow-up surgery CPT 24925 | not published | not published | $830.42 – $1,543.50 | 4 |
| Amputation follow-up surgery CPT 25907 | not published | not published | $830.42 – $1,543.50 | 4 |
| Amputation follow-up surgery CPT 25909 | not published | not published | $830.42 – $2,225.50 | 4 |
| Amputation follow-up surgery CPT 25929 | not published | not published | $703.71 – $1,543.50 | 4 |
| Amputation follow-up surgery CPT 25931 | not published | not published | $830.42 – $2,225.50 | 4 |
| Amputation follow-up surgery CPT 27594 | not published | not published | $830.42 – $1,543.50 | 4 |
| Amputation follow-up surgery CPT 27884 | not published | not published | $830.42 – $1,543.50 | 4 |
| Amputation leg thr tib/fib 27880 CPT 27880 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Amputation of foot at ankle CPT 27889 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Amputation of lower leg CPT 27882 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Amputation of midtarsal 28800 CPT 28800 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Amputation thru metatarsal CPT 28805 | not published | not published | $871.76 – $2,225.50 | 4 |
| Amputation toe interphalangeal joint CPT 28825 | not published | not published | $871.76 – $1,246.50 | 4 |
| Amputation toe metatarsophalangeal joint CPT 28820 | not published | not published | $871.76 – $1,246.50 | 4 |
| Amylase CPT 82150 | $85.65 | $285.50 | $4.54 – $24.85 | 36 |
| Ana ds-dna CPT 86226 | not published | not published | $8.49 – $47.40 | 36 |
| Analgesics non-opioid definitive assay 1 or 2 acetaminophen CPT 80329 | not published | not published | $0.02 – $0.02 | 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.