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 |
|---|---|---|---|---|
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $703.71 – $1,543.50 | 4 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $5.28 – $170.34 | 27 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $1,105.06 – $1,985.50 | 4 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $1,105.06 – $1,543.50 | 4 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $1,889.50 – $3,161.40 | 4 |
| Fusion of big toe joint CPT 28750 | not published | not published | $1,889.50 – $2,609.58 | 4 |
| Fusion of big toe joint CPT 28755 | not published | not published | $871.76 – $1,985.50 | 4 |
| Fusion of finger joint CPT 26860 | not published | not published | $1,105.06 – $1,543.50 | 4 |
| Fusion of finger tendons CPT 26471 | not published | not published | $614.17 – $1,246.50 | 4 |
| Fusion of finger tendons CPT 26474 | not published | not published | $614.17 – $1,246.50 | 4 |
| Fusion of foot bones CPT 28730 | not published | not published | $1,889.50 – $2,609.58 | 4 |
| Fusion of foot bones CPT 28735 | not published | not published | $1,889.50 – $2,609.58 | 4 |
| Fusion of foot bones CPT 28740 | not published | not published | $1,889.50 – $2,609.58 | 4 |
| Fusion of hand joint CPT 26843 | not published | not published | $1,105.06 – $1,543.50 | 4 |
| Fusion of knuckle CPT 26850 | not published | not published | $1,105.06 – $1,985.50 | 4 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $954.50 – $1,105.06 | 4 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $1,105.06 – $1,543.50 | 4 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $1,105.06 – $1,543.50 | 4 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $1,105.06 – $1,985.50 | 4 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $906.09 – $1,985.50 | 4 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $906.09 – $1,985.50 | 4 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Fusion of thumb CPT 26841 | not published | not published | $1,105.06 – $1,985.50 | 4 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $1,889.50 – $3,161.40 | 4 |
| Fusion of toes CPT 28280 | not published | not published | $871.76 – $1,246.50 | 4 |
| G6pc gene CPT 81250 | not published | not published | $52.64 – $261.99 | 36 |
| G6pd full gene sequence CPT 81249 | not published | not published | $487.46 – $1,881.64 | 36 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $142.02 – $548.59 | 36 |
| G6pd known familial variant CPT 81248 | not published | not published | $304.87 – $1,176.17 | 36 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $1.79 | $5.95 | $0.38 – $2.92 | 6 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $1.08 | $3.60 | $0.15 – $1.76 | 8 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $30.53 | $101.75 | $17.97 – $49.86 | 6 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $14.77 – $81.26 | 36 |
| Galactokinase - sendout CPT 82759 | not published | not published | $15.07 – $83.52 | 36 |
| Galactose transferase test CPT 82776 | not published | not published | $5.88 – $37.24 | 36 |
| Galectin-3 CPT 82777 | not published | not published | $8.81 – $138.85 | 36 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $1,889.70 – $3,160.00 | 4 |
| Gammaglobulin iga CPT 82784 | $99.06 | $330.20 | $6.52 – $36.12 | 36 |
| Gammaglobulin ige CPT 82785 | $68.25 | $227.50 | $11.54 – $63.20 | 36 |
| Gamma glutamyltransferase CPT 82977 | $92.03 | $306.75 | $5.05 – $28.22 | 36 |
| Gardner vag dna quant CPT 87512 | not published | not published | $29.27 – $161.40 | 36 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $3.83 – $21.44 | 36 |
| Gastric emptying imag study CPT 78265 | not published | not published | $164.67 – $965.44 | 34 |
| Gastric emptying imag study CPT 78266 | not published | not published | $218.47 – $1,161.35 | 34 |
| Gastric motility studies CPT 91020 | not published | not published | $23.50 – $701.16 | 27 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $116.01 – $589.01 | 34 |
| Gastrin test CPT 82938 | not published | not published | $12.40 – $68.87 | 36 |
| Gastroesophageal reflux study CPT 78262 | $366.68 | $1,222.25 | $120.09 – $589.01 | 34 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $145.24 – $701.16 | 27 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $372.80 – $2,225.50 | 22 |
| Gated heart multiple CPT 78473 | not published | not published | $147.30 – $602.13 | 34 |
| Gba gene CPT 81251 | not published | not published | $42.52 – $261.99 | 36 |
| General health panel CPT 80050 | not published | not published | $19.54 – $149.01 | 17 |
| Genetic tstg severe inh cond CPT 81443 | not published | not published | $1,989.31 – $7,677.23 | 17 |
| Genioplasty augmentation CPT 21120 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $973.10 – $2,981.50 | 4 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $973.10 – $2,981.50 | 4 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $973.10 – $2,981.50 | 4 |
| Genome sequence analysis CPT 81425 | not published | not published | $0.02 – $15,774.77 | 17 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $71.60 | $238.65 | $2.53 – $4.51 | 9 |
| Gentamicin peak therapeutic drug level CPT 80170 | $54.89 | $182.95 | $11.49 – $63.20 | 36 |
| G-esoph reflx tst w/electrod CPT 91035 | $546.59 | $1,821.95 | $164.37 – $829.10 | 27 |
| Ghs abscess perianal iandd CPT 46050 | not published | not published | $221.26 – $1,204.78 | 22 |
| Ghs abscess postoperative iandd complex CPT 10180 | not published | not published | $817.89 – $1,246.50 | 4 |
| Ghs acetylcholinesterase, rbc CPT 82482 | not published | not published | $5.39 – $30.48 | 36 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $93.03 | $310.10 | $11.28 – $62.08 | 36 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | not published | not published | $92.03 – $500.55 | 36 |
| Ghs analysis neurostim without reprogramming CPT 95970 | not published | not published | $20.13 – $170.34 | 27 |
| Ghs antibodies (torch) igm CPT 86694 | $83.06 | $276.85 | $10.10 – $55.30 | 36 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $45.00 – $2,225.50 | 22 |
| Ghs bladder cath - complex-foley CPT 51703 | $333.18 | $1,110.60 | $56.62 – $1,004.50 | 22 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $3.16 – $16.95 | 36 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | not published | not published | $186.38 – $1,004.50 | 22 |
| Ghs central line insert < age 5, failed CPT 36555 | not published | not published | $421.75 – $1,004.50 | 4 |
| Ghs change cysto/gastrost CPT 43762 | not published | not published | $206.61 – $1,004.50 | 21 |
| Ghs chemo >8 hrs CPT 96416 | not published | not published | $103.89 – $438.31 | 27 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $43.72 – $438.31 | 27 |
| Ghs chemo IV push, ea addtl CPT 96411 | not published | not published | $36.35 – $127.28 | 27 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $161.01 | $536.70 | $24.61 – $135.44 | 36 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | not published | not published | $45.00 – $2,225.50 | 24 |
| Ghs closed reduction ankle dislocation CPT 27840 | not published | not published | $106.92 – $1,004.50 | 22 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | not published | not published | $356.63 – $1,004.50 | 4 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | not published | not published | $106.92 – $1,004.50 | 22 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | not published | not published | $656.09 – $1,004.50 | 4 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | not published | not published | $703.71 – $1,246.50 | 4 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | not published | not published | $106.92 – $1,004.50 | 22 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | not published | not published | $656.09 – $1,004.50 | 4 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | not published | not published | $656.09 – $1,246.50 | 4 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | not published | not published | $106.92 – $1,004.50 | 22 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | not published | not published | $45.00 – $2,225.50 | 22 |
| Ghs community re-entry 15 minutes CPT 97537 | $56.19 | $187.30 | $16.29 – $66.36 | 28 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | not published | not published | $21.65 – $2,225.50 | 24 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | not published | not published | $18.94 – $2,225.50 | 24 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | not published | not published | $20.30 – $2,225.50 | 24 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | not published | not published | $24.35 – $2,225.50 | 24 |
| Ghs cricothyroidotomy CPT 31605 | not published | not published | $197.27 – $1,004.50 | 22 |
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.