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 |
|---|---|---|---|---|
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $105.61 – $1,004.50 | 22 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $109.36 – $145.56 | 2 |
| Injection epidural blood patch or clot CPT 62273 | $1,079.45 | $3,598.15 | $336.03 – $1,004.50 | 22 |
| Injection eye drug CPT 67028 | not published | not published | $157.21 – $1,004.50 | 22 |
| Injection for arthrography wrist (both sides) CPT 25246 | $395.57 | $1,318.55 | $32.47 – $2,225.50 | 5 |
| Injection for bladder x-ray CPT 51600 | not published | not published | $38.31 – $2,225.50 | 5 |
| Injection for hip x-ray CPT 27095 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection for ureter x-ray CPT 50690 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection glatiramer acetate HCPCS J1595 | $387.62 | $1,292.05 | $55.54 – $338.45 | 12 |
| Injection into brain canal CPT 61026 | not published | not published | $336.03 – $1,004.50 | 22 |
| Injection into brain canal CPT 61055 | not published | not published | $250.77 – $1,004.50 | 22 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $221.26 – $2,225.50 | 22 |
| Injection into spinal artery CPT 62294 | not published | not published | $336.03 – $1,543.50 | 22 |
| Injection into vocal cord CPT 31513 | not published | not published | $193.20 – $1,246.50 | 22 |
| Injection jugular CPT 36299 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection of sinus tract CPT 20500 | not published | not published | $45.00 – $2,225.50 | 4 |
| Injection,onabotulinumtoxina HCPCS J0585 | $13.88 | $46.25 | $2.69 – $13.90 | 14 |
| Injection px peyronie ds CPT 54200 | not published | not published | $106.89 – $1,004.50 | 22 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $347.75 | $1,159.15 | $140.14 – $1,004.50 | 22 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $761.37 | $2,537.90 | $336.03 – $1,004.50 | 4 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | not published | not published | $186.38 – $1,004.50 | 22 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | not published | not published | $186.38 – $1,004.50 | 22 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | not published | not published | $336.03 – $1,176.48 | 22 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | not published | not published | $336.03 – $1,176.48 | 22 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | not published | not published | $336.03 – $1,176.48 | 22 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | not published | not published | $588.30 – $1,004.50 | 21 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $984.14 | $3,280.45 | $588.30 – $1,004.50 | 21 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | not published | not published | $20.30 – $1,004.50 | 24 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | not published | not published | $105.61 – $1,004.50 | 22 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | not published | not published | $105.61 – $1,004.50 | 22 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $55.98 | $186.60 | $17.41 – $87.00 | 22 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $55.98 | $186.60 | $10.70 – $87.00 | 3 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $127.74 | $425.80 | $17.41 – $278.42 | 22 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $56.00 | $186.65 | $16.71 – $94.05 | 22 |
| Injection treatment of eye CPT 66020 | not published | not published | $376.09 – $1,004.50 | 4 |
| Injection treatment of eye CPT 66030 | not published | not published | $376.09 – $1,004.50 | 4 |
| Injection treatment of nerve CPT 64605 | not published | not published | $692.04 – $1,004.50 | 4 |
| Injection treatment of nerve CPT 64610 | not published | not published | $692.04 – $1,004.50 | 4 |
| Injection treatment of nerve CPT 64681 | not published | not published | $336.03 – $1,246.50 | 22 |
| Injection treatment of nose CPT 30200 | not published | not published | $18.94 – $1,004.50 | 24 |
| Inject sacroiliac joint CPT 27096 | not published | not published | $45.00 – $2,225.50 | 3 |
| Inject/treat eye socket CPT 67500 | not published | not published | $45.00 – $2,225.50 | 22 |
| Inject/treat eye socket CPT 67505 | not published | not published | $149.18 – $1,004.50 | 22 |
| Inject/treat eye socket CPT 67515 | not published | not published | $149.18 – $1,004.50 | 22 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $588.30 – $1,004.50 | 21 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $756.31 – $1,176.48 | 21 |
| Inj for ext venography CPT 36005 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj for mammo ductogram CPT 19030 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj hrt cath w/s&i nonsel p-art angrp CPT 93568 | not published | not published | $115.90 – $154.26 | 2 |
| Inj hrt cath w/s&i sel hrt ang CPT 93563 | not published | not published | $48.85 – $65.02 | 2 |
| Inj hrt cath w/s&i sel hrt art CPT 93564 | not published | not published | $50.85 – $67.68 | 2 |
| Inj hrt cath w/s&i sel left vent CPT 93565 | not published | not published | $37.96 – $50.52 | 2 |
| Inj hrt cath w/s&i sel right vent CPT 93566 | not published | not published | $129.35 – $172.16 | 2 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $735.02 – $1,176.48 | 22 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | not published | not published | $12.18 – $2,225.50 | 24 |
| Inj intralesional > 7 lsns CPT 11901 | not published | not published | $20.30 – $2,225.50 | 24 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | $11.66 | $38.85 | $2.67 – $7.37 | 9 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | not published | not published | $262.24 – $1,543.50 | 22 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Inj peritoneal venous shunt CPT 49427 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj proc ankle arthr CPT 27648 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj proc elbow arthro CPT 24220 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj proc for lymphang CPT 38790 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj proc lumbr disk ea lvl CPT 62290 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj proc myelogram lumbar CPT 62284 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj proc sialogram CPT 42550 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj retro urethrocysto CPT 51610 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Inj scleros sol mult veins CPT 36471 | not published | not published | $34.20 – $2,225.50 | 24 |
| Inj scleros sol sgl vein CPT 36470 | not published | not published | $45.00 – $2,225.50 | 22 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | not published | not published | $45.00 – $2,225.50 | 22 |
| Inj w/fluor eval cv device CPT 36598 | $1,228.01 | $4,093.35 | $97.60 – $1,004.50 | 22 |
| Ins cath ren art 1st bi CPT 36252 | not published | not published | $1,280.21 – $2,225.50 | 4 |
| Ins cath ren art 1st uni CPT 36251 | not published | not published | $1,280.21 – $2,225.50 | 4 |
| Ins cath ren art 2nd+ bi CPT 36254 | not published | not published | $1,280.21 – $2,225.50 | 4 |
| Ins cath ren art 2nd+ uni CPT 36253 | not published | not published | $1,280.21 – $2,225.50 | 4 |
| Ins cerv dilator (sep proc) CPT 59200 | not published | not published | $113.08 – $1,004.50 | 22 |
| Insemination of oocytes CPT 89268 | not published | not published | $28.54 – $558.59 | 32 |
| Insert abdomen-venous drain CPT 49425 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Insert and remove bone pin CPT 20650 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Insert ant drainage device CPT 66183 | not published | not published | $1,561.28 – $3,160.00 | 4 |
| Insert brain-fluid device 61215 CPT 61215 | not published | not published | $1,468.50 – $1,543.50 | 4 |
| Insert cannula hemo oth 36815 CPT 36815 | not published | not published | $1,118.14 – $1,543.50 | 4 |
| Insert cannula vein-to-vein hemodialysis CPT 36800 | not published | not published | $1,118.14 – $1,543.50 | 4 |
| Insert cath pleura with image CPT 32557 | not published | not published | $244.68 – $1,004.50 | 4 |
| Insert cath pleura without image CPT 32556 | not published | not published | $244.68 – $1,004.50 | 4 |
| Insert drug delivery implant CPT 11981 | not published | not published | $45.00 – $2,225.50 | 22 |
| Insert epicard eltrd endo 33203 CPT 33203 | not published | not published | $6,190.50 – $6,935.50 | 3 |
| Insert epicardial lead open 33202 CPT 33202 | not published | not published | $6,190.50 – $6,935.50 | 3 |
| Insert eye socket implant CPT 67550 | not published | not published | $1,334.00 – $1,985.50 | 4 |
| Insert hepatic shunt (tips) CPT 37182 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Insert heyman uteri capsule CPT 58346 | not published | not published | $923.10 – $1,246.50 | 4 |
| Insert intervert bimech device 22854 CPT 22854 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Insert intrauterine device iud CPT 58300 | not published | not published | $26.10 – $2,225.50 | 6 |
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.