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 |
|---|---|---|---|---|
| Optx acute shoulder dislc CPT 23660 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx carpl scphd fx int fixj CPT 25628 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx clavicular fx w/int fix CPT 23515 | not published | not published | $1,468.50 – $2,784.74 | 4 |
| Optx complicated mndblr fx CPT 21470 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Optx crpl fx oth/thn scph ea CPT 25645 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx gr hmrl tbrs fx int fix CPT 23630 | not published | not published | $2,187.00 – $2,784.74 | 4 |
| Optx lunate dislocation CPT 25695 | not published | not published | $1,021.33 – $1,246.50 | 4 |
| Optx medial ankle fx CPT 27766 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx mndblr cndylr fx CPT 21465 | not published | not published | $1,865.02 – $1,985.50 | 4 |
| Optx mndblr fx wo ntrdntl CPT 21461 | not published | not published | $1,865.02 – $1,985.50 | 4 |
| Optx mndblr fx xtrnl fixj CPT 21454 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Optx mndblr/max alv ridge fx CPT 21445 | not published | not published | $1,865.02 – $1,985.50 | 4 |
| Optx palatal/max fracture CPT 21422 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Optx partclr fx&/dslc elbw w CPT 24587 | not published | not published | $2,187.00 – $2,784.74 | 4 |
| Optx post ankle fx CPT 27769 | not published | not published | $2,114.20 – $3,160.00 | 4 |
| Optx prox humrl fx w/int fix CPT 23615 | not published | not published | $1,889.50 – $2,784.74 | 4 |
| Optx prx hmrl fx fix rpr rpl CPT 23616 | not published | not published | $1,889.50 – $2,784.74 | 4 |
| Optx radial shaft fracture CPT 25515 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx rad/uln dislc aqt/chrnc CPT 25676 | not published | not published | $1,021.33 – $1,246.50 | 4 |
| Optx rdcrpl/ntrcrpl dislc 1+ CPT 25670 | not published | not published | $1,021.33 – $1,543.50 | 4 |
| Optx rdl shft fx&cltx rad/ul CPT 25525 | not published | not published | $1,889.50 – $2,114.20 | 4 |
| Optx rdl shft fx&dstl rad/ul CPT 25526 | not published | not published | $2,114.20 – $2,298.50 | 4 |
| Optx rdl&uln shft fx rds&uln CPT 25575 | not published | not published | $1,468.50 – $2,784.74 | 4 |
| Optx rdl&uln shft fx rds/uln CPT 25574 | not published | not published | $1,468.50 – $2,784.74 | 4 |
| Optx scapular fx w/int fixj CPT 23585 | not published | not published | $1,468.50 – $2,784.74 | 4 |
| Optx sho dislc fx CPT 23670 | not published | not published | $1,468.50 – $2,784.74 | 4 |
| Optx sho dislc neck fx fixj CPT 23680 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx strclv dslc aq/chrn grf CPT 23532 | not published | not published | $1,021.33 – $1,985.50 | 4 |
| Optx strnclav dislc aqt/chrn CPT 23530 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx tmprmand dislocation CPT 21490 | not published | not published | $1,468.50 – $1,865.02 | 4 |
| Optx trns-scphprlnr fx dislc CPT 25685 | not published | not published | $1,021.33 – $1,543.50 | 4 |
| Optx ulnar shft fx int fixj CPT 25545 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Optx ulnar styloid fracture CPT 25652 | not published | not published | $1,468.50 – $2,114.20 | 4 |
| Orchiectomy partial CPT 54522 | not published | not published | $906.09 – $1,543.50 | 4 |
| Orchiopexy (fowler-stephens) CPT 54650 | not published | not published | $1,337.72 – $2,225.50 | 4 |
| Orchiopexy ingun/scrot appr CPT 54640 | not published | not published | $1,337.72 – $1,985.50 | 4 |
| Organic acids total quant ea spec CPT 83918 | $259.52 | $865.05 | $11.54 – $74.51 | 36 |
| Oropharyngeal biopsy 42800 CPT 42800 | not published | not published | $323.33 – $2,225.50 | 4 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $33.53 | $111.75 | $3.06 – $21.54 | 9 |
| Orthopantogram CPT 70355 | not published | not published | $10.47 – $127.70 | 34 |
| Orthop traing supvj phys/qhp CPT 92066 | not published | not published | $50.46 – $78.50 | 18 |
| Oscillation chest wall mechanical per session CPT 94669 | $229.95 | $766.50 | $19.68 – $268.77 | 27 |
| Osmolality blood CPT 83930 | $48.57 | $161.90 | $4.63 – $25.96 | 36 |
| Osmolality urine CPT 83935 | $43.53 | $145.10 | $4.78 – $25.96 | 36 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | not published | not published | $871.76 – $1,543.50 | 4 |
| Ostectomy scapula partial CPT 23190 | not published | not published | $1,301.07 – $1,985.50 | 4 |
| Osteochondral knee allograft CPT 27415 | not published | not published | $2,118.00 – $5,112.00 | 4 |
| Osteochondral knee autograft CPT 27416 | not published | not published | $1,881.50 – $3,160.00 | 4 |
| Osteochondral talus autogrft CPT 28446 | not published | not published | $2,609.58 – $3,160.00 | 4 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | not published | not published | $12.55 – $54.16 | 21 |
| Osteopath manip tx/7-8 body region 98928 CPT 98928 | not published | not published | $12.55 – $62.92 | 21 |
| Osteopath manip tx/9-10 body region98929 CPT 98929 | not published | not published | $12.55 – $68.49 | 21 |
| Osteoplasty humerus CPT 24420 | not published | not published | $1,468.50 – $1,881.50 | 4 |
| Osteot humerus w/wo int fixj CPT 24400 | not published | not published | $1,881.50 – $1,985.50 | 4 |
| Osteotomy/graft tarsal/calcaneus/talus 28305 CPT 28305 | not published | not published | $1,468.50 – $2,609.58 | 4 |
| Ot evaluation high complexity patient/family CPT 97167 | $129.60 | $432.00 | $64.77 – $170.98 | 28 |
| Ot evaluation low complexity patient/family CPT 97165 | $129.60 | $432.00 | $64.77 – $170.98 | 28 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $129.60 | $432.00 | $64.77 – $170.98 | 28 |
| Other immunoelectrophoresis CPT 86325 | not published | not published | $15.68 – $86.93 | 36 |
| Oth resp proc, group HCPCS G0239 | $102.12 | $340.40 | $10.30 – $26.34 | 9 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $50.48 | $168.25 | $39.61 – $104.56 | 28 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $54.56 | $181.85 | $25.36 – $82.75 | 28 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $54.83 | $182.75 | $19.99 – $65.46 | 28 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | not published | not published | $14.03 – $64.10 | 8 |
| Otoplasty 69300 CPT 69300 | not published | not published | $973.10 – $1,543.50 | 4 |
| Ot re-evaluation patient/family CPT 97168 | $48.26 | $160.85 | $42.73 – $112.79 | 28 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $58.22 | $194.05 | $22.01 – $75.90 | 28 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $28.16 | $93.85 | $18.05 – $51.29 | 28 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $42.78 | $142.60 | $18.89 – $53.68 | 28 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $53.57 | $178.55 | $20.30 – $70.06 | 28 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $46.65 | $155.50 | $15.11 – $73.03 | 28 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $44.01 | $146.70 | $16.29 – $75.99 | 28 |
| Outflow tarct agmntj heart chamber 33478 CPT 33478 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Ovarian cystectomy 58925 CPT 58925 | not published | not published | $1,989.59 – $2,225.50 | 4 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $7.20 | $24.00 | $1.58 – $3.81 | 7 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $229.82 – $958.95 | 35 |
| Palb2 gene known famil vrnt CPT 81308 | not published | not published | $244.83 – $644.44 | 35 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | not published | not published | $373.65 – $3,140.28 | 31 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $58.04 | $193.45 | $14.24 – $25.43 | 7 |
| Pancreatectomy 48153 CPT 48153 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Pancreatectomy dist subtot w/wo splenecto 48140 CPT 48140 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $10.61 | $35.35 | $4.55 – $21.03 | 9 |
| Parathormone (pth) intact CPT 83970 | $138.12 | $460.40 | $28.94 – $160.29 | 36 |
| Parathyrdec/expl parathyr medstnl sternal/tthrc 60505 CPT 60505 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Parathyrd planar w/spect&ct CPT 78072 | not published | not published | $61.09 – $931.13 | 34 |
| Parathyroid autotransplantation 60512 CPT 60512 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Parathyroid planar imaging CPT 78070 | $579.72 | $1,932.40 | $51.32 – $719.70 | 34 |
| Parathyroid planar img w/tomo spect CPT 78071 | not published | not published | $159.41 – $824.28 | 34 |
| Paravaginal defect repair 57284 CPT 57284 | not published | not published | $1,989.59 – $2,225.50 | 4 |
| Parial mast w/lymph removal 19302 CPT 19302 | not published | not published | $2,075.23 – $2,981.50 | 4 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | not published | not published | $45.00 – $2,225.50 | 22 |
| Parotid duct diversion CPT 42507 | not published | not published | $1,468.50 – $1,865.02 | 4 |
| Parotid duct diversion CPT 42509 | not published | not published | $1,865.02 – $1,985.50 | 4 |
| Parotid duct diversion CPT 42510 | not published | not published | $1,865.02 – $1,985.50 | 4 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | not published | not published | $2,056.59 – $3,160.00 | 4 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | not published | not published | $923.10 – $1,004.50 | 4 |
| Partial complicated cystectomy 51555 CPT 51555 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial exc bone humerus CPT 24140 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | not published | not published | $871.76 – $1,543.50 | 4 |
| Partial excision of lip CPT 40500 | not published | not published | $633.43 – $1,246.50 | 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.