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 |
|---|---|---|---|---|
| Partial hip replacement CPT 27125 | not published | not published | $2,118.00 – $28,151.00 | 11 |
| Partial hysterectomy CPT 58180 | not published | not published | $2,118.00 – $4,813.00 | 4 |
| Partial proctectomy; perineal 45123 CPT 45123 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial removal finger bone CPT 26235 | not published | not published | $614.17 – $1,543.50 | 4 |
| Partial removal finger bone CPT 26236 | not published | not published | $614.17 – $1,543.50 | 4 |
| Partial removal foot fascia CPT 28060 | not published | not published | $871.76 – $1,246.50 | 4 |
| Partial removal leg bone(s) CPT 27360 | not published | not published | $1,301.07 – $2,298.50 | 4 |
| Partial removal of bladder CPT 51550 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial removal of esophagus 43117 CPT 43117 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial removal of esophagus 43122 CPT 43122 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial removal of eye fluid CPT 67005 | not published | not published | $876.31 – $1,985.50 | 4 |
| Partial removal of eye fluid CPT 67010 | not published | not published | $876.31 – $1,985.50 | 4 |
| Partial removal of fibula CPT 27641 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Partial removal of foot bone CPT 28288 | not published | not published | $871.76 – $1,543.50 | 4 |
| Partial removal of hand bone CPT 26230 | not published | not published | $614.17 – $2,981.50 | 4 |
| Partial removal of heart sac 33030 CPT 33030 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial removal of lip CPT 40530 | not published | not published | $973.10 – $1,246.50 | 4 |
| Partial removal of lung 32480 CPT 32480 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial removal of nose CPT 30150 | not published | not published | $1,468.50 – $1,865.02 | 4 |
| Partial removal of penis CPT 54120 | not published | not published | $1,117.60 – $1,246.50 | 4 |
| Partial removal of pharynx 42890 CPT 42890 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Partial removal of radius CPT 25151 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Partial removal of radius CPT 25230 | not published | not published | $1,301.07 – $1,985.50 | 4 |
| Partial removal of rib CPT 21600 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Partial removal of sternum CPT 21620 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Partial removal of thyroid CPT 60220 | not published | not published | $1,185.00 – $2,119.81 | 4 |
| Partial removal of thyroid CPT 60225 | not published | not published | $1,468.50 – $2,119.81 | 4 |
| Partial removal of tibia CPT 27640 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Partial removal of toe CPT 28160 | not published | not published | $871.76 – $1,543.50 | 4 |
| Partial removal of tongue CPT 41120 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Partial removal of ulna CPT 25119 | not published | not published | $1,301.07 – $1,543.50 | 4 |
| Partial removal of ulna CPT 25150 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Partial removal of ulna CPT 25240 | not published | not published | $1,301.07 – $1,985.50 | 4 |
| Partial removal of vaginal wall 57106 CPT 57106 | not published | not published | $923.10 – $2,225.50 | 4 |
| Partial removal tear gland CPT 68505 | not published | not published | $767.34 – $1,543.50 | 4 |
| Partial thyroid excision CPT 60210 | not published | not published | $2,118.00 – $2,225.50 | 4 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | not published | not published | $2,118.00 – $2,225.50 | 4 |
| Part removal of metatarsal CPT 28110 | not published | not published | $871.76 – $1,543.50 | 4 |
| Part removal of metatarsal CPT 28113 | not published | not published | $871.76 – $1,543.50 | 4 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $871.76 – $1,543.50 | 4 |
| Path clin consltj high 41-60 CPT 80505 | not published | not published | $121.73 – $226.45 | 27 |
| Path clin consltj mod 21-40 CPT 80504 | not published | not published | $64.68 – $226.45 | 27 |
| Path clin consltj sf 5-20 CPT 80503 | not published | not published | $30.32 – $70.60 | 27 |
| Patient recorded spirometry CPT 94014 | not published | not published | $25.88 – $527.31 | 25 |
| Patient recorded spirometry CPT 94015 | not published | not published | $25.88 – $411.50 | 25 |
| Pdgfra gene CPT 81314 | not published | not published | $163.11 – $1,032.83 | 36 |
| Pdt dstr prmlg les phys/qhp CPT 96573 | not published | not published | $168.80 – $402.66 | 24 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $703.71 – $1,543.50 | 4 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $32.70 – $206.75 | 24 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $32.70 – $452.39 | 24 |
| Pedicle enel/ntroral 15576 CPT 15576 | not published | not published | $703.71 – $1,543.50 | 4 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | $1,149.47 | $3,831.55 | $30.77 – $120.13 | 11 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $926.10 | $3,087.00 | $151.23 – $739.53 | 34 |
| Pelvic CT scan (with contrast) CPT 72193 | $838.05 | $2,793.50 | $148.75 – $622.36 | 34 |
| Pelvic CT scan (without contrast) CPT 72192 | $817.49 | $2,724.95 | $90.33 – $562.76 | 34 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,333.79 | $4,445.95 | $264.35 – $1,176.18 | 34 |
| Pelvic MRI (with contrast) CPT 72196 | $976.83 | $3,256.10 | $215.74 – $970.79 | 34 |
| Pelvic MRI (without contrast) CPT 72195 | $882.27 | $2,940.90 | $167.52 – $906.80 | 34 |
| Pelvic Ultrasound (complete) CPT 76856 | $371.07 | $1,236.90 | $43.30 – $202.10 | 34 |
| Pelvic Ultrasound (limited) CPT 76857 | not published | not published | $29.66 – $179.33 | 34 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $82.91 | $276.35 | $22.85 – $123.46 | 14 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $173.78 | $579.25 | $4.27 – $87.03 | 14 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $54.63 | $182.10 | $16.13 – $52.23 | 13 |
| Penile injection CPT 54235 | not published | not published | $45.00 – $2,225.50 | 22 |
| Penile vascular study CPT 93980 | not published | not published | $76.07 – $171.14 | 31 |
| Penile vascular study CPT 93981 | not published | not published | $76.07 – $146.79 | 31 |
| Penile venous occlusion CPT 37790 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Penis plastic surgery CPT 54360 | not published | not published | $1,468.50 – $1,708.17 | 4 |
| Penis study CPT 54240 | not published | not published | $45.00 – $2,225.50 | 22 |
| Perc cryo ablate renal tum CPT 50593 | not published | not published | $2,047.95 – $3,160.00 | 4 |
| Perc rf ablate renal tumor CPT 50592 | not published | not published | $954.50 – $2,047.95 | 4 |
| Percut ablate liver rf CPT 47382 | not published | not published | $2,047.95 – $2,225.50 | 4 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $182.99 | $609.95 | $50.98 – $64.08 | 5 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Pericardiocentesis wwo imaging CPT 33016 | not published | not published | $2,836.50 – $2,981.50 | 3 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $1,506.39 – $1,985.50 | 4 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $923.10 – $2,298.50 | 4 |
| Peripheral vascular rehab CPT 93668 | not published | not published | $0.19 – $78.50 | 27 |
| Peri-proc device eval icd CPT 93287 | not published | not published | $10.54 – $26.34 | 8 |
| Peri-proc device eval pm CPT 93286 | not published | not published | $9.32 – $24.10 | 8 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $954.50 – $1,118.14 | 4 |
| Peritoneogram rs&i CPT 74190 | not published | not published | $36.29 – $958.33 | 34 |
| Perit-vens shunt pat tst CPT 78291 | not published | not published | $86.64 – $589.38 | 34 |
| Perq art m-thrombect &/nfs CPT 61645 | not published | not published | $404.41 – $2,225.50 | 4 |
| Perq clsr tcat l atr apndge CPT 33340 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Perq dev breast 1st mr guide CPT 19287 | not published | not published | $65.88 – $1,004.50 | 22 |
| Perq dev breast 1st strtctc CPT 19283 | $1,769.70 | $5,899.00 | $65.88 – $1,004.50 | 22 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $1,556.88 – $2,225.50 | 4 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $1,556.88 – $2,225.50 | 4 |
| Perq plmt bile duct stent CPT 47538 | not published | not published | $2,059.12 – $3,160.00 | 4 |
| Perq plmt bile duct stent CPT 47539 | not published | not published | $2,059.12 – $3,160.00 | 4 |
| Perq plmt bile duct stent CPT 47540 | not published | not published | $2,059.12 – $3,160.00 | 4 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | not published | not published | $206.61 – $1,004.50 | 21 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $954.50 – $1,021.33 | 4 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $1,021.33 – $1,543.50 | 4 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $526.32 – $2,225.50 | 4 |
| Perq transcath closure each CPT 93592 | not published | not published | $360.20 – $16,047.00 | 11 |
| Perq transcath closure pda CPT 93582 | not published | not published | $545.55 – $16,047.00 | 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.