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 |
|---|---|---|---|---|
| Rebuild outer ear canal CPT 69320 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Rechanneling of artery CPT 35361 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rechanneling of artery 35305 CPT 35305 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rechanneling of artery 35341 CPT 35341 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rechanneling w/graft tibioperoneal trunk artery 35304 CPT 35304 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rechanneling w/wo patch graft abd aorta 35331 CPT 35331 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rechanneling w/wo patch graft deep profunda fem art 35372 CPT 35372 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rechanneling w/wo patch grf axillary-brachial 35321 CPT 35303 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconst lwr jaw w/fixation CPT 21196 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconst lwr jaw w/graft CPT 21194 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconst lwr jaw without fixation CPT 21195 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Reconst lwr jaw without graft CPT 21193 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Reconst major injured chest 32820 CPT 32820 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconst pectus excavatum/carinatum opn 21740 CPT 21740 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconstr lwr jaw segment CPT 21198 | not published | not published | $973.10 – $2,225.50 | 4 |
| Reconstr lwr jaw w/advance CPT 21199 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Reconstruct ankle joint CPT 27702 | not published | not published | $2,118.00 – $28,151.00 | 7 |
| Reconstruct cleft foot CPT 28360 | not published | not published | $2,118.00 – $2,609.58 | 4 |
| Reconstruct cleft palate CPT 42200 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruct cleft palate CPT 42205 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruct cleft palate CPT 42210 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruct cleft palate CPT 42215 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Reconstruct cleft palate CPT 42220 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruct cleft palate CPT 42225 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruct elbow joint CPT 24360 | not published | not published | $1,682.15 – $2,298.50 | 4 |
| Reconstruct elbow joint CPT 24361 | not published | not published | $2,118.00 – $5,112.00 | 4 |
| Reconstruct elbow joint CPT 24362 | not published | not published | $1,682.15 – $2,298.50 | 4 |
| Reconstruct elbow lat ligmnt CPT 24344 | not published | not published | $1,468.50 – $1,881.50 | 4 |
| Reconstruct elbow med ligmnt CPT 24346 | not published | not published | $1,468.50 – $1,881.50 | 4 |
| Reconstruct extra finger CPT 26587 | not published | not published | $614.17 – $2,298.50 | 4 |
| Reconstruct finger joint CPT 26545 | not published | not published | $1,105.06 – $1,985.50 | 4 |
| Reconstruct finger joint CPT 26548 | not published | not published | $1,105.06 – $1,985.50 | 4 |
| Reconstruct head of radius CPT 24365 | not published | not published | $2,187.00 – $5,112.00 | 4 |
| Reconstruct head of radius CPT 24366 | not published | not published | $2,118.00 – $5,112.00 | 4 |
| Reconstruction ankle joint CPT 27703 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconstruction knee CPT 27427 | not published | not published | $1,468.50 – $3,161.40 | 4 |
| Reconstruction knee CPT 27428 | not published | not published | $1,889.50 – $5,112.00 | 4 |
| Reconstruction knee CPT 27429 | not published | not published | $1,889.50 – $3,161.40 | 4 |
| Reconstruction of anus CPT 46753 | not published | not published | $970.72 – $1,543.50 | 4 |
| Reconstruction of bile ducts 47800 CPT 47800 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconstruction of eyelid CPT 67971 | not published | not published | $767.34 – $1,543.50 | 4 |
| Reconstruction of eyelid CPT 67973 | not published | not published | $767.34 – $1,543.50 | 4 |
| Reconstruction of eyelid CPT 67974 | not published | not published | $767.34 – $1,543.50 | 4 |
| Reconstruction of eyelid CPT 67975 | not published | not published | $767.34 – $1,543.50 | 4 |
| Reconstruction of jaw CPT 21245 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Reconstruction of jaw CPT 21246 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Reconstruction of jaw CPT 21248 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Reconstruction of jaw CPT 21249 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Reconstruction of jaw joint CPT 21240 | not published | not published | $1,865.02 – $1,985.50 | 4 |
| Reconstruction of jaw joint CPT 21242 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruction of jaw joint CPT 21243 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruction of lower jaw CPT 21244 | not published | not published | $1,865.02 – $2,981.50 | 4 |
| Reconstruction of mouth CPT 40840 | not published | not published | $973.10 – $1,246.50 | 4 |
| Reconstruction of mouth CPT 40842 | not published | not published | $1,468.50 – $1,865.02 | 4 |
| Reconstruction of mouth CPT 40843 | not published | not published | $973.10 – $1,543.50 | 4 |
| Reconstruction of mouth CPT 40844 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruction of mouth CPT 40845 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruction of nail bed CPT 11762 | not published | not published | $45.00 – $2,225.50 | 4 |
| Reconstruction of nose CPT 30410 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruction of nose CPT 30420 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruction of orbit CPT 21256 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Reconstruction of throat CPT 42950 | not published | not published | $1,185.00 – $1,865.02 | 4 |
| Reconstruction of urethra CPT 53410 | not published | not published | $1,185.00 – $1,254.79 | 4 |
| Reconstruction of urethra CPT 53415 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconstruction of urethra CPT 53430 | not published | not published | $1,185.00 – $1,254.79 | 4 |
| Reconstruction of urethra CPT 54308 | not published | not published | $1,468.50 – $1,708.17 | 4 |
| Reconstruction of urethra CPT 54312 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Reconstruction of urethra CPT 54316 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Reconstruction of urethra CPT 54318 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Reconstruction of urethra CPT 54322 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Reconstruction of urethra CPT 54324 | not published | not published | $1,468.50 – $1,708.17 | 4 |
| Reconstruction of urethra CPT 54326 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Reconstruction tongue fold CPT 41520 | not published | not published | $1,185.00 – $1,865.02 | 4 |
| Reconstruct lip with flap CPT 40527 | not published | not published | $1,185.00 – $1,865.02 | 4 |
| Reconstruct lip w/local flap 40525 CPT 40525 | not published | not published | $973.10 – $1,246.50 | 4 |
| Reconstruct lower jaw bone CPT 21255 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reconstruct orbit/forehead CPT 21172 | not published | not published | $1,865.02 – $2,225.50 | 4 |
| Reconstruct shoulder joint CPT 23470 | not published | not published | $2,118.00 – $28,151.00 | 11 |
| Reconstruct shoulder joint CPT 23472 | not published | not published | $2,118.00 – $28,151.00 | 11 |
| Reconstruct ulna/radioulnar CPT 25337 | not published | not published | $1,881.50 – $2,298.50 | 4 |
| Reconstruct upper jaw bone CPT 21206 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reconstruct urethra/bladder CPT 53431 | not published | not published | $1,185.00 – $1,254.79 | 4 |
| Reconstruct urethra stage 1 CPT 53420 | not published | not published | $1,254.79 – $1,543.50 | 4 |
| Reconstruct urethra stage 2 CPT 53425 | not published | not published | $1,185.00 – $1,254.79 | 4 |
| Reconstruct vena cava 34502 CPT 34502 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rectal sensation test CPT 91120 | not published | not published | $56.62 – $724.78 | 27 |
| Red blood cells each unit HCPCS P9021 | $416.07 | $1,386.90 | $48.05 – $348.43 | 9 |
| Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit HCPCS P9057 | $422.13 | $1,407.10 | $224.17 – $999.53 | 7 |
| Red blood cells leukocytes reduced each unit HCPCS P9016 | $315.66 | $1,052.20 | $74.58 – $438.63 | 9 |
| Red blood cells leukocytes reduced irradiated each unit HCPCS P9040 | $359.36 | $1,197.85 | $130.47 – $640.34 | 9 |
| Red blood cells washed each unit HCPCS P9022 | $455.57 | $1,518.55 | $88.45 – $665.64 | 9 |
| Red cell mass multiple CPT 78121 | not published | not published | $82.27 – $755.17 | 34 |
| Red cell mass single CPT 78120 | not published | not published | $49.07 – $589.01 | 34 |
| Red cell sequestration CPT 78140 | not published | not published | $111.37 – $589.01 | 34 |
| Red cell survival study CPT 78130 | not published | not published | $80.87 – $589.01 | 34 |
| Redo endovas vena cava filtr CPT 37192 | not published | not published | $1,118.14 – $2,225.50 | 4 |
| Reduce bowel obstruction 44050 CPT 44050 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Reduce testis torsion CPT 54600 | not published | not published | $906.09 – $1,985.50 | 4 |
| Reduction of facial bones CPT 21209 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Reduction of procidentia 45900 CPT 45900 | not published | not published | $221.26 – $1,204.78 | 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.