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 |
|---|---|---|---|---|
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $1,865.02 – $2,298.50 | 4 |
| Rpr csf leak/pseudomeng/laminectomy63709 CPT 63709 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rpr diaphragm hernia/chronic/not neonate 39541 CPT 39541 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rpr diaphragm lac/any approach 39501 CPT 39501 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Rpr fem hernia init blocked CPT 49553 | not published | not published | $1,337.72 – $3,160.00 | 4 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | $1,337.72 – $2,225.50 | 4 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $1,337.72 – $1,985.50 | 4 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $1,337.72 – $1,985.50 | 4 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $1,337.72 – $3,160.00 | 4 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $1,337.72 – $1,985.50 | 4 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $1,337.72 – $2,225.50 | 4 |
| Rpr nsl vlv collapse w/implt CPT 30468 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Rpr parastomal hernia rdc 49621 CPT 49621 | not published | not published | $1,889.50 – $1,985.50 | 3 |
| Rpr parastomal hrna ncr/strn 49622 CPT 49622 | not published | not published | $3,006.00 – $3,160.00 | 3 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $18.69 – $78.50 | 27 |
| Rpr rem hernia init reduce CPT 49550 | not published | not published | $1,337.72 – $2,298.50 | 4 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $114.01 – $640.28 | 24 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $1,117.60 – $1,543.50 | 4 |
| Rsv assay w/optic CPT 87807 | not published | not published | $8.42 – $46.28 | 36 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $31.30 – $170.30 | 23 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $31.68 – $113.99 | 23 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $31.68 – $113.99 | 23 |
| Rubella antibody igg CPT 86762 | $73.10 | $243.65 | $9.33 – $55.30 | 36 |
| Rubeola antibody igg CPT 86765 | $74.43 | $248.10 | $9.04 – $49.66 | 36 |
| Russell viper venom diluted CPT 85613 | $108.20 | $360.65 | $6.71 – $37.24 | 36 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $825.37 – $1,935.04 | 28 |
| Salivary gland function exam CPT 78232 | not published | not published | $84.94 – $589.01 | 34 |
| Salivary gland imaging CPT 78230 | not published | not published | $61.58 – $589.01 | 34 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $89.58 – $589.01 | 34 |
| Salmonella antibody CPT 86768 | $37.58 | $125.25 | $9.25 – $50.81 | 36 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $923.10 – $2,225.50 | 4 |
| Same day nb discharge 99463 CPT 99463 | not published | not published | $36.06 – $170.30 | 21 |
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $37.92 – $108.52 | 30 |
| Sarscov coronavirus ag ia CPT 87426 | not published | not published | $31.80 – $74.55 | 30 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $63.26 – $138.90 | 30 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $1,587.54 – $3,160.00 | 4 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | not published | not published | $122.34 – $122.34 | 1 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | not published | not published | $62.28 – $62.28 | 1 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | not published | not published | $82.20 – $82.20 | 1 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | not published | not published | $40.44 – $40.44 | 1 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $523.35 | $1,744.50 | $76.07 – $601.58 | 31 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $440.79 | $1,469.30 | $76.07 – $334.25 | 31 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | not published | not published | $76.07 – $407.01 | 31 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | not published | not published | $48.16 – $278.62 | 31 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | not published | not published | $76.07 – $280.81 | 31 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $444.86 | $1,482.85 | $48.16 – $262.06 | 31 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $389.69 | $1,298.95 | $76.07 – $591.26 | 31 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $369.29 | $1,230.95 | $48.16 – $343.25 | 31 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $366.44 | $1,221.45 | $48.16 – $294.17 | 31 |
| Scan proc cranial extra CPT 61782 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Scan proc cranial intra 61781 CPT 61781 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Scan proc spinal CPT 61783 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | not published | not published | $470.99 – $2,981.50 | 4 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $871.76 – $3,160.00 | 4 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $1,093.16 | $3,643.85 | $237.14 – $1,246.50 | 6 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $1,093.16 | $3,643.85 | $237.14 – $1,246.50 | 6 |
| Screening Mammogram CPT 77067 | $189.54 | $631.80 | $72.15 – $263.95 | 35 |
| Screen pap by tech w md supv HCPCS P3000 | $27.65 | $92.15 | $7.42 – $46.28 | 12 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | not published | not published | $1.53 – $1.53 | 1 |
| Sc ther infusion reset pump CPT 96371 | not published | not published | $17.41 – $94.05 | 22 |
| Sec abd wall suture evisceration/dehsn 49900 CPT 49900 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Sec art mech thrmbc non-intracranial add-on CPT 37186 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Sedimentation rate erythrocyte automated CPT 85652 | not published | not published | $1.90 – $10.16 | 36 |
| Segmentectomy 32484 CPT 32484 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Select picture audiometry CPT 92583 | not published | not published | $17.18 – $106.97 | 27 |
| Self-meas bp pt educaj/train CPT 99473 | not published | not published | $20.81 – $32.37 | 18 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | not published | not published | $6.64 – $33.29 | 9 |
| Self-mgmt educ/train 5-8 pt 30min CPT 98962 | not published | not published | $4.94 – $36.10 | 9 |
| Semen analysis presence/motility CPT 89321 | $51.29 | $170.95 | $8.45 – $46.28 | 36 |
| Semen analysis w/count CPT 89310 | not published | not published | $6.04 – $33.86 | 36 |
| Sensorimotor examination CPT 92060 | not published | not published | $5.59 – $78.50 | 27 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $9.18 – $154.33 | 27 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $767.34 – $1,985.50 | 4 |
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $67.98 – $272.16 | 36 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $1,185.00 – $1,301.07 | 4 |
| Serpina1 gene CPT 81332 | not published | not published | $29.48 – $169.30 | 36 |
| Sertraline (zoloft) - sendout CPT 80332 | not published | not published | $0.02 – $0.02 | 2 |
| Set radiation therapy field CPT 77280 | not published | not published | $53.24 – $650.16 | 33 |
| Set radiation therapy field CPT 77285 | not published | not published | $130.50 – $1,071.99 | 33 |
| Set radiation therapy field CPT 77290 | not published | not published | $130.50 – $1,184.09 | 33 |
| Set-up cardiovert-defibrill CPT 93745 | not published | not published | $123.77 – $602.35 | 25 |
| Sever cranial nerve CPT 64771 | not published | not published | $692.04 – $1,246.50 | 4 |
| Sex transformation f to m CPT 55980 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Sex transformation m to f CPT 55970 | not published | not published | $2,118.00 – $2,225.50 | 3 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $413.71 – $1,985.50 | 4 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | not published | not published | $23.00 – $2,225.50 | 24 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | not published | not published | $31.12 – $2,225.50 | 24 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | not published | not published | $37.88 – $2,225.50 | 24 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | not published | not published | $45.00 – $2,225.50 | 24 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | not published | not published | $20.30 – $2,225.50 | 24 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | not published | not published | $28.41 – $2,225.50 | 24 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | not published | not published | $33.83 – $2,225.50 | 24 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | not published | not published | $45.00 – $2,225.50 | 24 |
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.