Ascension Seton Smithville (Ascension Seton)
1201 Hill Rd, Smithville, TX · Ascension · · NPI 1154612638
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 |
|---|---|---|---|---|
| Infratemporal approach/skull CPT 61590 | not published | not published | $969.15 – $3,718.18 | 7 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | not published | not published | $969.15 – $1,000.00 | 2 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | not published | not published | $969.15 – $1,000.00 | 2 |
| Infuse radioactive materials CPT 77750 | not published | not published | $120.53 – $1,215.72 | 18 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $69.40 – $294.65 | 5 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $75.72 – $899.85 | 7 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $144.40 – $763.43 | 7 |
| Initial foot exam pt lops HCPCS G0245 | $125.64 | $349.00 | $43.59 – $198.24 | 4 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $346.37 – $1,473.21 | 5 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $128.49 – $128.49 | 1 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $164.74 – $164.74 | 1 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $88.91 – $88.91 | 1 |
| Initial observation care CPT 99218 | not published | not published | $98.46 – $98.46 | 1 |
| Initial observation care CPT 99219 | not published | not published | $134.31 – $134.31 | 1 |
| Initial observation care CPT 99220 | not published | not published | $183.47 – $183.47 | 1 |
| Initiation & management bipap/cpap initial day CPT 94660 | $696.33 | $1,934.25 | $38.24 – $763.43 | 7 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $62.58 – $266.22 | 6 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $126.85 – $539.92 | 5 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | $784.17 | $2,178.25 | $22.01 – $27.44 | 4 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | $1,613.97 | $4,483.25 | $4.10 – $23.59 | 16 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | $1,038.87 | $2,885.75 | $16.66 – $75.59 | 8 |
| Inj., aristada initio, 1 mg HCPCS J1943 | $1,052.01 | $2,922.25 | $3.06 – $12.44 | 13 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | $1,896.48 | $5,268.00 | $49.53 – $49.53 | 4 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | $3.42 | $9.50 | $0.52 – $0.52 | 1 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $79.20 | $220.00 | $2.16 – $7.92 | 8 |
| Inj ceftolozane tazobactam HCPCS J0695 | $163.62 | $454.50 | $5.41 – $23.88 | 15 |
| Inj, clevidipine butyrate HCPCS C9248 | $4.86 | $13.50 | $3.06 – $3.06 | 4 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | not published | not published | $40.82 – $1,000.00 | 3 |
| Inj crotalidae im f(ab')2 eq HCPCS J0841 | $2,388.06 | $6,633.50 | $1,019.46 – $5,111.80 | 13 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $162.41 – $1,000.00 | 3 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $30.94 – $1,000.00 | 21 |
| Inj dx for sinogram CPT 20501 | $275.67 | $765.75 | $38.18 – $969.15 | 2 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $113.81 – $1,174.46 | 19 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $454.68 | $1,263.00 | $70.14 – $969.15 | 2 |
| Injection, belinostat, 10mg HCPCS J9032 | $2,863.53 | $7,954.25 | $38.89 – $170.16 | 15 |
| Injection, cangrelor HCPCS C9460 | $1,305.72 | $3,627.00 | $18.13 – $22.11 | 5 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $29.88 – $1,000.00 | 21 |
| Injection, daratumumab 10 mg HCPCS J9145 | $3,147.75 | $8,743.75 | $52.29 – $220.39 | 15 |
| Injection, doxercalciferol HCPCS J1270 | $58.41 | $162.25 | $0.30 – $0.30 | 1 |
| Injection during cath supravalvular aortography CPT 93567 | $7,393.68 | $20,538.00 | $52.76 – $52.76 | 1 |
| Injection epidural blood patch or clot CPT 62273 | $1,936.98 | $5,380.50 | $114.04 – $1,174.46 | 20 |
| Injection eye drug CPT 67028 | not published | not published | $34.04 – $1,000.00 | 21 |
| Injection for arthrography wrist (both sides) CPT 25246 | $165.06 | $458.50 | $75.54 – $969.15 | 2 |
| Injection for bladder x-ray CPT 51600 | $53.64 | $149.00 | $45.11 – $969.15 | 2 |
| Injection for hip x-ray CPT 27095 | not published | not published | $83.74 – $1,000.00 | 3 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $390.78 | $1,085.50 | $51.47 – $969.15 | 2 |
| Injection for spleen x-ray CPT 38200 | $207.90 | $577.50 | $134.53 – $969.15 | 2 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $55.18 – $1,000.00 | 3 |
| Injection for ureter x-ray CPT 50684 | $83.16 | $231.00 | $50.31 – $969.15 | 2 |
| Injection for ureter x-ray CPT 50690 | not published | not published | $70.32 – $1,000.00 | 3 |
| Injection, fulvestrant HCPCS J9395 | $107.55 | $298.75 | $9.47 – $283.46 | 14 |
| Injection glatiramer acetate HCPCS J1595 | $1,210.77 | $3,363.25 | $151.43 – $391.72 | 9 |
| Injection, inclisiran, 1 mg HCPCS J1306 | $5.22 | $14.50 | $12.06 – $12.06 | 4 |
| Injection into brain canal CPT 61026 | $702.45 | $1,951.25 | $105.24 – $1,174.46 | 20 |
| Injection into brain canal CPT 61055 | $672.66 | $1,868.50 | $108.15 – $969.15 | 20 |
| Injection into hemorrhoid(s) CPT 46500 | not published | not published | $94.11 – $1,546.19 | 21 |
| Injection into spinal artery CPT 62294 | not published | not published | $565.37 – $1,509.87 | 9 |
| Injection into vocal cord CPT 31513 | not published | not published | $130.21 – $1,002.38 | 21 |
| Injection intraop add-on CPT 48400 | not published | not published | $79.66 – $1,000.00 | 7 |
| Injection, isavuconazonium HCPCS J1833 | $477.45 | $1,326.25 | $0.91 – $3.56 | 9 |
| Injection jaw joint x-ray CPT 21116 | $128.34 | $356.50 | $47.74 – $969.15 | 2 |
| Injection of sinus tract CPT 20500 | not published | not published | $38.81 – $1,000.00 | 20 |
| Injection,onabotulinumtoxina HCPCS J0585 | $16.56 | $46.00 | $5.72 – $24.47 | 16 |
| Injection, peramivir HCPCS J2547 | $553.86 | $1,538.50 | $1.68 – $6.62 | 9 |
| Injection px peyronie ds CPT 54200 | not published | not published | $46.42 – $1,000.00 | 21 |
| Injection radioactive tracer sentinel node (both sides) CPT 38792 | $240.48 | $668.00 | $33.50 – $969.15 | 8 |
| Injection, renflexis HCPCS Q5104 | $325.53 | $904.25 | $35.55 – $299.00 | 13 |
| Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides) HCPCS G0260 | $1,112.85 | $3,091.25 | $450.04 – $1,583.42 | 6 |
| Injection(s) anesthetic agent(s) and/or steroid femoral nerve left CPT 64447 | not published | not published | $34.82 – $1,174.46 | 21 |
| Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides) CPT 64450 | not published | not published | $34.82 – $1,174.46 | 21 |
| Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides) CPT 64483 | not published | not published | $111.31 – $1,509.87 | 21 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level CPT 64491 | $681.75 | $1,893.75 | $60.23 – $969.15 | 3 |
| Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level CPT 64490 | $533.34 | $1,481.50 | $105.68 – $1,509.87 | 20 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance CPT 64494 | $681.75 | $1,893.75 | $52.14 – $969.15 | 3 |
| Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level CPT 64493 | $1,355.22 | $3,764.50 | $89.95 – $1,509.87 | 20 |
| Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance CPT 62321 | $1,064.07 | $2,955.75 | $107.32 – $1,174.46 | 19 |
| Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance CPT 62323 | $1,245.06 | $3,458.50 | $99.21 – $1,174.46 | 19 |
| Injection(s) tendon sheath/ligament aponeurosis single (both sides) CPT 20550 | not published | not published | $18.71 – $1,000.00 | 21 |
| Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s) CPT 20552 | not published | not published | $21.83 – $1,000.00 | 21 |
| Injection(s) trigger point(s) single/multiple >= 3 muscle(s) CPT 20553 | not published | not published | $25.47 – $1,000.00 | 21 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug CPT 96375 | $180.00 | $500.00 | $16.06 – $78.24 | 7 |
| Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug CPT 96376 | $169.20 | $470.00 | $16.06 – $98.73 | 5 |
| Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug CPT 96374 | $309.60 | $860.00 | $37.48 – $357.31 | 7 |
| Injection therapeutic/prophylactic/diagnostic subcutaneous/im CPT 96372 | $166.05 | $461.25 | $16.22 – $250.95 | 7 |
| Injection treatment of eye CPT 66020 | not published | not published | $129.48 – $2,365.58 | 20 |
| Injection treatment of eye CPT 66030 | not published | not published | $109.21 – $2,365.58 | 20 |
| Injection treatment of nerve CPT 64605 | not published | not published | $345.52 – $2,011.64 | 20 |
| Injection treatment of nerve CPT 64610 | not published | not published | $486.00 – $2,011.64 | 20 |
| Injection treatment of nerve CPT 64681 | not published | not published | $251.94 – $1,509.87 | 21 |
| Injection treatment of nose CPT 30200 | not published | not published | $57.29 – $1,000.00 | 21 |
| Inject sacroiliac joint CPT 27096 | $271.98 | $755.50 | $61.75 – $969.15 | 6 |
| Inject/treat eye socket CPT 67500 | not published | not published | $26.30 – $1,000.00 | 21 |
| Inject/treat eye socket CPT 67505 | not published | not published | $28.07 – $1,000.00 | 21 |
| Inject/treat eye socket CPT 67515 | not published | not published | $19.38 – $1,000.00 | 21 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | $607.86 | $1,688.50 | $629.06 – $1,659.56 | 7 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | $15,669.18 | $43,525.50 | $48.08 – $186.41 | 14 |
| Inj epidural sgl cerv-thor without img CPT 62320 | not published | not published | $99.55 – $1,174.46 | 20 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | not published | not published | $85.91 – $1,509.87 | 20 |
| Inj., eravacycline, 1 mg HCPCS J0122 | $169.02 | $469.50 | $1.66 – $4.11 | 9 |
| Inj, factor x, (human), 1iu HCPCS J7175 | $4.23 | $11.75 | $7.17 – $11.43 | 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.