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 |
|---|---|---|---|---|
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $50.85 | $141.25 | $9.05 – $31.62 | 2 |
| Lipase CPT 83690 | $66.42 | $184.50 | $5.79 – $62.21 | 35 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $351.35 – $3,064.57 | 20 |
| Lipoprotein blood high res frac & quant CPT 83701 | $188.64 | $524.00 | $9.46 – $184.54 | 35 |
| Lipoprotein blood quant CPT 83704 | not published | not published | $28.44 – $234.57 | 30 |
| Lipoprotein direct measurement hdl CPT 83718 | $62.28 | $173.00 | $6.88 – $60.88 | 36 |
| Lipoprotein direct measurement ldl CPT 83721 | $31.68 | $88.00 | $8.82 – $70.96 | 35 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $8.82 – $186.34 | 26 |
| Lip surgery procedure CPT 40799 | not published | not published | $124.92 – $1,000.00 | 8 |
| Listeria monocytogenes CPT 86723 | not published | not published | $9.35 – $71.89 | 30 |
| Lithium therapeutic drug level CPT 80178 | $80.28 | $223.00 | $5.55 – $72.00 | 35 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $693.33 – $1,126.66 | 6 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $825.93 – $1,342.13 | 6 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $912.60 – $1,482.98 | 7 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $308.33 – $2,371.01 | 5 |
| Liver elastography 91200 CPT 91200 | $33.30 | $92.50 | $27.10 – $574.15 | 25 |
| Liver Function Test CPT 80076 | $163.35 | $453.75 | $6.86 – $169.09 | 35 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $969.15 – $1,776.02 | 7 |
| Liver image (3d) with flow CPT 78206 | not published | not published | $265.13 – $2,730.60 | 19 |
| Liver imaging CPT 78201 | $353.34 | $981.50 | $176.23 – $1,659.60 | 35 |
| Liver imaging (3d) CPT 78205 | not published | not published | $191.93 – $1,668.06 | 19 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $185.60 – $1,812.60 | 30 |
| Liver/spleen imag static only CPT 78215 | $724.05 | $2,011.25 | $177.31 – $1,682.91 | 35 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $832.68 | $2,313.00 | $104.51 – $1,040.85 | 35 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $71.97 – $2,264.18 | 6 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $461.45 – $3,202.82 | 20 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $1.80 | $5.00 | $1.01 – $1.01 | 1 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $62.10 | $172.50 | $0.73 – $0.73 | 1 |
| Loudness balance test CPT 92562 | not published | not published | $43.22 – $574.15 | 7 |
| Low back disk surgery CPT 63030 | not published | not published | $961.76 – $6,998.88 | 20 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,461.33 | $4,059.25 | $180.34 – $2,039.13 | 36 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $955.26 | $2,653.50 | $173.02 – $1,706.87 | 36 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $731.43 | $2,031.75 | $106.88 – $1,610.00 | 36 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,556.09 | $7,100.25 | $275.11 – $3,097.24 | 36 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,821.96 | $5,061.00 | $241.65 – $2,715.03 | 36 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,242.99 | $3,452.75 | $156.11 – $1,969.00 | 36 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $346.68 | $963.00 | $24.52 – $453.92 | 36 |
| Lower jaw bone graft CPT 21215 | not published | not published | $859.53 – $5,675.12 | 20 |
| Low frequency non-thermal Ultrasound CPT 97610 | $284.04 | $789.00 | $16.91 – $725.13 | 7 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $708.28 – $5,655.44 | 20 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $818.22 – $9,843.34 | 8 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $810.25 – $9,843.34 | 20 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $887.96 – $9,843.34 | 8 |
| L/s ratio fetal lung CPT 83661 | $250.65 | $696.25 | $10.17 – $163.45 | 35 |
| Lumbar diskogram s&i CPT 72295 | $3,947.94 | $10,966.50 | $55.77 – $8,790.80 | 35 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $969.15 – $13,923.83 | 20 |
| Lumizyme injection HCPCS J0221 | $1,048.95 | $2,913.75 | $153.60 – $663.82 | 16 |
| Lung function test (mbc/mvv) CPT 94200 | $1,123.83 | $3,121.75 | $22.69 – $228.29 | 7 |
| Lung Function Test (Spirometry) CPT 94010 | $356.04 | $989.00 | $28.58 – $574.15 | 7 |
| Lung perfusion imaging CPT 78580 | $502.11 | $1,394.75 | $196.83 – $1,965.60 | 35 |
| Lung transplant double CPT 32853 | not published | not published | $969.15 – $5,629.97 | 7 |
| Lung transplant single CPT 32851 | not published | not published | $969.15 – $4,020.51 | 7 |
| Lung transplant with bypass CPT 32852 | not published | not published | $969.15 – $4,370.90 | 7 |
| Lung transplant with bypass CPT 32854 | not published | not published | $969.15 – $5,975.31 | 7 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $969.15 – $1,791.62 | 7 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $16.55 – $1,000.00 | 9 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $10.06 – $149.11 | 30 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $531.68 – $1,000.00 | 7 |
| Lymphatics/lymph node imaging CPT 78195 | $684.27 | $1,900.75 | $257.02 – $2,911.77 | 35 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $21.68 – $385.91 | 30 |
| Lymphocyte transformation mitogen CPT 86353 | $423.18 | $1,175.50 | $8.73 – $364.55 | 35 |
| Lymphocytotoxicity assay CPT 86805 | $326.25 | $906.25 | $14.15 – $1,032.83 | 35 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $13.36 – $353.87 | 30 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $185.48 – $2,553.57 | 27 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $277.30 – $4,429.85 | 26 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $285.91 – $4,429.85 | 26 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $138.46 – $16,617.92 | 25 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $135.48 – $1,000.00 | 21 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $141.29 – $2,922.78 | 20 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $200.53 – $2,072.71 | 20 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $6.15 – $45.34 | 16 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $3.59 – $31.72 | 30 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $3.62 – $31.72 | 30 |
| Magnesium CPT 83735 | $120.15 | $333.75 | $5.63 – $52.31 | 35 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $98.01 | $272.25 | $0.64 – $0.64 | 1 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $232.31 – $3,197.98 | 30 |
| Makena, 10 mg HCPCS J1726 | $22.86 | $63.50 | $14.74 – $14.74 | 4 |
| Malaria antibody CPT 86750 | not published | not published | $11.08 – $98.10 | 30 |
| Male sling procedure CPT 53440 | not published | not published | $758.59 – $9,439.48 | 20 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $969.15 – $3,710.58 | 7 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $330.64 – $1,585.81 | 20 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $411.62 – $1,585.81 | 20 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $41.85 | $116.25 | $31.00 – $452.47 | 7 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $46.44 | $129.00 | $23.90 – $452.47 | 7 |
| Manipulation of hip joint CPT 27275 | not published | not published | $181.14 – $1,585.81 | 20 |
| Manipulation of spine CPT 22505 | not published | not published | $130.36 – $1,585.81 | 20 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $43.88 – $1,000.00 | 21 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $3.60 | $10.00 | $3.49 – $3.49 | 1 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $3.19 – $27.69 | 30 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $317.34 | $881.50 | $92.52 – $375.41 | 5 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $137.79 – $1,000.00 | 3 |
| Map tachycard site(s) CPT 93609 | $1,694.16 | $4,706.00 | $499.18 – $1,432.00 | 5 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $851.10 – $1,383.03 | 7 |
| Mastectomy partial CPT 19301 | not published | not published | $647.96 – $3,544.57 | 20 |
| Mast mod rad CPT 19307 | not published | not published | $969.15 – $6,127.63 | 8 |
| Mastoidectomy CPT 69501 | not published | not published | $710.88 – $5,675.12 | 20 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $943.75 – $5,675.12 | 20 |
| Mastoids complete CPT 70130 | $325.26 | $903.50 | $38.12 – $453.92 | 36 |
| Mastoid surgery revision CPT 69603 | not published | not published | $969.15 – $5,675.12 | 20 |
| Mastopexy CPT 19316 | not published | not published | $764.00 – $6,127.63 | 20 |
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.