Visits & medical services prices at Ascension Saint Thomas River Park

McMinnville, TN · every code in this section with a posted price and a Medicare benchmark.

130 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Airway inhalation treatment (94640) $128.94 $429.80 0.6×
Assessment of aphasia (96105) $189.75 $632.50 2.0×
Bfb training 1st 15 min (90912) $41.93 $139.75 0.5×
Bfb training ea addl 15 min (90913) $41.93 $139.75 1.3×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $536.34 $1,787.80 1.5×
Cardiac Stress Tst,Tracing Only (93017) $663.66 $2,212.20 3.2×
Cardiopulmonary resuscitation (92950) $923.46 $3,078.20 4.5×
Cardioversion (92960) $912.80 $3,042.65 1.5×
Cbt 1st hour (94644) $114.54 $381.80 0.9×
Chemo IV push addl drug (96411) $126.77 $422.55 1.9×
Chemo Iv Push Sngl Drug (96409) $126.77 $422.55 0.4×
Chemother, IV infusion, 1 hr (96413) $251.42 $838.05 0.8×
Chemother, IV infusion, ea add hr (96415) $42.27 $140.90 0.6×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $190.16 $633.85 2.8×
Color/duplex Doppler, complete (93975) $523.35 $1,744.50 2.3×
Color/duplex Doppler, limited (93976) $440.78 $1,469.25 4.4×
Cpap initiation and management (94660) $481.11 $1,603.70 2.3×
Cpt initial (94667) $72 $239.98 0.6×
Critical care (99291) $1,382.76 $4,609.20 1.8×
Debridement Open Wound 20 Sq Cm< (97597) $59.03 $196.75 0.3×
Demo &/or eval,pt use,aerosol device (94664) $128.94 $429.80 0.6×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $855.18 $2,850.60 2.2×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $389.69 $1,298.95 1.7×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $369.28 $1,230.92 3.7×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $477.78 $1,592.58 2.1×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $392.52 $1,308.40 4.0×
Dup-scan xtr veins unilateral/limited study (93971) $444.86 $1,482.85 4.5×
Duplex scan extracranial art compl bi study (93880) $571.17 $1,903.90 2.5×
Echo Heart Xthoracic,Limited (93308) $489.71 $1,632.35 2.2×
Echo transesophageal (93312) $1,149.90 $3,832.98 2.2×
EEG awake asleep (95819) $305.15 $1,017.15 1.5×
EEG cerebral death evaluation (95824) $495.47 $1,651.55 1.4×
EKG (93005) $106.86 $356.20 1.9×
Er level 1 (99281) $207.68 $692.25 2.6×
Er level ii (99282) $573 $1,910 3.9×
Er level iii (99283) $735 $2,450 2.8×
Er level IV (99284) $945 $3,150 2.4×
Er level v (99285) $960.02 $3,200.05 1.7×
Evaluation of swallowing function (92610) $146.93 $489.75 1.7×
External Ecg Scanning Analysis Report (93226) $588.86 $1,962.85 10.5×
Flexible Endoscopic Eval Swallow C/V Rec (92612) $185.87 $619.55 0.9×
Flow volume loop (94375) $308.69 $1,028.95 1.5×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $460.58 $1,535.25 1.3×
Gastroesophag reflx test w/telemtry ph eltrd (91035) $546.59 $1,821.95 0.7×
Group Therapeutic Procedures (97150) $31.70 $105.65 1.8×
Holter Monitor Recording (93225) $395.99 $1,319.95 3.1×
Hypoxia Response Curve (94450) $80.40 $268 0.7×
Immunization Admin (90471) $43.88 $146.25 0.6×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $46.80 $156 0.8×
IV infusion hydration each additional hour (96361) $53.08 $176.92 1.2×
IV infusion hydration initial 31 min-1 hour (96360) $174.96 $583.18 0.9×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $148.43 $494.75 2.2×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $148.43 $494.75 0.7×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $67.89 $226.30 1.5×
IV push initial (96374) $127.74 $425.80 0.6×
Manual therapy 15 min (97140) $52.22 $174.05 1.9×
Massage 15 min (97124) $46.96 $156.50 1.6×
Mechanical chest wall oscillation (94669) $229.95 $766.50 1.1×
Mechanical traction (97012) $60.16 $200.52 4.2×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $28.62 $95.40 0.8×
Methacholine challenge (94070) $536.54 $1,788.45 1.5×
Mnt Group Ea 30 Min (97804) $126.06 $420.20 7.4×
Motility study esophagus (91010) $546.59 $1,821.95 1.5×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $154.22 $514.05 1.7×
Multiple sleep latency test (95805) $879.38 $2,931.25 1.1×
Neg press wnd tx </=50 sq cm (97607) $733.55 $2,445.15 1.9×
Neg press wound tx >50 cm (97608) $673.01 $2,243.35 1.7×
Neurobehavioral Status Exam (96116) $189.75 $632.50 0.9×
Newborn resuscitation (99465) $388.95 $1,296.50 0.6×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $288.34 $961.10 2.3×
Non-Invasive Physiologic Study Extremity 3 Levls (93923) $272.96 $909.85 1.3×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $207.80 $692.65 1.7×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $46.66 $155.52 1.0×
Ot Community/Work Reintegration Trainj Ea 15 Min (97537) $39.14 $130.45 1.2×
Ot Contrast Bath Ea 15 Min (97034) $40.50 $135 2.9×
Ot eval high complex 60 min (97167) $123.42 $411.40 1.2×
Ot eval low complex 30 min (97165) $123.42 $411.40 1.2×
Ot eval mod complex 45 min (97166) $123.42 $411.40 1.2×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $42.56 $141.85 0.8×
Ot Range Motion Measure,Each Extrem (95851) $10.71 $35.70 0.4×
Ot re-eval est plan care (97168) $45.95 $153.15 0.7×
Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) $125.21 $417.35 1.0×
Outpatient cardiac rehab w/o cont ECG monitor (93797) $92.70 $309 0.8×
Paraffin bath (97018) $32.24 $107.45 5.4×
Phy/qhp op pulm rhb w/mntr (94626) $105.44 $351.45 1.9×
Phy/qhp op pulm rhb w/o mntr (94625) $105.44 $351.45 1.9×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $1,569.15 $5,230.50 1.9×
Pt Electric Current Therapy (97033) $54.86 $182.85 2.9×
Pt Electrical Stimulation (97032) $60.20 $200.65 4.1×
Pt eval high complex 45 min (97163) $123.42 $411.40 1.3×
Pt eval low complex 20 min (97161) $123.42 $411.40 1.3×
Pt Gait Training Therapy (97116) $41.48 $138.25 1.4×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $42.36 $141.18 1.3×
Pt Physical Performance Test (97750) $34.06 $113.52 1.0×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $123.42 $411.40 1.3×
Pt re-evaluation (97164) $45.95 $153.15 0.7×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $41.91 $139.70 1.3×
Pt Ultrasound Therapy (97035) $41.91 $139.70 2.9×
Pt Whirlpool Therapy (97022) $65.46 $218.18 4.2×
Pulm function test by gas (94727) $194.73 $649.10 0.9×
Pulmonary stress testing (94618) $98.05 $326.82 0.8×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $95.82 $319.40 0.5×
Rom meas&reprt hand w/wo comparison normal sid (95852) $14.28 $47.60 0.7×
Rt Chest Wall Manipulation,Subsequent (94668) $72 $240 0.6×
Sensory Integration Ea 15 Min (97533) $41.73 $139.10 0.7×
Smoking cessation > 10 min (99407) $36.39 $121.30 1.0×
Speech group therapy (92508) $47.94 $159.80 2.0×
Speech sound lang comprehen (92523) $141.20 $470.65 0.6×
Spirometry (94010) $161.93 $539.75 0.8×
Subcut infusion, therap/proph/diagnost,ea add hour (96370) $36.90 $123 0.8×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $148.44 $494.80 0.7×
Surfactant Admin Thru Tube (94610) $128.94 $429.80 0.6×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $28.16 $93.85 1.3×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $28.16 $93.85 1.3×
Ther/Proph/Diag Inj Sc/Im (96372) $86.07 $286.90 1.3×
Therapeutic Activities (97530) $43.87 $146.22 1.3×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $20.19 $67.30 0.6×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,198.62 $3,995.40 2.3×
Tte W/O Doppler Complete - Tte Complete No Doppler No Color (93307) $859.97 $2,866.55 3.8×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $73.11 $243.70 1.0×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $107.12 $357.05 1.3×
Tx/Pro/Dx Inj New Drug Addon (96375) $55.98 $186.60 1.3×
Ultrasound of heart with probe in esophagus to assess heart pump function (93318) $1,149.95 $3,833.15 2.2×
Ultraviolet Light Therapy (96900) $102.66 $342.20 2.9×
Unlisted pulmonary service/procedure (94799) $482.84 $1,609.45 4.0×
Vasc Duplex Extrem Venous,Bilat (93970) $581.72 $1,939.08 2.6×
Vasc Non-Invasive Lower Extrem Art Stress/Rest, Complete,Bilateral (93924) $293.79 $979.30 1.4×
Ventilation assist & mgmt inpatient 1st day (94002) $485.18 $1,617.25 0.8×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $451.82 $1,506.05 0.8×
Wheelchair Mgmt Ea 15 Min (97542) $43.90 $146.30 1.4×