Visits & medical services prices at Dolly Parton Children’s Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Advance care planning first 30 mins (99497) $102 $170 1.1×
Aep hearing status deter broadband stimuli i&r (92651) $234 $390 1.2×
Aep Neurodiagnostic I&R (92653) $291.30 $485.50 1.5×
Aep threshold estimation mlt frequencies i&r (92652) $156 $260 0.8×
Airway inhalation treatment (94640) $102 $170 0.5×
Analyze neurostim no prog (95970) $71.40 $119 0.6×
Anogenital exam, child (99170) $130.20 $217 0.7×
Appl on-body injector for timed subq injection (96377) $121.20 $202 2.9×
Assessment of aphasia (96105) $254.40 $424 2.6×
Asstv Technol Assmt Dir Cntct W/Reprt Ea 15 Min (97755) $66 $110 1.7×
Behav assmt w/score & docd/stand instrument (96127) $10.80 $18 0.3×
Behavioral and qualitative analysis of voice and resonance (92524) $227.40 $379 2.1×
Biofeedback training any modality (90901) $57 $95 1.4×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $93.60 $156 0.3×
C motor evoked uppr limbs (95928) $401.10 $668.50 0.5×
C motor evoked upr&lwr limbs (95939) $627.60 $1,046 0.8×
Capsule endoscopy (91110) $751.57 $1,252.62 0.9×
Car seat/bed test 60 min (94780) $112.80 $188 3.3×
Cardiac Stress Tst,Tracing Only (93017) $1,005 $1,675 5.1×
Cardiopulmonary exercise testing (94621) $295.20 $492 0.9×
Cardiopulmonary resuscitation (92950) $464.40 $774 2.4×
Cardioversion (92960) $1,667.40 $2,779 2.8×
Care mgmt svc bhvl hlth cond (99484) $39.60 $66 1.2×
Caregiver hlth risk assmt score doc stnd instrm (96161) $20.40 $34 0.6×
Caregiver training 1st 30 min (97550) $86.40 $144 1.6×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $43.20 $72 1.7×
Cath Perc Clos,Cong Interatrial Commun W/Impl (93580)
likely a partial charge, not the full procedure
$1,230 $2,050 0.1×
Cbt 1st hour (94644) $418.20 $697 3.5×
Chemo Hormon Antineopl Sq/Im (96402) $190.20 $317 2.9×
Chemo inj subarach/intravent (96542) $303 $505 1.0×
Chemo IV push addl drug (96411) $174 $290 2.7×
Chemo Iv Push Sngl Drug (96409) $571.80 $953 1.9×
Chemo prolong 8+ hrs infuse w/pump (96416) $951.60 $1,586 3.2×
Chemother, IV infusion, 1 hr (96413) $593.40 $989 2.0×
Chemother, IV infusion, ea add hr (96415) $198.60 $331 3.0×
Chemother,Non-Hormone Anti-Neopl, Sub-Q/Im (96401) $190.20 $317 2.9×
Chemotherapy, unspecified procedure (96549) $444.60 $741 10.5×
Chemotx Admn Cns Req Spinal Puncture (96450) $300 $500 1.0×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $295.80 $493 4.5×
Chronic care mgmt svcs staff 1st 20 min cal mo (99490) $39 $65 0.4×
Color/duplex Doppler, complete (93975) $947.40 $1,579 4.4×
Cont Gluc Monitoring Patient Provided Equipment (95249) $99.60 $166 1.9×
Cpap initiation and management (94660) $430.80 $718 2.2×
Cpt initial (94667) $159.60 $266 1.3×
Critical care (99291) $345 $575 0.5×
Ctr motor ep std transcrnl motor stimj lwr limbs (95929) $101.40 $169 0.3×
Debridement Open Wound 20 Sq Cm< (97597) $138 $230 0.8×
Demo &/or eval,pt use,aerosol device (94664) $78.60 $131 0.4×
Developmental tst admin phys/qhp 1st hour (96112) $15 $25 0.1×
Dialysis other/than hemodialysis 1 phys/qhp eval (90945) $393 $655 1.0×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $784.20 $1,307 3.6×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $761.40 $1,269 3.5×
Dup-scan lxtr art/artl bpgs uni/lmtd study (93926) $510.60 $851 5.4×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $534.60 $891 2.5×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $342.60 $571 3.6×
Dup-scan xtr veins unilateral/limited study (93971) $561.60 $936 5.9×
Duplex scan extracranial art compl bi study (93880) $1,259.40 $2,099 5.8×
Echo Heart Xthoracic,Limited (93308) $487.20 $812 2.3×
Echo transesophageal (93312) $823.80 $1,373 1.7×
Echo Transesophageal - Congenital Tee Complete (93315) $1,440.60 $2,401 2.9×
Echo Transthoracic - Congenital Tte Complete (93303) $91.80 $153 0.2×
Echo Transthoracic - Congenital Tte Limited (93304) $272.40 $454 0.5×
EEG awake asleep (95819) $106.80 $178 0.5×
EEG cerebral death evaluation (95824) $66.60 $111 0.2×
EEG coma or sleep only (95822) $104.10 $173.50 0.5×
EEG cont rec w/video by tech min 8 channels (95700) $522 $870 2.7×
Eeg Extended Monitoring 61-119 Minutes (95813) $169.80 $283 0.9×
EEG w/o vid by tech ea incr 12-26hr unmonitored (95708) $764.40 $1,274 2.3×
EKG (93005) $147 $245 2.7×
EKG rhythm strip (93041) $98.40 $164 1.8×
Elec alys implt cplx cn npgt prgrmg (95977) $45.60 $76 0.5×
Elec Alys Implt Smpl Cn Npgt Prgrmg (95976) $48.60 $81 1.4×
Electroencephalogram Extend Monitoring 41-60 Min (95812) $106.80 $178 0.5×
EMG cranial nerve unilat (95867) $283.80 $473 1.4×
EMG four extremities (95864) $3,032.40 $5,054 26.0×
EMG one extremity (95860) $499.20 $832 4.1×
EMG three extremities (95863) $2,326.80 $3,878 19.9×
EMG two extremities (95861) $1,942.80 $3,238 16.1×
Er level 1 (99281) $25.80 $43 0.3×
Er level ii (99282) $161.40 $269 1.2×
Er level iii (99283) $85.20 $142 0.3×
Er level IV (99284) $176.40 $294 0.5×
Er level v (99285) $210.60 $351 0.4×
Esoph imped funct test > 1hr - esophageal ph monitoring 24-hour (91038) $85.93 $143.21 0.3×
Eval&/Fitg Voice Prostc Dev Suplmnt Oral Speec (92597) $154.20 $257 2.2×
Evaluation of speech fluency (92521) $227.40 $379 1.7×
Evaluation of speech sound production (92522) $235.20 $392 2.1×
Evaluation of swallowing function (92610) $262.20 $437 3.1×
Evaluation with prescription of speech-generating alternative (92607) $388.20 $647 3.2×
Exercise tst brncspsm (94617) $254.40 $424 2.1×
Exhaled Air Analysis (94690) $231.60 $386 4.3×
External ECG rec>48hr<7d recording (93242) $22.20 $37 0.7×
External ECG rec>7d<15d recording (93246) $22.20 $37 0.7×
Eye exam w anesth; complete (92018) $1,092 $1,820 0.5×
Flow volume loop (94375) $249 $415 1.3×
Full field erg w/i&r (92273) $603.60 $1,006 3.1×
Gastroesophag Reflx Test W/Cath Ph Eltrd Plcmt (91034) $180.30 $300.50 0.5×
Group Therapeutic Procedures (97150) $189.60 $316 10.5×
Hast w/report (94452) $108 $180 0.9×
Health Behavior Assessment/Re-Assessment (96156) $15 $25 0.2×
Health behavior ivntj fam w/pt f2f 1st 30 min (96167) $15 $25 0.4×
Health behavior ivntj indiv f2f 1st 30 min (96158) $15 $25 0.1×
Hemodialysis (90935) $90 $150 0.1×
High altitude simulation test (94453) $79.88 $133.14 0.7×
Holter Monitor Recording (93225) $64.80 $108 0.5×
Hypoxia Response Curve (94450) $207.60 $346 1.8×
Icd Device Interrogate (93289) $57.54 $95.91 1.7×
Ilr Device Eval Progr (93285) $37.78 $62.98 1.1×
Imm Admn Sarscov2 Vaccine Single Dose (90480) $36 $60 1.0×
Immuniz admin,intranasal/oral,1 vac/tox (90473) $64.20 $107 1.0×
Immunization Admin (90471) $82.80 $138 1.3×
Immunotherapy, 2+ Injections (95117) $13.20 $22 0.3×
Injection intra arterial (96373) $578.40 $964 3.0×
Interrog dev eval scrms phys/qhp in person (93291) $38.16 $63.61 1.5×
Intralesional Chemo Admin,8+ Lesn (96406) $522.60 $871 2.7×
Intralesional Chemo Admin,<8 Lesn (96405) $165 $275 2.5×
Irrigaj Implntd Venous Access Drug Delivery Syst (96523) $159 $265 3.0×
IV infusion hydration each additional hour (96361) $102 $170 2.4×
IV infusion hydration initial 31 min-1 hour (96360) $276 $460 1.4×
IV infusion, therap/proph/diagnost,add infusion,1st hour (96367) $191.40 $319 2.9×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $358.20 $597 1.9×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $121.80 $203 2.9×
IV push initial (96374) $285.60 $476 1.5×
Manual therapy 15 min (97140) $51 $85 1.8×
Massage 15 min (97124) $44.40 $74 1.5×
Maximum voluntary ventilation (94200) $143.40 $239 2.7×
Mechanical chest wall oscillation (94669) $679.20 $1,132 3.4×
Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) $181.50 $302.50 5.7×
Medical nutrition assmt&ivntj indiv each 15 mi (97802) $229.80 $383 6.3×
Methacholine challenge (94070) $724.20 $1,207 2.1×
Mnt Group Ea 30 Min (97804) $50.40 $84 3.0×
Motion Fluor Eval Swlng Funcj C/V Rec (92611) $382.20 $637 4.2×
Multiple sleep latency test (95805) $181.20 $302 0.2×
Nasal function studies (92512) $480 $800 2.5×
Needle EMG lmtd std musc 1 xtr/non-limb uni/bi (95870) $445.20 $742 3.7×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $50.40 $84 0.3×
Nerve conduction studies 13/> studies (95913) $1,763.40 $2,939 5.2×
Nerve Conduction Studies 3-4 Studies (95908) $639.90 $1,066.50 3.3×
Nerve Conduction Studies 9-10 Studies (95911) $1,328.10 $2,213.50 3.9×
Nerve conduction studies; 1-2 studies (95907) $415.50 $692.50 2.1×
Nerve conduction studies; 11-12 studies (95912) $1,532.70 $2,554.50 4.5×
Nerve conduction studies; 5-6 studies (95909) $861 $1,435 4.4×
Nerve conduction studies; 7-8 studies (95910) $1,094.70 $1,824.50 3.2×
Neurobehavioral Status Exam (96116) $15 $25 0.1×
Neuromuscular junction test (95937) $173.40 $289 1.5×
Nitric oxide expired gas determination (95012) $87.60 $146 2.6×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $61.80 $103 0.5×
Nonphysician Telephone Assessment 11-20 Min (98967) $45 $75 1.8×
Nonphysician Telephone Assessment 21-30 Min (98968) $45 $75 1.3×
Nonphysician Telephone Assessment 5-10 Min (98966) $45 $75 3.3×
Nrpsyc tst eval phys/qhp 1st (96132) $15 $25 0.0×
O2 uptk exp gas alys w/co2 output % o2 xtrc (94681) $699 $1,165 2.1×
Orthotics mgmt & traing initial enctr ea 15 mins (97760) $156 $260 3.4×
Ot eval high complex 60 min (97167) $470.40 $784 4.7×
Ot eval low complex 30 min (97165) $357 $595 3.6×
Ot eval mod complex 45 min (97166) $394.80 $658 3.9×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $102 $170 2.0×
Ot Prosthetic Training, Each 15 Min (97761) $56.40 $94 1.4×
Ot Range Motion Measure,Each Extrem (95851) $40.20 $67 1.5×
Ot re-eval est plan care (97168) $207.60 $346 3.0×
Paraffin bath (97018) $18 $30 3.0×
Patient-initiated spirometric recording (94015) $700.80 $1,168 3.6×
Pediatric apnea monitor analyses computer (94776) $424.20 $707 3.6×
Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of… (94775) $87.60 $146 0.8×
Pentamidine Aersl Inhalation Pneumocystis/Proph (94642) $418.20 $697 2.1×
Plethysmography (94726) $485.40 $809 1.4×
Pm device eval in person (93288) $41.30 $68.82 1.2×
Pm device progr eval multi (93281) $56.33 $93.88 1.7×
Pm device progr eval sngl (93279) $43.04 $71.74 1.3×
Pm/Icd Remote Tech Serv (93296) $34.20 $57 1.0×
Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) $649.20 $1,082 0.8×
Polysom <6 yrs 4/> paramtrs (95782) $315 $525 0.4×
Polysom <6 Yrs Sleep W/Cpap/Bilvl Vent 4/> Param (95783) $933 $1,555 1.2×
Programming of dual lead implantable defibrillator system (93283) $63.56 $105.93 1.9×
Programming of single lead implantable defibrillator system (93282) $52.02 $86.70 1.5×
Psych diag eval w/med srvcs (90792) $15 $25 0.1×
Psychiatric diagnostic evaluation (90791) $15 $25 0.1×
Psychoanalysis (90845) $123.60 $206 0.8×
Psycl tst eval phys/qhp 1st (96130) $15 $25 0.1×
Psyl/nrpsycl tst phys/qhp 2+ tst 1st 30 min (96136) $15 $25 0.1×
Pt Aquatic Therapy/Exercises (97113) $66 $110 1.8×
Pt Electrical Stimulation (97032) $78.60 $131 5.3×
Pt eval high complex 45 min (97163) $470.40 $784 4.8×
Pt eval low complex 20 min (97161) $357 $595 3.6×
Pt Gait Training Therapy (97116) $48 $80 1.7×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $57 $95 1.7×
Pt Physical Therapy Evaluation Mod Complex 30 Mins (97162) $394.80 $658 4.0×
Pt re-evaluation (97164) $207.60 $346 3.1×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $57.60 $96 1.8×
Pt Ultrasound Therapy (97035) $22.80 $38 1.6×
Pt-focused hlth risk assmt (96160) $20.40 $34 0.6×
Pulm function test by gas (94727) $112.20 $187 0.6×
Pulmonary stress testing (94618) $396 $660 3.3×
Pure Tone Audiometry, Air (92552) $38.40 $64 0.3×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $39.60 $66 1.2×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $138 $230 0.8×
Rom meas&reprt hand w/wo comparison normal sid (95852) $27.60 $46 1.3×
Rt Chest Wall Manipulation,Subsequent (94668) $159.60 $266 1.3×
Rx Sp-Genratj Augmnt&Comunicaj Dev Ea 30 Min (92608) $78.60 $131 1.6×
Sensory Integration Ea 15 Min (97533) $69.60 $116 1.1×
Short-latency somatosens ep std lwr limbs (95926) $48 $80 0.2×
Short-latency somatosens ep std upr limbs (95925) $48 $80 0.2×
Sleep study attended (95807) $2,536.50 $4,227.50 7.5×
Sleep study unattended (95806) $35.40 $59 0.2×
Somatosensory testing (95938) $1,038.60 $1,731 1.3×
Speech group therapy (92508) $227.40 $379 9.5×
Speech sound lang comprehen (92523) $382.20 $637 1.7×
Spirometry (94010) $218.70 $364.50 1.1×
Standardized Cognitive Performance Testing (96125) $247.80 $413 2.4×
Subcut infusion, therap/proph/diagnost,initial,1st hour (96369) $147 $245 0.8×
Surfactant Admin Thru Tube (94610) $315.60 $526 1.6×
Temp transcutaneous pacing (92953) $335.40 $559 0.6×
Testing of autonomic (sympathetic) nervous system function (95923) $165.60 $276 1.4×
Ther ivntj cog funcj cntct 1st 15 minutes (97129) $78.60 $131 3.5×
Ther Ivntj Cog Funcj Cntct Ea Addl 15 Minutes (97130) $78.60 $131 3.7×
Ther Sp-Genratj Dev Prgrmg&Modificaj (92609) $209.40 $349 2.0×
Ther/prop/diag inj/inf proc (96379) $118.80 $198 2.8×
Ther/Proph/Diag Inj Sc/Im (96372) $102 $170 1.6×
Therapeutic Activities (97530) $90 $150 2.6×
Therapeutic phlebotomy (99195) $169.20 $282 1.4×
Trans Care Mgmt 14 Day Disch (99495) $133.80 $223 1.1×
Trans Care Mgmt 7 Day Disch (99496) $193.80 $323 1.6×
Transcran Doppler Intracran Art - Transcranial Doppler (93886) $1,135.20 $1,892 5.2×
Tte W/Doppler Complete - Tte Complete W/ Contrast (93306) $1,205.10 $2,008.50 2.4×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $349.20 $582 4.6×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $222 $370 2.6×
Tx/Pro/Dx Inj New Drug Addon (96375) $204 $340 4.8×
Tympanometry (92567) $19.20 $32 0.6×
Unlisted Cardiovascular Service/Procedure (93799) $233.40 $389 2.0×
Vasc Duplex Extrem Venous,Bilat (93970) $837 $1,395 3.9×
Veeg by tech 2-12 hours unmonitored (95711) $6,261.60 $10,436 32.0×
Veeg by tech 2-12 hr intermittent monitoring (95712) $6,261.60 $10,436 18.5×
Veeg Ea 12-26 Hr Unmntr (95714) $900 $1,500 2.7×
Ventilation assist & mgmt inpatient 1st day (94002) $675.60 $1,126 1.2×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $675.60 $1,126 1.2×
Visual Evoked Potential Test (95930) $945.60 $1,576 4.8×
Vital capacity total (94150) $60.60 $101 0.5×
Wheelchair Mgmt Ea 15 Min (97542) $43.80 $73 1.4×
Xers tst brncspsm pre&post spmtry&pls ox wo /ECG (94619) $355.88 $593.12 6.6×