Supplies, drugs & other prices at Highpoint Health – Sumner with Ascension Saint Thomas
Gallatin, TN · every code in this section with a posted price and a Medicare benchmark.
49 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 2d tte w or w/o fol w/con,fu (C8924) | $497.08 | $2,133.37 | 1.5× |
| Adm tocilizu covid-19 1st (M0249) | $531.69 | $2,281.91 | 1.3× |
| Adm tocilizu covid-19 2nd (M0250) | $531.69 | $2,281.91 | 1.3× |
| Ca screen;flexi sigmoidscope (G0104) | $1,600.23 | $6,867.92 | 1.8× |
| Catheterize for urine spec (P9612) | $52.47 | $225.18 | 5.6× |
| Cbc without platelet (G0307) | $46.09 | $197.81 | 7.1× |
| Cbc/diffwbc w/o platelet (G0306) | $53 | $227.48 | 6.8× |
| Colon ca scrn not hi rsk ind (G0121) | $1,692.64 | $7,264.54 | 1.9× |
| Colorectal scrn; hi risk ind (G0105) | $1,597.63 | $6,856.78 | 1.8× |
| Cysto impl 4 or more (C9740) unusually low: confirm this is the full procedure |
$3,570.15 | $15,322.51 | 0.4× |
| Diab manage trn per indiv (G0108) | $84.51 | $362.69 | 1.5× |
| Diab manage trn ind/group (G0109) | $37.01 | $158.86 | 2.3× |
| Direct refer hospital observ (G0379) | $528.12 | $2,266.59 | 0.9× |
| Drug test def 1-7 classes (G0480) | $135.97 | $583.57 | 1.2× |
| Elec stim other than wound (G0283) | $45.66 | $198.52 | 3.6× |
| Group mnt 2 or more 30 mins (G0271) | $18.44 | $79.16 | 1.1× |
| Hbot, full body chamber, 30m (G0277) | $308.74 | $1,325.08 | 2.3× |
| Home sleep test/type 3 porta (G0399) | $243.71 | $1,053.02 | 1.2× |
| Hopd mntl hlt, 15-29 min (C7900) | $34.08 | $146.27 | 0.9× |
| Hopd mntl hlt, 30-60 min (C7901) | $87.09 | $373.79 | 0.9× |
| Hopd mntl hlt, grp (C7903) | $188.38 | $808.50 | 5.2× |
| Hospital outpt clinic visit (G0463) | $153.64 | $659.41 | 1.2× |
| Mnt subs tx for change dx (G0270) | $43.78 | $187.91 | 1.4× |
| Mra w/cont, abd (C8900) | $2,064.16 | $8,859.04 | 6.2× |
| Mra w/cont, chest (C8909) | $2,177.08 | $9,343.68 | 6.5× |
| Mra w/cont, lwr ext (C8912) | $2,142.56 | $9,257.70 | 6.4× |
| Mra w/o cont, abd (C8901) | $2,064.16 | $8,859.04 | 9.0× |
| Mra w/o cont, chest (C8910) | $2,177.08 | $9,343.68 | 9.5× |
| Mra w/o cont, lwr ext (C8913) | $1,521.62 | $6,615.72 | 6.6× |
| Mra w/o fol w/cont, abd (C8902) | $2,064.16 | $8,859.04 | 6.2× |
| Mra w/o fol w/cont, chest (C8911) | $2,177.08 | $9,343.68 | 6.5× |
| Mra w/o fol w/cont, lwr ext (C8914) | $2,142.56 | $9,257.70 | 6.4× |
| Mra w/o fol w/cont, pelvis (C8920) | $3,305.55 | $14,186.92 | 9.9× |
| Mra, w/o&w/dye, upper extr (C8936) | $1,550.11 | $6,667.78 | 4.6× |
| Mri w/o fol w/cont, breast, (C8908) | $1,486.65 | $6,380.46 | 4.4× |
| Mri w/o fol w/cont, brst, un (C8905) | $1,007.31 | $4,379.60 | 3.0× |
| Oth resp proc, group (G0239) | $92.18 | $395.62 | 2.6× |
| Oth resp proc, indiv (G0238) | $33.31 | $142.96 | 1.2× |
| Perc d-e cor revasc t cabg s (C9604) | $12,030.91 | $51,634.81 | 1.1× |
| Perc drug-el cor stent sing (C9600) | $14,559.43 | $62,486.81 | 1.3× |
| Perq Tcat Ther Rx Dlvr Ntrac Rx Balo 1 Maj C Art (0913T) unusually low: confirm this is the full procedure |
$5,313.82 | $22,806.08 | 0.5× |
| Prostate biopsy, any mthd (G0416) | $208.06 | $899.02 | 0.6× |
| Psa screening (G0103) | $104.49 | $448.44 | 5.4× |
| Therapeutic procd strg endur (G0237) | $33.31 | $142.96 | 1.2× |
| Tomosynthesis, mammo (G0279) | $103.40 | $449.57 | 8.1× |
| Transcatheter renal sympath denervation unilat (0338T) | $5,313.82 | $22,806.08 | 1.0× |
| Trauma respons w/hosp criti (G0390) | $5,134.22 | $22,035.28 | 4.0× |
| Tte w or wo fol wcon,doppler (C8929) | $965.72 | $4,144.71 | 1.3× |
| Unsched dialysis esrd pt hos (G0257) | $1,053.21 | $4,520.22 | 1.6× |