▸ Hospital · TN · CCN 440151

Ascension Saint Thomas River Park

1559 SPARTA ROAD, MCMINNVILLE, TN, 37110

45 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
197
of 209 target codes
Payers
22
with negotiated rates
Rates published
41,353
last crawl 2026-05-24

Procedures & rates

ProcedureTypeCodePayersGrossCashNeg minNeg medianNeg max
behavioral
PsychosesMS-DRG88521$1,612.22$11,792$20,671
Psychiatric diagnostic evaluationCPT9079119$55.08$151.66$212.32
Psychiatric eval with medical servicesCPT9079219$55.08$151.66$212.32
Psychotherapy 30 minutesCPT9083219$41.43$151.66$212.32
Psychotherapy 45 minutesCPT9083419$55.08$151.66$212.32
Psychotherapy 60 minutesCPT9083719$55.08$151.66$212.32
Crisis psychotherapy 60 minutesCPT9083919$55.08$151.66$212.32
emergency
ED visit level 1CPT9928119$692.25$207.68$19.26$86.02$1,386
ED visit level 2CPT9928219$1,910$573$37.71$154.71$1,910
ED visit level 3CPT9928319$2,450$735$56.4$270.51$2,453
ED visit level 4CPT9928419$3,150$945$107.34$405.95$4,291
ED visit level 5CPT9928519$3,200.05$960.02$158.13$584.5$4,558
Critical care, first hourCPT9929119$4,609.2$1,382.76$232.88$795.34$1,483
imaging
CT head without contrastCPT7045020$2,578.5$773.55$86.77$103.89$1,340.82
CT head with contrastCPT7046020$2,799.55$839.87$120.17$171.39$1,455.77
CT head with and without contrastCPT7047020$2,812.5$843.75$148.64$173.91$1,462.5
CT neck with contrastCPT7049120$3,558.6$1,067.58$148.75$176.43$1,850.47
MRI brain without contrastCPT7055120$3,823.15$1,146.95$167.52$236.15$1,988.04
MRI brain with contrastCPT7055220$4,396.25$1,318.88$215.74$343.84$2,286.05
MRI brain with and without contrastCPT7055320$5,055.2$1,516.56$264.35$348.9$2,628.7
Chest X-ray single viewCPT7104520$336.7$101.01$11.33$83.11$127.7
Chest X-ray 2 viewsCPT7104620$344.2$103.26$20.89$83.11$127.7
Chest X-ray 3 viewsCPT7104719$26.63$83.11$127.7
CT chest without contrastCPT7125020$3,481.85$1,044.56$90.33$105.39$1,810.56
CT chest with contrastCPT7126020$2,642.7$792.81$148.75$176.43$1,374.2
CT chest with and without contrastCPT7127020$3,035.45$910.64$151.23$176.43$1,578.43
MRI chest without contrastCPT7155020$2,398.1$719.43$167.52$239.57$1,273.66
MRI chest with contrastCPT7155120$215.74$745.74$1,380.32
MRI chest with and without contrastCPT7155220$3,954.25$1,186.28$264.35$353.96$2,056.21
Lumbosacral spine X-rayCPT7210021$574.5$172.35$22.18$100.37$179.33
CT cervical spine without contrastCPT7212520$2,819.65$845.9$90.33$105.39$1,466.22
CT thoracic spine without contrastCPT7212820$2,727.75$818.33$90.33$105.39$1,418.43
CT lumbar spine without contrastCPT7213120$2,966.4$889.92$90.33$105.39$1,542.53
MRI cervical spine without contrastCPT7214120$3,101$930.3$167.52$235.19$1,612.52
MRI thoracic spine without contrastCPT7214620$3,101$930.3$167.52$235.19$1,612.52
MRI lumbar spine without contrastCPT7214820$3,101$930.3$167.52$235.19$1,612.52
MRI lumbar spine with and without contrastCPT7214920$3,217.75$965.33$215.74$343.84$1,673.23
MRI cervical spine with and without contrastCPT7215620$4,416.35$1,324.91$264.35$348.9$2,296.5
MRI lumbar spine with contrastCPT7215820$4,523.25$1,356.98$264.35$348.9$2,352.09
CT pelvis without contrastCPT7219220$2,724.95$817.49$90.33$104.25$1,416.97
CT pelvis with contrastCPT7219320$2,793.5$838.05$148.75$176.43$1,452.62
Shoulder X-rayCPT7303021$477.1$143.13$22.18$83.11$127.7
Humerus X-rayCPT7306020$363.8$109.14$21.85$83.11$127.7
Hand X-ray 3 viewsCPT7313020$374.1$112.23$22.18$83.11$127.7
MRI upper extremity joint without contrastCPT7322120$2,971.9$891.57$167.52$236.15$1,545.39
MRI upper extremity joint with and without contrastCPT7322320$3,796.1$1,138.83$264.35$353.96$1,973.97
Knee X-ray 1-2 viewsCPT7356021$366.2$109.86$22.18$83.11$127.7
Ankle X-ray 3 viewsCPT7361020$442.2$132.66$22.18$83.11$127.7
MRI lower extremity joint without contrastCPT7372120$3,092.15$927.65$167.52$236.15$1,607.92
MRI lower extremity joint with and without contrastCPT7372320$3,242.9$972.87$264.35$353.96$1,686.31
CT abdomen without contrastCPT7415020$2,589.2$776.76$90.33$103.89$1,346.38
CT abdomen with contrastCPT7416020$2,828.7$848.61$148.75$176.43$1,470.92
CT abdomen with and without contrastCPT7417020$3,211.3$963.39$151.23$176.43$1,669.88
CT abdomen and pelvis without contrastCPT7417620$5,738.75$1,721.63$137.64$228.16$2,984.15
CT abdomen and pelvis with contrastCPT7417720$6,034.15$1,810.25$248.47$340.47$3,137.76
CT abdomen and pelvis with and without contrastCPT7417820$6,670.25$2,001.08$287.37$348.9$3,468.53
MRI abdomen without contrastCPT7418120$2,936.35$880.91$167.52$239.57$1,526.9
MRI abdomen with and without contrastCPT7418320$4,610.45$1,383.14$264.35$353.96$2,397.43
Abdominal ultrasound completeCPT7670020$1,488.85$446.66$47.68$102.38$387.1
Abdominal ultrasound limitedCPT7670520$758.45$227.54$47.68$100.37$197.2
Retroperitoneal ultrasound completeCPT7677020$933.9$280.17$47.68$102.38$242.81
Obstetric ultrasound first trimesterCPT7680120$843.85$253.16$44.45$100.37$219.4
Obstetric ultrasound after first trimesterCPT7680520$1,150.1$345.03$47.68$102.38$299.03
Obstetric ultrasound with fetal anatomyCPT7681120$1,075.85$322.76$75.31$228.16$372.86
Transvaginal ultrasoundCPT7683020$1,175.35$352.61$47.68$100.37$305.59
Pelvic ultrasound completeCPT7685620$1,178$353.4$47.68$100.37$306.28
Scrotal ultrasoundCPT7687020$1,059.8$317.94$44.64$100.37$275.55
Diagnostic mammography unilateralCPT7706520$718.6$215.58$68.4$98.8$249.9
Diagnostic mammography bilateralCPT7706620$814.2$244.26$87.17$125.92$319.26
Screening mammography bilateralCPT7706720$631.8$189.54$72.15$104.22$263.95
EKG completeCPT930001$28.46$33.42$45.49
EKG tracing onlyCPT9300519$356.2$106.86$13.36$56.07$181.66
EKG interpretation onlyCPT930101$15.75$17.89$20.03
Transthoracic echocardiogram completeCPT9330619$4,070.75$1,221.23$196.39$517.54$2,076.08
Transthoracic echocardiogramCPT9330719$2,866.55$859.97$142.99$228.16$1,461.94
Stress echocardiogramCPT9335019$157.19$517.54$724.56
inpatient
Respiratory infections & inflammations w MCCMS-DRG17721$3,657.7$11,915$30,699
COPD w MCCMS-DRG19021$2,097.75$11,555$20,300
COPD w CCMS-DRG19121$1,494.35$9,656$20,300
COPD w/o CC/MCCMS-DRG19221$1,112.18$8,513.49$20,300
Simple pneumonia & pleurisy w CCMS-DRG19421$1,410.09$9,564$20,300
Simple pneumonia & pleurisy w/o CC/MCCMS-DRG19521$990.17$8,344.4$20,300
AMI discharged alive w MCCMS-DRG28021$4,518.26$11,915$37,921
AMI discharged alive w CCMS-DRG28121$3,424.49$10,900$20,300
AMI discharged alive w/o CC/MCCMS-DRG28221$2,810.24$9,564$27,789
Heart failure & shock w MCCMS-DRG29121$2,435.94$11,915$20,300
Heart failure & shock w CCMS-DRG29221$1,562.49$9,744.36$20,300
Heart failure & shock w/o CC/MCCMS-DRG29321$1,153.85$8,225$20,300
Cardiac arrhythmia w MCCMS-DRG30821$3,198.19$11,860$26,842
Cardiac arrhythmia w CCMS-DRG30921$1,877.89$9,564$20,300
Cardiac arrhythmia w/o CC/MCCMS-DRG31021$1,363.12$7,540.63$20,300
GI hemorrhage w CCMS-DRG37821$1,572.16$10,491$20,300
GI hemorrhage w/o CC/MCCMS-DRG37921$1,234.66$8,394.5$20,300
Esophagitis/gastroenteritis w/o MCCMS-DRG39221$1,047.49$8,791.51$20,300
Fractures of femur w/o MCCMS-DRG53321$5,327.08$11,915$49,793
Kidney/UTI w MCCMS-DRG68921$1,647.9$11,485$20,300
Kidney/UTI w/o MCCMS-DRG69021$989.02$9,204.69$20,300
Septicemia or severe sepsis w MV 96+ hrsMS-DRG87121$3,130.73$13,609$28,188
Septicemia or severe sepsis w/o MV 96+ hrsMS-DRG87221$1,618.89$10,900$20,300
Initial hospital care, low complexityCPT992212$86.63$91.84$110.16
Initial hospital care, moderate complexityCPT992222$124.98$131.9$181.93
Initial hospital care, high complexityCPT992232$184.22$184.51$234.27
Hospital discharge, <30 minCPT992382$65.76$70.44$101.06
Hospital discharge, >30 minCPT992392$97.13$104$139.65
lab
Basic metabolic panel (BMP)CPT8004820$250.3$75.09$5.93$8.46$130.16
General health panelCPT800505$19.54$45.26$149.01
Electrolyte panelCPT8005120$187.5$56.25$4.92$7.01$97.5
Comprehensive metabolic panelCPT8005320$597.25$179.18$7.42$10.57$310.57
Lipid panelCPT8006120$338.1$101.43$9.4$13.39$175.81
Renal function panelCPT8006920$242.4$72.72$6.09$8.69$126.05
Hepatic function panelCPT8007620$350.85$105.26$5.73$8.17$182.44
Urinalysis non-automatedCPT8100220$1.79$3.48$11.28
Urinalysis automatedCPT8100320$116$34.8$1.57$2.25$60.32
Glucose quantitativeCPT8294720$122.5$36.75$2.75$3.93$63.7
Hemoglobin A1cCPT8303620$139.95$41.99$6.81$9.71$72.77
Thyroid stimulating hormone (TSH)CPT8444320$247.55$74.27$11.78$16.8$128.73
Complete blood count with automated differentialCPT8502520$249.15$74.75$5.45$7.77$129.56
Complete blood count without differentialCPT8502720$174.75$52.43$4.54$6.47$90.87
Urine culture bacterialCPT8708620$121.85$36.56$5.66$8.07$63.36
Urine culture identificationCPT8708820$5.68$8.09$31.6
Tissue exam by pathologist level IVCPT8830520$374$112.2$18.23$50.43$194.48
maternity
Fetal non-stress testCPT5902520$1,668.55$500.57$10.76$189.88$5,600
Routine obstetric care including vaginal deliveryCPT594001$2,118$2,215$5,600
Vaginal delivery onlyCPT594092$923.1$2,176.75$5,600
Vaginal delivery with postpartumCPT594101$2,118$2,215$5,600
Routine obstetric care with C-sectionCPT595101$2,118$2,215$5,600
C-section delivery onlyCPT595141$2,118$2,215$5,600
C-section with postpartumCPT595151$2,118$2,215$5,600
office
Office visit, new patient, 15-29 minCPT992023$36.06$47.07$77.98
Office visit, new patient, 30-44 minutesCPT992033$47.56$71.27$107.14
Office visit, new patient, 45-59 minCPT992043$65.21$121.37$158.65
Office visit, new patient, 60-74 minCPT992053$88.26$155.1$199.58
Office visit, established patient, 5 minCPT992112$8.47$8.7$26.9
Office visit, established patient, 10-19 minCPT992122$22.92$23.72$36.06
Office visit, established patient, 20-29 minutesCPT992132$36.06$46.61$49.51
Office visit, established patient, 30-39 minutesCPT992142$47.56$71.66$75.95
Office visit, established patient, 40-54 minCPT992152$65.21$100.98$107.26
preventive
Upper GI endoscopy diagnosticCPT4323520$3,643.85$1,093.16$372.8$884.96$1,467
Upper GI endoscopy with biopsyCPT4323920$3,643.85$1,093.16$372.8$884.96$2,984
Sigmoidoscopy diagnosticCPT4533020$2,242.35$672.71$37.88$860.56$1,467
Sigmoidoscopy with biopsyCPT4533120$2,242.35$672.71$48.71$860.56$1,467
Colonoscopy diagnosticCPT4537820$4,204.35$1,261.31$394.93$860.56$2,984
Colonoscopy with biopsyCPT453802$4,177.1$1,253.13$394.93$1,217.75$2,984
Colonoscopy with polyp removalCPT453852$5,076.65$1,523$394.93$1,217.75$2,984
surgery
Total shoulder arthroplastyCPT234724$2,118$19,804$28,151
Hip hemiarthroplastyCPT271254$2,118$21,555$28,151
Total hip replacementCPT271304$2,118$21,555$28,151
Total knee replacementCPT274474$2,118$21,670$28,151
Knee revision arthroplasty single componentCPT274862$2,118$12,597$23,491
Knee revision arthroplasty all componentsCPT274872$2,118$12,597$23,491
Shoulder arthroscopy with decompressionCPT298261$1,468.5$1,535$3,099
Shoulder arthroscopy with rotator cuff repairCPT298272$2,172.78$2,246.75$4,888
Knee arthroscopy with meniscectomyCPT298812$1,075.79$1,941$3,580
ACL reconstructionCPT298882$1,468.5$1,539.25$3,161.4
Major small/large bowel procedures w MCCMS-DRG32921$8,225$20,468$71,071
Major small/large bowel procedures w CCMS-DRG33021$4,555.32$16,794$38,232
Major small/large bowel procedures w/o CC/MCCMS-DRG33121$3,108.63$11,915$25,058
CABG single arterial graftCPT335331$2,118$2,215$5,600
CABG 2 arterial graftsCPT335341$2,118$2,215$5,600
CABG 3 arterial graftsCPT335351$2,118$2,215$5,600
CABG 4+ arterial graftsCPT335361$2,118$2,215$5,600
Laparoscopic cholecystectomy w/o CDE w MCCMS-DRG41821$4,247.98$11,915$24,736
Laparoscopic cholecystectomy w/o CDE w CCMS-DRG41921$2,448.14$11,915$20,300
Laparoscopic cholecystectomy w/o CDE w/o CC/MCCMS-DRG42021$3,310.07$18,292$51,492
Open appendectomyCPT449502$1,142.96$2,176.75$5,600
Laparoscopic appendectomyCPT449702$1,889.5$1,941$3,580
Major joint replacement w MCCMS-DRG46921$7,315.64$19,547$61,400
Major joint replacement w/o MCCMS-DRG47021$6,155.57$13,648$51,663
Laparoscopic cholecystectomyCPT475622$1,889.7$3,088.5$5,086
Lap cholecystectomy with cholangiographyCPT475632$1,889.7$3,088.5$5,086
Hip & femur procedures except major joint w MCCMS-DRG48021$6,334.68$18,292$44,318
Hip & femur procedures except major joint w CCMS-DRG48121$5,631.82$14,673$30,958
Hip & femur procedures except major joint w/o CC/MCCMS-DRG48221$4,256.27$11,915$24,131
Open umbilical hernia repairCPT495602$1,337.72$2,176.75$5,600
Umbilical hernia repair age 5+CPT495852$1,337.72$2,176.75$5,600
Lap inguinal hernia repairCPT496502$1,889.5$1,941$3,580
Lap incisional hernia repairCPT496522$2,118$2,220.25$5,600
Total abdominal hysterectomyCPT581502$2,118$2,225.5$5,600
Vaginal hysterectomyCPT582603$1,989.59$3,151$5,086
Lap-assisted vaginal hysterectomyCPT585502$2,739.57$3,088.5$5,086
Lap-assisted vaginal hysterectomy >250gCPT585522$1,889.7$2,246.75$4,888
Lap salpingo-oophorectomyCPT586612$1,889.7$2,246.75$4,888
OR procedure for obesity w MCCMS-DRG61921$6,359.77$18,249$44,854
OR procedure for obesity w CCMS-DRG62021$4,601.14$11,915$42,515
OR procedure for obesity w/o CC/MCCMS-DRG62121$3,936.04$11,915$42,515
Complex cataract surgeryCPT669822$876.31$2,865.75$3,339
Cataract surgery with lens implantCPT669842$876.31$2,865.75$3,339
Intravitreal injectionCPT6702820$157.21$313.08$1,467
Vitrectomy mechanicalCPT670422$1,561.28$3,088.5$5,086
Uterine & adnexa procedures w CC/MCCMS-DRG74321$1,632.25$11,792$20,300
Uterine & adnexa procedures w/o CC/MCCMS-DRG74421$2,332.57$14,355$26,966
PCI single major coronary arteryCPT929205$658.06$13,091$16,976
PCI with drug-eluting stentCPT929285$732.09$12,902$16,976
PCI bypass graftCPT929375$731.63$12,902$16,976
Left heart catheterizationCPT934524$691.13$8,875$11,857
Coronary angiography with cathCPT934554$822.31$7,684$11,857
Coronary angiography with bypass cathCPT934584$836.85$8,875$11,857

Payer mix (top 22)

PayerCodes coveredMedian rate
Cigna170$2,544
community plan165$165.38
Aetna162$343.84
Blue Cross Blue Shield158$285.95
UnitedHealthcare147$610.96
Ambetter136$218.44
smart health136$767.38
ascension complete136$168.03
centurion of tn136$168.03
amerigroup mcr replacement136$189.88
amerigroup mcaid replacement136$3,610.96
healthspring mcr replacement136$168.03
Humana136$168.03
Medicare136$168.03
Medicare Advantage136$168.03
nhc advantage136$168.03
optum va136$168.03
Oscar Health136$767.38
point comfort underwriters136$151.23
Self-Pay (Cash)136$228.16
health 2 business40$17,332
bridgestone5$85