▸ Hospital · TN · CCN 440192
Ascension Saint Thomas Highlands
401 SEWELL ROAD, SPARTA, TN, 38583
14 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
197
of 209 target codes
Payers
21
with negotiated rates
Rates published
42,675
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 21 | — | — | $1,612.22 | $11,826 | $20,671 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 18 | — | — | $55.08 | $151.66 | $212.32 |
| Psychiatric eval with medical services | CPT | 90792 | 18 | — | — | $55.08 | $151.66 | $212.32 |
| Psychotherapy 30 minutes | CPT | 90832 | 18 | — | — | $41.43 | $151.66 | $212.32 |
| Psychotherapy 45 minutes | CPT | 90834 | 18 | — | — | $55.08 | $151.66 | $212.32 |
| Psychotherapy 60 minutes | CPT | 90837 | 18 | — | — | $55.08 | $151.66 | $212.32 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 18 | — | — | $55.08 | $151.66 | $212.32 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 18 | $692.3 | $207.69 | $19.26 | $87.27 | $1,386 |
| ED visit level 2 | CPT | 99282 | 18 | $1,910 | $573 | $37.71 | $154.71 | $1,910 |
| ED visit level 3 | CPT | 99283 | 18 | $2,450 | $735 | $56.4 | $274.43 | $2,453 |
| ED visit level 4 | CPT | 99284 | 18 | $3,150 | $945 | $107.34 | $409.97 | $4,291 |
| ED visit level 5 | CPT | 99285 | 18 | $3,200.05 | $960.02 | $158.13 | $590.28 | $4,558 |
| Critical care, first hour | CPT | 99291 | 18 | $3,253.4 | $976.02 | $232.88 | $795.34 | $1,483 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 19 | $2,707.45 | $812.24 | $86.77 | $105.39 | $1,407.87 |
| CT head with contrast | CPT | 70460 | 19 | $2,939.6 | $881.88 | $120.17 | $171.39 | $1,528.59 |
| CT head with and without contrast | CPT | 70470 | 19 | $2,953.15 | $885.95 | $148.64 | $176.43 | $1,535.64 |
| CT neck with contrast | CPT | 70491 | 19 | $3,736.55 | $1,120.97 | $148.75 | $176.43 | $1,943.01 |
| MRI brain without contrast | CPT | 70551 | 19 | $3,823.15 | $1,146.95 | $167.52 | $239.57 | $1,988.04 |
| MRI brain with contrast | CPT | 70552 | 19 | $4,616.05 | $1,384.82 | $215.74 | $343.84 | $2,400.35 |
| MRI brain with and without contrast | CPT | 70553 | 19 | $5,307.95 | $1,592.39 | $264.35 | $353.96 | $2,760.13 |
| Chest X-ray single view | CPT | 71045 | 18 | $337.4 | $101.22 | $7.8 | $83.11 | $127.7 |
| Chest X-ray 2 views | CPT | 71046 | 18 | $379.55 | $113.87 | $14.38 | $83.11 | $127.7 |
| Chest X-ray 3 views | CPT | 71047 | 18 | $314.5 | $94.35 | $18.33 | $83.11 | $127.7 |
| CT chest without contrast | CPT | 71250 | 19 | $2,569.45 | $770.84 | $90.33 | $105.39 | $1,336.11 |
| CT chest with contrast | CPT | 71260 | 19 | $2,774.85 | $832.46 | $148.75 | $176.43 | $1,442.92 |
| CT chest with and without contrast | CPT | 71270 | 19 | $3,187.2 | $956.16 | $151.23 | $176.43 | $1,657.34 |
| MRI chest without contrast | CPT | 71550 | 19 | $2,518 | $755.4 | $167.52 | $239.57 | $1,309.36 |
| MRI chest with contrast | CPT | 71551 | 19 | — | — | $215.74 | $745.74 | $1,380.32 |
| MRI chest with and without contrast | CPT | 71552 | 19 | $4,152.05 | $1,245.62 | $264.35 | $353.96 | $2,159.07 |
| Lumbosacral spine X-ray | CPT | 72100 | 19 | $603.2 | $180.96 | $19.13 | $100.37 | $179.33 |
| CT cervical spine without contrast | CPT | 72125 | 19 | $2,960.6 | $888.18 | $90.33 | $105.39 | $1,539.51 |
| CT thoracic spine without contrast | CPT | 72128 | 19 | $2,864.15 | $859.25 | $90.33 | $105.39 | $1,489.36 |
| CT lumbar spine without contrast | CPT | 72131 | 19 | $3,114.7 | $934.41 | $90.33 | $105.39 | $1,619.64 |
| MRI cervical spine without contrast | CPT | 72141 | 19 | $3,256.1 | $976.83 | $167.52 | $237.66 | $1,693.17 |
| MRI thoracic spine without contrast | CPT | 72146 | 19 | $3,256.1 | $976.83 | $167.52 | $237.66 | $1,693.17 |
| MRI lumbar spine without contrast | CPT | 72148 | 19 | $3,256.1 | $976.83 | $167.52 | $237.66 | $1,693.17 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 19 | $3,378.65 | $1,013.6 | $215.74 | $343.84 | $1,756.9 |
| MRI cervical spine with and without contrast | CPT | 72156 | 19 | $4,416.35 | $1,324.91 | $264.35 | $353.96 | $2,296.5 |
| MRI lumbar spine with contrast | CPT | 72158 | 19 | $4,749.45 | $1,424.84 | $264.35 | $353.96 | $2,469.71 |
| CT pelvis without contrast | CPT | 72192 | 19 | $2,724.95 | $817.49 | $90.33 | $105.39 | $1,416.97 |
| CT pelvis with contrast | CPT | 72193 | 19 | $2,793.5 | $838.05 | $148.75 | $176.43 | $1,452.62 |
| Shoulder X-ray | CPT | 73030 | 19 | $500.95 | $150.29 | $16.3 | $83.11 | $130.25 |
| Humerus X-ray | CPT | 73060 | 19 | $382.05 | $114.62 | $16.3 | $83.11 | $127.7 |
| Hand X-ray 3 views | CPT | 73130 | 19 | $392.8 | $117.84 | $15.33 | $83.11 | $127.7 |
| MRI upper extremity joint without contrast | CPT | 73221 | 19 | $3,120.5 | $936.15 | $167.52 | $239.57 | $1,622.66 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 19 | $3,796.1 | $1,138.83 | $264.35 | $353.96 | $1,973.97 |
| Knee X-ray 1-2 views | CPT | 73560 | 19 | $384.5 | $115.35 | $15.04 | $83.11 | $127.7 |
| Ankle X-ray 3 views | CPT | 73610 | 19 | $464.4 | $139.32 | $15.33 | $83.11 | $127.7 |
| MRI lower extremity joint without contrast | CPT | 73721 | 19 | $3,246.75 | $974.03 | $167.52 | $239.57 | $1,688.31 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 19 | $3,405.05 | $1,021.52 | $264.35 | $353.96 | $1,770.63 |
| CT abdomen without contrast | CPT | 74150 | 19 | $2,589.2 | $776.76 | $90.33 | $105.39 | $1,346.38 |
| CT abdomen with contrast | CPT | 74160 | 19 | $2,828.7 | $848.61 | $148.75 | $176.43 | $1,470.92 |
| CT abdomen with and without contrast | CPT | 74170 | 19 | $3,211.3 | $963.39 | $151.23 | $176.43 | $1,669.88 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 19 | $5,738.75 | $1,721.63 | $101.11 | $228.16 | $2,984.15 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 19 | $6,034.15 | $1,810.25 | $192.93 | $337.1 | $3,137.76 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 19 | $6,670.25 | $2,001.08 | $255.01 | $343.84 | $3,468.53 |
| MRI abdomen without contrast | CPT | 74181 | 19 | $3,083.15 | $924.95 | $167.52 | $239.57 | $1,603.24 |
| MRI abdomen with and without contrast | CPT | 74183 | 19 | $4,160.95 | $1,248.29 | $264.35 | $353.96 | $2,163.69 |
| Abdominal ultrasound complete | CPT | 76700 | 19 | $1,563.35 | $469.01 | $47.68 | $102.38 | $406.47 |
| Abdominal ultrasound limited | CPT | 76705 | 19 | $758.45 | $227.54 | $40.08 | $101.38 | $197.2 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 19 | $797.15 | $239.15 | $47.68 | $102.38 | $207.26 |
| Obstetric ultrasound first trimester | CPT | 76801 | 19 | $843.85 | $253.16 | $29.75 | $101.38 | $219.4 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 19 | $1,207.65 | $362.3 | $47.68 | $102.38 | $313.99 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 19 | $1,129.7 | $338.91 | $75.31 | $228.16 | $372.86 |
| Transvaginal ultrasound | CPT | 76830 | 19 | $1,234.1 | $370.23 | $43.3 | $101.38 | $320.87 |
| Pelvic ultrasound complete | CPT | 76856 | 19 | $1,236.9 | $371.07 | $43.3 | $101.38 | $321.59 |
| Scrotal ultrasound | CPT | 76870 | 19 | $1,112.8 | $333.84 | $43.3 | $100.37 | $289.33 |
| Diagnostic mammography unilateral | CPT | 77065 | 19 | $718.6 | $215.58 | $68.4 | $98.8 | $249.9 |
| Diagnostic mammography bilateral | CPT | 77066 | 19 | $814.2 | $244.26 | $87.17 | $125.92 | $319.26 |
| Screening mammography bilateral | CPT | 77067 | 19 | $631.8 | $189.54 | $72.15 | $104.22 | $263.95 |
| EKG complete | CPT | 93000 | 1 | — | — | $23.94 | $32.64 | $35.91 |
| EKG tracing only | CPT | 93005 | 18 | $356.2 | $106.86 | $13.36 | $56.07 | $181.66 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $10.54 | $13.18 | $15.81 |
| Transthoracic echocardiogram complete | CPT | 93306 | 18 | $4,070.75 | $1,221.23 | $148.77 | $517.54 | $2,076.08 |
| Transthoracic echocardiogram | CPT | 93307 | 18 | $2,866.55 | $859.97 | $117.72 | $228.16 | $1,461.94 |
| Stress echocardiogram | CPT | 93350 | 18 | — | — | $105.21 | $517.54 | $724.56 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 21 | — | — | $3,657.7 | $11,946 | $30,699 |
| COPD w MCC | MS-DRG | 190 | 21 | — | — | $2,097.75 | $11,561 | $20,300 |
| COPD w CC | MS-DRG | 191 | 21 | — | — | $1,494.35 | $9,668.93 | $20,300 |
| COPD w/o CC/MCC | MS-DRG | 192 | 21 | — | — | $1,112.18 | $8,454 | $20,300 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 21 | — | — | $1,410.09 | $9,536.72 | $20,300 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 21 | — | — | $990.17 | $8,434.96 | $20,300 |
| AMI discharged alive w MCC | MS-DRG | 280 | 21 | — | — | $4,518.26 | $12,175 | $24,837 |
| AMI discharged alive w CC | MS-DRG | 281 | 21 | — | — | $3,424.49 | $11,122 | $20,300 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 21 | — | — | $2,810.24 | $9,610 | $27,789 |
| Heart failure & shock w MCC | MS-DRG | 291 | 21 | — | — | $2,435.94 | $11,915 | $20,300 |
| Heart failure & shock w CC | MS-DRG | 292 | 21 | — | — | $1,562.49 | $9,744.36 | $20,300 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 21 | — | — | $1,153.85 | $8,603.61 | $20,300 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 21 | — | — | $3,198.19 | $11,915 | $26,842 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 21 | — | — | $1,877.89 | $9,575.77 | $20,300 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 21 | — | — | $1,363.12 | $7,693.48 | $20,300 |
| GI hemorrhage w CC | MS-DRG | 378 | 21 | — | — | $1,572.16 | $10,491 | $20,300 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 21 | — | — | $1,234.66 | $8,409.12 | $20,300 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 21 | — | — | $1,047.49 | $9,537 | $20,300 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 21 | — | — | $5,327.08 | $11,966 | $33,949 |
| Kidney/UTI w MCC | MS-DRG | 689 | 21 | — | — | $1,647.9 | $11,666 | $20,300 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 21 | — | — | $989.02 | $9,014.08 | $20,300 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 21 | — | — | $3,130.73 | $14,597 | $28,188 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 21 | — | — | $1,618.89 | $10,898 | $20,300 |
| Initial hospital care, low complexity | CPT | 99221 | 2 | — | — | $57.98 | $91.84 | $97.29 |
| Initial hospital care, moderate complexity | CPT | 99222 | 2 | — | — | $95.75 | $124.98 | $143.63 |
| Initial hospital care, high complexity | CPT | 99223 | 2 | — | — | $123.3 | $184.51 | $195.88 |
| Hospital discharge, <30 min | CPT | 99238 | 2 | — | — | $53.19 | $65.76 | $79.78 |
| Hospital discharge, >30 min | CPT | 99239 | 2 | — | — | $73.5 | $97.13 | $110.25 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 19 | $250.3 | $75.09 | $5.93 | $8.46 | $130.16 |
| General health panel | CPT | 80050 | 5 | — | — | $19.54 | $42.55 | $149.01 |
| Electrolyte panel | CPT | 80051 | 19 | $187.5 | $56.25 | $4.92 | $7.01 | $97.5 |
| Comprehensive metabolic panel | CPT | 80053 | 19 | $597.25 | $179.18 | $7.42 | $10.57 | $310.57 |
| Lipid panel | CPT | 80061 | 19 | $338.1 | $101.43 | $9.4 | $13.39 | $175.81 |
| Renal function panel | CPT | 80069 | 19 | $242.4 | $72.72 | $6.09 | $8.69 | $126.05 |
| Hepatic function panel | CPT | 80076 | 19 | $350.85 | $105.26 | $5.73 | $8.17 | $182.44 |
| Urinalysis non-automated | CPT | 81002 | 19 | — | — | $1.79 | $3.48 | $11.28 |
| Urinalysis automated | CPT | 81003 | 19 | $116 | $34.8 | $1.57 | $2.25 | $60.32 |
| Glucose quantitative | CPT | 82947 | 19 | $169.4 | $50.82 | $2.75 | $3.93 | $88.09 |
| Hemoglobin A1c | CPT | 83036 | 19 | $139.85 | $41.96 | $6.81 | $9.71 | $72.72 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 19 | $247.55 | $74.27 | $11.78 | $16.8 | $128.73 |
| Complete blood count with automated differential | CPT | 85025 | 19 | $249.15 | $74.75 | $5.45 | $7.77 | $129.56 |
| Complete blood count without differential | CPT | 85027 | 19 | $174.75 | $52.43 | $4.54 | $6.47 | $90.87 |
| Urine culture bacterial | CPT | 87086 | 19 | $121.85 | $36.56 | $5.66 | $8.07 | $63.36 |
| Urine culture identification | CPT | 87088 | 19 | — | — | $5.68 | $8.09 | $31.6 |
| Tissue exam by pathologist level IV | CPT | 88305 | 19 | $374 | $112.2 | $15.18 | $50.43 | $194.48 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 19 | — | — | $7.2 | $189.88 | $5,600 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| Vaginal delivery only | CPT | 59409 | 2 | — | — | $923.1 | $2,176.75 | $5,600 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| C-section delivery only | CPT | 59514 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 3 | — | — | $36.06 | $45.55 | $61.56 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 3 | — | — | $47.56 | $69.16 | $84.58 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 3 | — | — | $65.21 | $118.41 | $125.25 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 3 | — | — | $88.26 | $153.26 | $162.31 |
| Office visit, established patient, 5 min | CPT | 99211 | 2 | — | — | $8.47 | $8.7 | $26.9 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 2 | — | — | $22.92 | $23.72 | $36.06 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 2 | — | — | $36.06 | $46.61 | $49.51 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 2 | — | — | $47.56 | $71.66 | $75.95 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 2 | — | — | $65.21 | $100.98 | $107.26 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 19 | $3,643.85 | $1,093.16 | $372.8 | $884.96 | $1,467 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 19 | $3,643.85 | $1,093.16 | $372.8 | $884.96 | $2,984 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 19 | $2,242.5 | $672.75 | $37.88 | $860.56 | $1,467 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 19 | $2,242.5 | $672.75 | $48.71 | $860.56 | $1,467 |
| Colonoscopy diagnostic | CPT | 45378 | 19 | $4,204.35 | $1,261.31 | $394.93 | $860.56 | $2,984 |
| Colonoscopy with biopsy | CPT | 45380 | 2 | $4,204.35 | $1,261.31 | $394.93 | $1,217.75 | $2,984 |
| Colonoscopy with polyp removal | CPT | 45385 | 2 | $4,204.35 | $1,261.31 | $394.93 | $1,217.75 | $2,984 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 4 | — | — | $2,118 | $19,804 | $28,151 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | — | — | $2,118 | $21,555 | $28,151 |
| Total hip replacement | CPT | 27130 | 4 | — | — | $2,118 | $21,555 | $28,151 |
| Total knee replacement | CPT | 27447 | 4 | — | — | $2,118 | $21,670 | $28,151 |
| Knee revision arthroplasty single component | CPT | 27486 | 2 | — | — | $2,118 | $12,597 | $23,491 |
| Knee revision arthroplasty all components | CPT | 27487 | 2 | — | — | $2,118 | $12,597 | $23,491 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $1,468.5 | $1,535 | $3,099 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 2 | — | — | $2,172.78 | $2,246.75 | $4,888 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 2 | — | — | $1,075.79 | $1,941 | $3,580 |
| ACL reconstruction | CPT | 29888 | 2 | — | — | $1,468.5 | $1,539.25 | $3,161.4 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 21 | — | — | $8,368.19 | $20,384 | $71,071 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 21 | — | — | $4,555.32 | $18,014 | $37,204 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 21 | — | — | $3,108.63 | $12,773 | $25,058 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $2,118 | $2,215 | $5,600 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 21 | — | — | $4,247.98 | $12,839 | $24,736 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 21 | — | — | $2,448.14 | $11,915 | $20,547 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 21 | — | — | $3,310.07 | $18,562 | $51,492 |
| Open appendectomy | CPT | 44950 | 2 | — | — | $1,142.96 | $2,176.75 | $5,600 |
| Laparoscopic appendectomy | CPT | 44970 | 2 | — | — | $1,889.5 | $1,941 | $3,580 |
| Major joint replacement w MCC | MS-DRG | 469 | 21 | — | — | $7,315.64 | $20,300 | $61,400 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 21 | — | — | $6,155.57 | $14,495 | $51,663 |
| Laparoscopic cholecystectomy | CPT | 47562 | 2 | — | — | $1,889.7 | $3,088.5 | $5,086 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 2 | — | — | $1,889.7 | $3,088.5 | $5,086 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 21 | — | — | $6,334.68 | $19,833 | $53,166 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 21 | — | — | $5,631.82 | $15,739 | $32,228 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 21 | — | — | $4,256.27 | $12,379 | $24,356 |
| Open umbilical hernia repair | CPT | 49560 | 2 | — | — | $1,337.72 | $2,176.75 | $5,600 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 2 | — | — | $1,337.72 | $2,176.75 | $5,600 |
| Lap inguinal hernia repair | CPT | 49650 | 2 | — | — | $1,889.5 | $1,941 | $3,580 |
| Lap incisional hernia repair | CPT | 49652 | 2 | — | — | $2,118 | $2,220.25 | $5,600 |
| Total abdominal hysterectomy | CPT | 58150 | 2 | — | — | $2,118 | $2,225.5 | $5,600 |
| Vaginal hysterectomy | CPT | 58260 | 3 | — | — | $1,989.59 | $3,151 | $5,086 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 2 | — | — | $2,739.57 | $3,088.5 | $5,086 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 2 | — | — | $1,889.7 | $2,246.75 | $4,888 |
| Lap salpingo-oophorectomy | CPT | 58661 | 2 | — | — | $1,889.7 | $2,246.75 | $4,888 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 21 | — | — | $6,359.77 | $19,970 | $53,377 |
| OR procedure for obesity w CC | MS-DRG | 620 | 21 | — | — | $4,601.14 | $12,266 | $42,515 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 21 | — | — | $3,936.04 | $11,915 | $42,515 |
| Complex cataract surgery | CPT | 66982 | 2 | — | — | $876.31 | $2,865.75 | $3,339 |
| Cataract surgery with lens implant | CPT | 66984 | 2 | — | — | $876.31 | $2,865.75 | $3,339 |
| Intravitreal injection | CPT | 67028 | 19 | — | — | $157.21 | $313.08 | $1,467 |
| Vitrectomy mechanical | CPT | 67042 | 2 | — | — | $1,561.28 | $3,088.5 | $5,086 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 21 | — | — | $1,632.25 | $11,674 | $20,300 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 21 | — | — | $2,332.57 | $15,398 | $26,966 |
| PCI single major coronary artery | CPT | 92920 | 5 | — | — | $440.44 | $13,091 | $16,976 |
| PCI with drug-eluting stent | CPT | 92928 | 5 | — | — | $489.99 | $12,902 | $16,976 |
| PCI bypass graft | CPT | 92937 | 5 | — | — | $489.68 | $12,902 | $16,976 |
| Left heart catheterization | CPT | 93452 | 4 | — | — | $462.57 | $8,875 | $11,857 |
| Coronary angiography with cath | CPT | 93455 | 4 | — | — | $550.37 | $7,684 | $11,857 |
| Coronary angiography with bypass cath | CPT | 93458 | 4 | — | — | $560.1 | $8,875 | $11,857 |
Payer mix (top 21)
| Payer | Codes covered | Median rate |
|---|---|---|
| Cigna | 170 | $2,984 |
| community plan | 165 | $165.38 |
| Aetna | 162 | $343.84 |
| Blue Cross Blue Shield | 158 | $272.37 |
| UnitedHealthcare | 147 | $610.96 |
| Ambetter | 136 | $218.44 |
| centurion of tn | 136 | $168.03 |
| amerigroup mcr replacement | 136 | $189.88 |
| smart health | 136 | $767.38 |
| ascension complete | 136 | $168.03 |
| healthspring mcr replacement | 136 | $168.03 |
| Humana | 136 | $168.03 |
| Medicare | 136 | $168.03 |
| Medicare Advantage | 136 | $168.03 |
| nhc advantage | 136 | $168.03 |
| optum va | 136 | $168.03 |
| Oscar Health | 136 | $767.38 |
| point comfort underwriters | 136 | $151.23 |
| Self-Pay (Cash) | 136 | $228.16 |
| amerigroup mcaid replacement | 40 | $5,199.22 |
| health 2 business | 40 | $17,332 |