Does Saint Thomas Hickman Hospital publish its standard charges and chargemaster?

Yes. Saint Thomas Hickman Hospital publishes a machine-readable file with 13,206 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does Saint Thomas Hickman Hospital charge for procedures?

Saint Thomas Hickman Hospital (Centerville, TN) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · TN · CCN 441300

Saint Thomas Hickman Hospital

Centerville, TN, 37033

25 bedsCritical Access Hospitals2

Compliance grade

92/100

Rates published

13,206

last crawl 2026-05-24

Procedures tracked

196

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All TN hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/tn-csv/581737573_saint-thomas-hickman-hospital_standardcharges.csv · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	9	—	—	$4,347.24	$13,531	1.1×	$20,671
Psychiatric diagnostic evaluation	CPT	90791	1	—	—	$105	$105	0.59×	$143.91
Psychiatric eval with medical services	CPT	90792	1	—	—	$135	$135	0.78×	$156.8
Psychotherapy 30 minutes	CPT	90832	1	—	—	$48	$48	0.32×	$68.6
Psychotherapy 45 minutes	CPT	90834	1	—	—	$80	$80	0.50×	$106.6
Psychotherapy 60 minutes	CPT	90837	1	—	—	$92	$92	0.48×	$137.4
Crisis psychotherapy 60 minutes	CPT	90839	1	—	—	$105	$105	0.66×	$143.91
emergency
ED visit level 1	CPT	99281	5	—	—	$19.26	$923	6.6×	$1,386
ED visit level 2	CPT	99282	5	—	—	$37.71	$1,243	5.2×	$1,910
ED visit level 3	CPT	99283	5	—	—	$56.4	$1,269	3.1×	$2,453
ED visit level 4	CPT	99284	5	—	—	$107.34	$2,380	3.6×	$4,291
ED visit level 5	CPT	99285	5	—	—	$158.13	$2,380	2.3×	$4,558
Critical care, first hour	CPT	99291	2	—	—	$326	$1,124	1.0×	$1,483
imaging
CT head without contrast	CPT	70450	4	—	—	$86.77	$179.33	0.87×	$562.76
CT head with contrast	CPT	70460	4	—	—	$120.17	$291.55	1.2×	$562.76
CT head with and without contrast	CPT	70470	4	—	—	$148.64	$291.55	1.1×	$562.76
CT neck with contrast	CPT	70491	4	—	—	$188.12	$301.21	1.1×	$562.76
MRI brain without contrast	CPT	70551	4	—	—	$182.43	$372.86	0.92×	$582.81
MRI brain with contrast	CPT	70552	4	—	—	$259.86	$610.96	1.3×	$860.15
MRI brain with and without contrast	CPT	70553	4	—	—	$297.06	$610.96	1.0×	$981.3
Chest X-ray single view	CPT	71045	4	—	—	$11.33	$25.64	0.27×	$127.7
Chest X-ray 2 views	CPT	71046	4	—	—	$20.89	$44.45	0.45×	$127.7
Chest X-ray 3 views	CPT	71047	4	—	—	$26.63	$56.58	0.59×	$127.7
CT chest without contrast	CPT	71250	4	—	—	$149.78	$237.36	1.1×	$562.76
CT chest with contrast	CPT	71260	4	—	—	$188.88	$301.85	1.1×	$562.76
CT chest with and without contrast	CPT	71270	4	—	—	$234.81	$372.11	1.3×	$617.08
MRI chest without contrast	CPT	71550	4	—	—	$366.53	$580.86	1.3×	$1,273.66
MRI chest with contrast	CPT	71551	4	—	—	$410.18	$1,089.31	1.3×	$1,380.32
MRI chest with and without contrast	CPT	71552	4	—	—	$512.3	$811.86	1.4×	$1,736.67
Lumbosacral spine X-ray	CPT	72100	4	—	—	$26.03	$55.03	0.53×	$179.33
CT cervical spine without contrast	CPT	72125	4	—	—	$151.68	$240.37	1.2×	$562.76
CT thoracic spine without contrast	CPT	72128	4	—	—	$150.92	$239.18	1.2×	$562.76
CT lumbar spine without contrast	CPT	72131	4	—	—	$150.16	$237.96	1.2×	$562.76
MRI cervical spine without contrast	CPT	72141	4	—	—	$179.77	$372.86	0.94×	$559.14
MRI thoracic spine without contrast	CPT	72146	4	—	—	$179.77	$372.86	1.0×	$560.44
MRI lumbar spine without contrast	CPT	72148	4	—	—	$179.77	$372.86	0.99×	$559.14
MRI lumbar spine with and without contrast	CPT	72149	4	—	—	$256.45	$610.96	1.3×	$865.43
MRI cervical spine with and without contrast	CPT	72156	4	—	—	$297.44	$610.96	1.1×	$989.22
MRI lumbar spine with contrast	CPT	72158	4	—	—	$295.54	$610.96	1.1×	$985.24
CT pelvis without contrast	CPT	72192	4	—	—	$103.1	$179.33	0.90×	$562.76
CT pelvis with contrast	CPT	72193	4	—	—	$188.88	$301.85	1.1×	$622.36
Shoulder X-ray	CPT	73030	4	—	—	$22.62	$46.9	0.50×	$127.7
Humerus X-ray	CPT	73060	4	—	—	$21.85	$46.68	0.52×	$127.7
Hand X-ray 3 views	CPT	73130	4	—	—	$26.03	$53.22	0.57×	$127.7
MRI upper extremity joint without contrast	CPT	73221	4	—	—	$197.99	$372.86	0.90×	$629.71
MRI upper extremity joint with and without contrast	CPT	73223	4	—	—	$401.45	$637.19	1.0×	$1,351.33
Knee X-ray 1-2 views	CPT	73560	4	—	—	$23	$51.11	0.55×	$127.7
Ankle X-ray 3 views	CPT	73610	4	—	—	$26.8	$53.14	0.58×	$127.7
MRI lower extremity joint without contrast	CPT	73721	4	—	—	$198.37	$372.86	0.80×	$629.71
MRI lower extremity joint with and without contrast	CPT	73723	4	—	—	$402.97	$638.6	1.0×	$1,350.03
CT abdomen without contrast	CPT	74150	4	—	—	$100.82	$179.33	0.95×	$562.76
CT abdomen with contrast	CPT	74160	4	—	—	$188.12	$301.21	1.1×	$621.02
CT abdomen with and without contrast	CPT	74170	4	—	—	$221.14	$350.46	1.0×	$714.52
CT abdomen and pelvis without contrast	CPT	74176	4	—	—	$137.64	$372.86	1.0×	$562.76
CT abdomen and pelvis with contrast	CPT	74177	4	—	—	$248.47	$610.96	1.1×	$818.54
CT abdomen and pelvis with and without contrast	CPT	74178	4	—	—	$295.17	$610.96	1.1×	$939.16
MRI abdomen without contrast	CPT	74181	4	—	—	$281.88	$446.71	1.1×	$779.03
MRI abdomen with and without contrast	CPT	74183	4	—	—	$434.48	$688.54	1.2×	$1,180.16
Abdominal ultrasound complete	CPT	76700	4	—	—	$107.65	$179.33	1.2×	$218.95
Abdominal ultrasound limited	CPT	76705	4	—	—	$84.87	$141.48	0.97×	$179.33
Retroperitoneal ultrasound complete	CPT	76770	4	—	—	$102.71	$174.31	1.2×	$203.95
Obstetric ultrasound first trimester	CPT	76801	4	—	—	$82.59	$167.91	1.2×	$196.47
Obstetric ultrasound after first trimester	CPT	76805	4	—	—	$103.47	$179.33	1.2×	$245.22
Obstetric ultrasound with fetal anatomy	CPT	76811	4	—	—	$95.88	$194.02	0.82×	$372.86
Transvaginal ultrasound	CPT	76830	4	—	—	$98.15	$179.33	1.2×	$233.01
Pelvic ultrasound complete	CPT	76856	4	—	—	$96.26	$172.73	1.2×	$202.1
Scrotal ultrasound	CPT	76870	4	—	—	$44.64	$87.98	0.67×	$179.33
Diagnostic mammography unilateral	CPT	77065	5	—	—	$73.27	$151.28	1.0×	$249.9
Diagnostic mammography bilateral	CPT	77066	5	—	—	$93.72	$192.86	1.0×	$319.26
Screening mammography bilateral	CPT	77067	5	—	—	$77.47	$159.95	1.0×	$263.95
EKG complete	CPT	93000	1	—	—	$28.46	$32.64	1.3×	$35.58
EKG tracing only	CPT	93005	1	—	—	$13.36	$15.32	0.13×	$16.7
Transthoracic echocardiogram complete	CPT	93306	1	—	—	$272.03	$311.94	0.52×	$340.03
Transthoracic echocardiogram	CPT	93307	1	—	—	$142.99	$163.97	0.66×	$178.73
Stress echocardiogram	CPT	93350	1	—	—	$280.32	$321.46	0.63×	$350.41
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	9	—	—	$6,855.93	$15,974	1.0×	$30,699
COPD w MCC	MS-DRG	190	9	—	—	$4,269.82	$12,614	1.1×	$20,300
COPD w CC	MS-DRG	191	9	—	—	$3,399.26	$11,860	1.3×	$20,300
COPD w/o CC/MCC	MS-DRG	192	9	—	—	$2,691.32	$10,900	1.6×	$20,300
Simple pneumonia & pleurisy w CC	MS-DRG	194	9	—	—	$3,457.05	$11,835	1.4×	$20,300
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	9	—	—	$2,629.83	$11,485	1.7×	$20,300
AMI discharged alive w MCC	MS-DRG	280	9	—	—	$6,140.96	$15,974	1.0×	$25,855
AMI discharged alive w CC	MS-DRG	281	9	—	—	$3,648.2	$11,915	1.2×	$28,741
AMI discharged alive w/o CC/MCC	MS-DRG	282	9	—	—	$2,810.24	$11,860	1.5×	$20,300
Heart failure & shock w MCC	MS-DRG	291	9	—	—	$5,467.48	$14,253	1.1×	$20,445
Heart failure & shock w CC	MS-DRG	292	9	—	—	$3,551.88	$11,915	1.3×	$20,300
Heart failure & shock w/o CC/MCC	MS-DRG	293	9	—	—	$2,495.36	$11,485	1.8×	$20,300
Cardiac arrhythmia w MCC	MS-DRG	308	9	—	—	$4,402.81	$14,363	1.2×	$20,300
Cardiac arrhythmia w CC	MS-DRG	309	9	—	—	$2,859.88	$11,555	1.5×	$20,300
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	9	—	—	$2,083.79	$10,748	1.7×	$20,300
GI hemorrhage w CC	MS-DRG	378	9	—	—	$3,594.48	$11,915	1.2×	$20,300
GI hemorrhage w/o CC/MCC	MS-DRG	379	9	—	—	$2,387.93	$10,900	1.6×	$20,300
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	9	—	—	$2,812.83	$11,485	1.4×	$20,300
Fractures of femur w/o MCC	MS-DRG	533	9	—	—	$5,327.08	$15,974	1.1×	$32,496
Kidney/UTI w MCC	MS-DRG	689	9	—	—	$3,998.27	$12,239	1.1×	$20,300
Kidney/UTI w/o MCC	MS-DRG	690	9	—	—	$2,943.23	$11,792	1.4×	$20,300
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	9	—	—	$6,752.95	$15,974	0.86×	$28,188
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	9	—	—	$3,906.77	$11,915	1.1×	$20,300
Initial hospital care, low complexity	CPT	99221	1	—	—	$91.84	$91.84	0.99×	$97.29
Initial hospital care, moderate complexity	CPT	99222	1	—	—	$124.98	$124.98	0.74×	$131.9
Initial hospital care, high complexity	CPT	99223	1	—	—	$184.51	$184.51	0.82×	$195.88
Hospital discharge, <30 min	CPT	99238	1	—	—	$65.76	$65.76	0.77×	$70.44
Hospital discharge, >30 min	CPT	99239	1	—	—	$97.13	$97.13	0.80×	$104
lab
Basic metabolic panel (BMP)	CPT	80048	5	—	—	$7.61	$11.84	0.37×	$32.75
General health panel	CPT	80050	4	—	—	$42.49	$57.36	0.53×	$149.01
Electrolyte panel	CPT	80051	5	—	—	$6.31	$9.81	0.41×	$27.07
Comprehensive metabolic panel	CPT	80053	5	—	—	$9.5	$14.78	0.33×	$40.65
Lipid panel	CPT	80061	5	—	—	$12.05	$18.75	0.49×	$51.92
Renal function panel	CPT	80069	5	—	—	$7.81	$12.15	0.45×	$33.86
Hepatic function panel	CPT	80076	5	—	—	$7.35	$11.44	0.43×	$31.6
Urinalysis non-automated	CPT	81002	5	—	—	$3.13	$4.87	0.70×	$11.28
Urinalysis automated	CPT	81003	5	—	—	$2.03	$3.15	0.23×	$9.01
Glucose quantitative	CPT	82947	5	—	—	$3.54	$5.5	0.31×	$14.69
Hemoglobin A1c	CPT	83036	5	—	—	$8.74	$13.59	0.50×	$37.24
Thyroid stimulating hormone (TSH)	CPT	84443	5	—	—	$15.12	$23.52	0.50×	$65.46
Complete blood count with automated differential	CPT	85025	5	—	—	$6.99	$10.88	0.41×	$30.48
Complete blood count without differential	CPT	85027	5	—	—	$5.82	$9.06	0.42×	$24.85
Urine culture bacterial	CPT	87086	5	—	—	$7.26	$11.3	0.48×	$31.6
Urine culture identification	CPT	87088	5	—	—	$7.28	$11.33	0.51×	$31.6
Tissue exam by pathologist level IV	CPT	88305	4	—	—	$34.29	$45.88	0.45×	$94.34
maternity
Fetal non-stress test	CPT	59025	1	—	—	$2,118	$2,220.25	11.8×	$5,600
Routine obstetric care including vaginal delivery	CPT	59400	1	—	—	$2,118	$2,215	0.97×	$5,600
Vaginal delivery only	CPT	59409	1	—	—	$2,118	$2,215	1.0×	$5,600
Vaginal delivery with postpartum	CPT	59410	1	—	—	$2,118	$2,215	2.1×	$5,600
Routine obstetric care with C-section	CPT	59510	1	—	—	$2,118	$2,215	0.89×	$5,600
C-section delivery only	CPT	59514	1	—	—	$2,118	$2,215	2.3×	$5,600
C-section with postpartum	CPT	59515	1	—	—	$2,118	$2,215	1.8×	$5,600
office
Office visit, new patient, 15-29 min	CPT	99202	1	—	—	$45.55	$45.55	0.53×	$48.58
Office visit, new patient, 30-44 minutes	CPT	99203	1	—	—	$69.16	$69.16	0.56×	$73.37
Office visit, new patient, 45-59 min	CPT	99204	1	—	—	$118.41	$118.41	0.68×	$124.32
Office visit, new patient, 60-74 min	CPT	99205	1	—	—	$153.26	$153.26	0.69×	$162.31
Office visit, established patient, 5 min	CPT	99211	1	—	—	$8.47	$8.47	0.13×	$8.93
Office visit, established patient, 10-19 min	CPT	99212	1	—	—	$22.92	$22.92	0.29×	$24.51
Office visit, established patient, 20-29 minutes	CPT	99213	1	—	—	$46.61	$46.61	0.41×	$49.51
Office visit, established patient, 30-39 minutes	CPT	99214	1	—	—	$71.66	$71.66	0.47×	$75.95
Office visit, established patient, 40-54 min	CPT	99215	1	—	—	$100.98	$100.98	0.54×	$107.26
preventive
Upper GI endoscopy diagnostic	CPT	43235	1	—	—	$954.5	$998.5	1.1×	$1,467
Upper GI endoscopy with biopsy	CPT	43239	1	—	—	$1,185	$1,239	1.3×	$2,984
Sigmoidoscopy diagnostic	CPT	45330	1	—	—	$954.5	$998.5	1.2×	$1,467
Sigmoidoscopy with biopsy	CPT	45331	1	—	—	$954.5	$998.5	1.1×	$1,467
Colonoscopy diagnostic	CPT	45378	1	—	—	$1,185	$1,239	1.4×	$2,984
Colonoscopy with biopsy	CPT	45380	1	—	—	$1,185	$1,239	1.0×	$2,984
Colonoscopy with polyp removal	CPT	45385	1	—	—	$1,185	$1,239	1.0×	$2,984
surgery
Total shoulder arthroplasty	CPT	23472	4	—	—	$2,118	$19,804	4.8×	$28,151
Hip hemiarthroplasty	CPT	27125	4	—	—	$2,118	$21,555	17.2×	$28,151
Total hip replacement	CPT	27130	4	—	—	$2,118	$21,555	5.0×	$28,151
Total knee replacement	CPT	27447	4	—	—	$2,118	$21,670	5.2×	$28,151
Knee revision arthroplasty single component	CPT	27486	2	—	—	$2,118	$12,597	7.5×	$23,491
Knee revision arthroplasty all components	CPT	27487	2	—	—	$2,118	$12,597	6.3×	$23,491
Shoulder arthroscopy with decompression	CPT	29826	1	—	—	$1,468.5	$1,535	4.7×	$3,099
Shoulder arthroscopy with rotator cuff repair	CPT	29827	1	—	—	$2,187	$2,285.5	0.69×	$4,888
Knee arthroscopy with meniscectomy	CPT	29881	1	—	—	$1,889.5	$1,974	0.96×	$3,580
ACL reconstruction	CPT	29888	1	—	—	$1,468.5	$1,535	0.46×	$3,099
Major small/large bowel procedures w MCC	MS-DRG	329	9	—	—	$8,394.5	$18,201	0.42×	$71,071
Major small/large bowel procedures w CC	MS-DRG	330	9	—	—	$8,394.5	$15,974	0.69×	$38,232
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	9	—	—	$6,208.01	$15,974	0.97×	$25,058
CABG single arterial graft	CPT	33533	1	—	—	$2,118	$2,215	1.2×	$5,600
CABG 2 arterial grafts	CPT	33534	1	—	—	$2,118	$2,215	1.0×	$5,600
CABG 3 arterial grafts	CPT	33535	1	—	—	$2,118	$2,215	0.97×	$5,600
CABG 4+ arterial grafts	CPT	33536	1	—	—	$2,118	$2,215	0.91×	$5,600
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	9	—	—	$6,172.45	$15,974	0.97×	$24,736
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	9	—	—	$4,835.12	$14,009	1.0×	$20,547
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	9	—	—	$8,394.5	$15,974	0.49×	$51,492
Open appendectomy	CPT	44950	1	—	—	$2,118	$2,215	1.9×	$5,600
Laparoscopic appendectomy	CPT	44970	1	—	—	$1,889.5	$1,974	1.3×	$3,580
Major joint replacement w MCC	MS-DRG	469	9	—	—	$8,394.5	$15,974	0.54×	$61,400
Major joint replacement w/o MCC	MS-DRG	470	9	—	—	$7,610.17	$15,974	0.84×	$51,663
Laparoscopic cholecystectomy	CPT	47562	1	—	—	$3,006	$3,142	1.8×	$5,086
Lap cholecystectomy with cholangiography	CPT	47563	1	—	—	$3,006	$3,142	1.7×	$5,086
Hip & femur procedures except major joint w MCC	MS-DRG	480	9	—	—	$8,394.5	$15,974	0.57×	$44,318
Hip & femur procedures except major joint w CC	MS-DRG	481	9	—	—	$7,594.61	$15,974	0.79×	$32,228
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	9	—	—	$6,183.56	$15,974	1.0×	$35,723
Open umbilical hernia repair	CPT	49560	1	—	—	$2,118	$2,215	1.2×	$5,600
Umbilical hernia repair age 5+	CPT	49585	1	—	—	$2,118	$2,215	1.7×	$5,600
Lap inguinal hernia repair	CPT	49650	1	—	—	$1,889.5	$1,974	1.8×	$3,580
Lap incisional hernia repair	CPT	49652	1	—	—	$2,118	$2,215	0.82×	$5,600
Total abdominal hysterectomy	CPT	58150	2	—	—	$2,118	$2,225.5	2.3×	$5,600
Vaginal hysterectomy	CPT	58260	2	—	—	$3,006	$3,160	1.7×	$5,086
Lap-assisted vaginal hysterectomy	CPT	58550	1	—	—	$3,006	$3,142	2.1×	$5,086
Lap-assisted vaginal hysterectomy >250g	CPT	58552	1	—	—	$2,187	$2,285.5	1.0×	$4,888
Lap salpingo-oophorectomy	CPT	58661	1	—	—	$2,187	$2,285.5	1.1×	$4,888
OR procedure for obesity w MCC	MS-DRG	619	9	—	—	$8,394.5	$15,974	0.59×	$53,377
OR procedure for obesity w CC	MS-DRG	620	9	—	—	$6,799.25	$15,974	0.99×	$42,515
OR procedure for obesity w/o CC/MCC	MS-DRG	621	9	—	—	$5,862.75	$15,974	1.1×	$42,515
Complex cataract surgery	CPT	66982	1	—	—	$2,789.5	$2,915.5	1.3×	$3,339
Cataract surgery with lens implant	CPT	66984	1	—	—	$2,789.5	$2,915.5	1.3×	$3,339
Intravitreal injection	CPT	67028	1	—	—	$954.5	$998.5	2.9×	$1,467
Vitrectomy mechanical	CPT	67042	1	—	—	$3,006	$3,142	1.2×	$5,086
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	9	—	—	$3,980.49	$12,124	0.99×	$20,300
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	9	—	—	$6,295.44	$15,584	0.81×	$26,966
PCI single major coronary artery	CPT	92920	4	—	—	$5,646	$14,281	2.5×	$16,976
PCI with drug-eluting stent	CPT	92928	4	—	—	$5,646	$14,281	1.4×	$16,976
PCI bypass graft	CPT	92937	4	—	—	$5,646	$14,281	1.3×	$16,976
Left heart catheterization	CPT	93452	3	—	—	$5,646	$9,492	3.1×	$11,857
Coronary angiography with cath	CPT	93455	2	—	—	$7,684	$10,362	3.3×	$11,857
Coronary angiography with bypass cath	CPT	93458	3	—	—	$5,646	$9,492	3.0×	$11,857

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 10)

Payer	Codes covered	Median rate
Cigna	170	$2,789.5
Aetna	150	$551.54
Blue Cross Blue Shield	134	$336.38
UnitedHealthcare	129	$4,291
community plan	58	$2,793
health 2 business	40	$17,332
Oscar Health	40	$8,394.5
smart health	40	$10,900
amerigroup mcaid replacement	40	$5,199.22
amerigroup mcr replacement	6	$326

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