▸ Hospital · · CCN 443435

Ascension Saint Thomas Hickman

Compliance grade

92/100

Procedures tracked

196

of 209 target codes

Payers

with negotiated rates

Rates published

13,206

last crawl 2026-05-24

▸ Compare with other hospitals JSON Full cost report on HCRIS.io →

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

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

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