ASCENSION SAINT THOMAS HICKMAN

Critical Access Hospitals

135 EAST SWAN STREET

CENTERVILLE, TN, 37033

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(931) 729-4271

Emergency Services: No

Voluntary non-profit - Private

Procedure Prices at ASCENSION SAINT THOMAS HICKMAN

COLLECTION VENOUS BLOOD VENIPUNCTURE

CPT 36415

$2.7

EKG Tracing

CPT 93005

$7.26

BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC

CPT 85025

$7.77

Chest X-Ray (1 view)

CPT 71045

$9.6

COMPREHENSIVE METABOLIC PANEL

CPT 80053

$10.57

Mechanical Traction

CPT 97012

$15.26

EKG

CPT 93000

$15.47

Chest X-Ray (2 views)

CPT 71046

$17.7

Thoracic Spine X-Ray

CPT 72072

$24.31

Therapeutic Exercises

CPT 97110

$30.46

Therapeutic Activities

CPT 97530

$33

Abdominal Ultrasound — Limited

CPT 76705

$71.92

Echocardiogram

CPT 93307

$77.71

Diagnostic Mammogram (unilateral)

CPT 77065

$85.46

Retroperitoneal Ultrasound

CPT 76770

$87.04

OB Ultrasound

CPT 76805

$87.69

Screening Mammogram (bilateral)

CPT 77067

$90.3

Abdominal Ultrasound

CPT 76700

$91.23

Diagnostic Mammogram (bilateral)

CPT 77066

$109.36

CT Chest

CPT 71250

$126.93

Echocardiogram w/ Doppler

CPT 93306

$147.84

MRI Brain w/o Contrast

CPT 70551

$154.6

MRI Joint of Lower Extremity

CPT 73721

$168.11

CT Abdomen & Pelvis

CPT 74177

$210.57

MRI Brain w/ Contrast

CPT 70553

$251.75

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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.