Ascension St. Vincent Carmel Ambulatory Surgery Center
13421 Old Meridian St., Carmel, IN · Ascension · · NPI 1497782833
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $199.72 | $332.86 | $0.60 – $1.32 | 22 |
| Adenovirus ag ia CPT 87301 | $140.40 | $234.00 | $5.75 – $27.31 | 25 |
| Adenovirus antibody,serum - quest CPT 86603 | $140.40 | $234.00 | $3.97 – $29.34 | 25 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $5.87 – $49.61 | 23 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $173.78 – $1,117.99 | 20 |
| Adh-sendout CPT 84588 | $283.20 | $472.00 | $11.90 – $77.38 | 25 |
| Adj gastric band via subq port CPT 43999 | $1,845.00 | $3,075.00 | $0.01 – $1,416.85 | 18 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $87.40 – $3,321.81 | 39 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $122.48 – $926.15 | 39 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $639.08 | $1,065.14 | $0.50 – $2.14 | 22 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $304.20 | $507.00 | $4.08 – $117.82 | 21 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $607.80 | $1,013.00 | $8.90 – $158.73 | 21 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $1,210.20 | $2,017.00 | $19.20 – $324.60 | 21 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $543.00 | $905.00 | $14.43 – $191.33 | 21 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $497.40 | $829.00 | $4.64 – $58.26 | 21 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $497.40 | $829.00 | $7.90 – $129.80 | 21 |
| Administration immunization 1 vaccine CPT 90471 | $99.00 | $165.00 | $3.46 – $15.87 | 20 |
| Administration immunization each additional component CPT 90461 | not published | not published | $1.73 – $12.51 | 14 |
| Administration immunization each additional vaccine CPT 90472 | $116.40 | $194.00 | $1.73 – $12.51 | 20 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $3.46 – $25.42 | 14 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $48.00 | $80.00 | $1.78 – $25.42 | 20 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | not published | not published | $1.54 – $12.51 | 20 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | not published | not published | $24.11 – $24.11 | 11 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | not published | not published | $24.11 – $24.11 | 11 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $59.76 | $99.60 | $36.62 – $93.26 | 42 |
| Adrenal cortex & medulla img CPT 78075 | $3,192.60 | $5,321.00 | $25.21 – $859.35 | 42 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $229.28 – $1,604.00 | 20 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $108.00 | $180.00 | $11.97 – $69.52 | 14 |
| Aep hearing status deter i&r CPT 92651 | $795.60 | $1,326.00 | $15.62 – $85.01 | 14 |
| Aep neurodiagnostic i&r CPT 92653 | $979.20 | $1,632.00 | $15.20 – $81.73 | 14 |
| Aep thrshld est mlt freq i&r CPT 92652 | $1,224.00 | $2,040.00 | $20.69 – $111.58 | 14 |
| _afb id by dna probe rflx ast CPT 87149 | $216.00 | $360.00 | $9.85 – $45.71 | 23 |
| #afb mycobacteria suscep. #1 CPT 87190 | $107.40 | $179.00 | $1.32 – $16.67 | 25 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | not published | not published | $11.71 – $263.02 | 23 |
| Aflibercept injection HCPCS J0178 | $3,893.02 | $6,488.36 | $862.28 – $2,816.63 | 42 |
| After cataract laser surgery CPT 66821 | not published | not published | $58.06 – $295.20 | 39 |
| Agalsidase beta 35 mg intravenous solution HCPCS J0180 | $335.46 | $559.10 | $200.65 – $528.00 | 42 |
| Air conduction bilat CPT 92552 | $169.80 | $283.00 | $4.06 – $20.58 | 20 |
| Air injection into abdomen 49400 CPT 49400 | $1,413.60 | $2,356.00 | $23.96 – $1,416.85 | 21 |
| Airway resistance by impulse oscillometry 94728 CPT 94728 | not published | not published | $6.66 – $30.56 | 20 |
| Albumin body fluid quantitative each specimen CPT 82042 | $105.60 | $176.00 | $2.65 – $17.74 | 25 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $481.30 | $802.16 | $45.83 – $137.03 | 42 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $471.44 | $785.74 | $48.60 – $140.10 | 42 |
| Albumin, human 5 % intravenous solution HCPCS P9041 | $470.97 | $784.95 | $9.78 – $25.18 | 41 |
| Albumin ischemia modified CPT 82045 | not published | not published | $16.76 – $77.38 | 23 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $226.20 | $377.00 | $2.65 – $13.18 | 25 |
| Albumin serum plasma or whole blood CPT 82040 | $87.60 | $146.00 | $2.65 – $11.29 | 25 |
| Albuterol ipratrop non-comp HCPCS J7620 | $9.18 | $15.30 | $0.13 – $0.43 | 22 |
| Albuterol non-comp unit HCPCS J7613 | $9.59 | $15.98 | $0.04 – $0.16 | 19 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | not published | not published | $6.91 – $39.38 | 22 |
| Aldesleukin injection HCPCS J9015 | $6,446.09 | $10,743.48 | $2,110.63 – $5,397.36 | 39 |
| Alemtuzumab 12 mg/1.2 ml intravenous solution HCPCS J0202 | $1,513.25 | $2,522.08 | $2,252.01 – $2,519.84 | 20 |
| Alkaline phosphatase CPT 84075 | $96.00 | $160.00 | $2.45 – $11.81 | 25 |
| Allergen alpha lactalbumin ige CPT 86008 | $61.80 | $103.00 | $8.86 – $40.88 | 16 |
| Allergen egg white ige CPT 86003 | $135.00 | $225.00 | $1.32 – $11.90 | 25 |
| Allergen specific ige qual multi scrn ea CPT 86005 | not published | not published | $2.65 – $18.17 | 25 |
| Allergy injections; 2 or more 95117 CPT 95117 | not published | not published | $2.22 – $19.30 | 20 |
| Allergy injection; single 95115 CPT 95115 | not published | not published | $1.87 – $15.00 | 20 |
| Allergy Skin Testing CPT 95004 | not published | not published | $0.86 – $6.07 | 20 |
| Allg patch or app # of tests 95044 CPT 95044 | not published | not published | $1.08 – $7.90 | 20 |
| Allgrft implnt knee w/scope CPT 29867 | not published | not published | $247.34 – $9,509.56 | 39 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $5,481.00 | $9,135.00 | $37.56 – $108.92 | 7 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $5,796.00 | $9,660.00 | $37.56 – $108.92 | 18 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $2,677.80 | $4,463.00 | $37.56 – $147.81 | 21 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $15,486.60 | $25,811.00 | $14.12 – $108.92 | 18 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $9,560.40 | $15,934.00 | $37.56 – $108.92 | 18 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $4,708.20 | $7,847.00 | $30.73 – $108.92 | 18 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $11,500.80 | $19,168.00 | $37.56 – $273.83 | 21 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $4,304.40 | $7,174.00 | $37.56 – $242.77 | 21 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $5,381.40 | $8,969.00 | $350.00 – $18,069.48 | 14 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $4,744.80 | $7,908.00 | $37.56 – $412.26 | 21 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $2,752.20 | $4,587.00 | $37.56 – $400.23 | 21 |
| All tstg perq&iq drugs/biol CPT 95018 | not published | not published | $1.33 – $13.66 | 20 |
| All tstg perq&iq w/venoms CPT 95017 | not published | not published | $0.69 – $5.59 | 20 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | not published | not published | $31.81 – $146.85 | 23 |
| Alpha-fetoprotein amniotic CPT 82106 | $169.80 | $283.00 | $5.29 – $38.76 | 25 |
| Alpha-fetoprotein tumor marker CPT 82105 | $352.80 | $588.00 | $5.29 – $38.24 | 25 |
| Alprostadil for injection HCPCS J0270 | $228.18 | $380.30 | $0.11 – $23.11 | 22 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $2,680.50 | $4,467.50 | $55.91 – $233.04 | 43 |
| Alt/sgpt CPT 84460 | $105.00 | $175.00 | $2.51 – $12.08 | 25 |
| Altuviiio per factor viii iu HCPCS J7214 | $8.21 | $13.68 | $4.63 – $10.55 | 31 |
| Aluminum - quest CPT 82108 | $177.00 | $295.00 | $9.26 – $58.09 | 25 |
| Alveoloplasty each quadrant CPT 41874 | not published | not published | $58.51 – $264.00 | 39 |
| Alys cplx sp/pn npgt w/prgrm CPT 95972 | $799.20 | $1,332.00 | $7.10 – $415.12 | 21 |
| Amantadine (symmetrel)-sendout CPT 80375 | not published | not published | $8.31 – $51.87 | 16 |
| Ambl bp mntr w/sw a/r CPT 93788 | not published | not published | $0.85 – $22.52 | 20 |
| Amikacin 4 mg/ml intravitreal injection - cnr HCPCS J0278 | $47.58 | $79.30 | $0.75 – $2.54 | 22 |
| Amino acid screen, urine CPT 82128 | $102.00 | $170.00 | $3.97 – $31.62 | 25 |
| Amino acid single qual CPT 82127 | not published | not published | $6.46 – $32.33 | 25 |
| Amino acids quant 2-5 CPT 82136 | not published | not published | $1.70 – $44.71 | 25 |
| Aminolevulinic acid delta CPT 82135 | $122.40 | $204.00 | $7.22 – $37.51 | 25 |
| Aminophylline 25 mg/ml intravenous solution (wrapper) HCPCS J0280 | $41.59 | $69.31 | $5.13 – $24.82 | 16 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $264.58 | $440.97 | $3.84 – $15.76 | 13 |
| Amiodarone 50 mg/ml intravenous solution HCPCS J0282 | $273.46 | $455.77 | $0.23 – $1.13 | 22 |
| Amitriptyline (elavil) -sendout CPT 80335 | not published | not published | $2.02 – $51.87 | 16 |
| Amivantamab-vmjw 50 mg/ml intravenous solution HCPCS J9061 | $16.14 | $26.90 | $19.70 – $24.12 | 36 |
| Ammonia CPT 82140 | $244.80 | $408.00 | $7.20 – $33.22 | 25 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $319.20 | $532.00 | $14.63 – $481.98 | 40 |
| Amniocentesis therapeutic CPT 59001 | $2,382.00 | $3,970.00 | $32.53 – $1,416.85 | 40 |
| Amniotic fluid scan CPT 82143 | $177.60 | $296.00 | $3.18 – $21.32 | 25 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.