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 |
|---|---|---|---|---|
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | $5,159.82 | $8,599.70 | $122.10 – $1,059.40 | 42 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | $5,961.60 | $9,936.00 | $122.54 – $1,059.40 | 42 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | $4,028.25 | $6,713.75 | $201.97 – $418.93 | 36 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | $41,940.84 | $69,901.40 | $1,782.38 – $8,602.88 | 41 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $542.40 | $904.00 | $43.49 – $433.67 | 42 |
| Pelvic CT scan (with contrast) CPT 72193 | $542.40 | $904.00 | $41.27 – $650.00 | 43 |
| Pelvic CT scan (without contrast) CPT 72192 | $542.40 | $904.00 | $30.12 – $650.00 | 43 |
| Pelvic exenteration CPT 45126 | not published | not published | $646.87 – $2,605.30 | 20 |
| Pelvic MRI (with and without contrast) CPT 72197 | $582.60 | $971.00 | $79.35 – $818.70 | 43 |
| Pelvic MRI (with contrast) CPT 72196 | $582.60 | $971.00 | $62.07 – $681.50 | 42 |
| Pelvic MRI (without contrast) CPT 72195 | $582.60 | $971.00 | $52.62 – $700.00 | 43 |
| Pelvic Ultrasound (complete) CPT 76856 | $343.20 | $572.00 | $20.59 – $400.00 | 43 |
| Pelvic Ultrasound (limited) CPT 76857 | $295.20 | $492.00 | $9.01 – $70.15 | 42 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | $85.04 | $141.73 | $44.62 – $131.00 | 41 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | $16.16 | $26.93 | $1.05 – $9.41 | 37 |
| Peng benzathine/procaine inj HCPCS J0558 | $338.23 | $563.72 | $2.75 – $43.92 | 41 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $48.74 | $81.23 | $16.14 – $54.83 | 35 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | $260.60 | $434.34 | $0.43 – $2.64 | 22 |
| Penicillin g procaine inj HCPCS J2510 | $107.18 | $178.64 | $23.50 – $103.39 | 41 |
| Penile injection CPT 54235 | not published | not published | $16.20 – $70.83 | 39 |
| Penile vascular study CPT 93980 | not published | not published | $20.22 – $282.55 | 21 |
| Penile vascular study CPT 93981 | not published | not published | $12.09 – $260.45 | 21 |
| Penile venous occlusion CPT 37790 | not published | not published | $123.89 – $1,592.02 | 39 |
| Penis plastic surgery CPT 54360 | not published | not published | $163.76 – $1,592.02 | 39 |
| Penis study CPT 54240 | not published | not published | $22.00 – $57.37 | 40 |
| Pentamidine non-comp unit HCPCS J2545 | $279.76 | $466.27 | $52.22 – $440.02 | 23 |
| Pentazocine injection HCPCS J3070 | $44.17 | $73.62 | $0.02 – $0.02 | 9 |
| Pentobarbital sodium inj HCPCS J2515 | $4,918.36 | $8,197.27 | $18.83 – $118.87 | 22 |
| Perc cryo ablate renal tum CPT 50593 | $11,829.60 | $19,716.00 | $104.32 – $6,293.17 | 41 |
| Perc d-e cor revasc chro add HCPCS C9608 | $34,522.80 | $57,538.00 | $20,827.85 – $22,370.66 | 7 |
| Perc d-e cor revasc chro sin HCPCS C9607 | $47,221.80 | $78,703.00 | $20,827.85 – $22,370.66 | 7 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | $34,522.80 | $57,538.00 | $20,827.85 – $22,370.66 | 7 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | $47,221.80 | $78,703.00 | $20,827.85 – $22,370.66 | 7 |
| Perc d-e cor stent ather br HCPCS C9603 | $34,522.80 | $57,538.00 | $20,827.85 – $22,370.66 | 7 |
| Perc d-e cor stent ather s HCPCS C9602 | $33,244.20 | $55,407.00 | $20,827.85 – $22,370.66 | 7 |
| Perc drug-el cor stent sing HCPCS C9600 | $16,846.20 | $28,077.00 | $6,561.53 – $22,370.66 | 27 |
| Perc rf ablate renal tumor CPT 50592 | $6,178.80 | $10,298.00 | $78.64 – $4,631.00 | 41 |
| Percut ablate liver rf CPT 47382 | $6,178.80 | $10,298.00 | $201.36 – $4,631.00 | 41 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $83.70 | $139.50 | $42.16 – $112.97 | 22 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $55.75 – $209.79 | 14 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $361.32 – $1,936.00 | 20 |
| Pericardiocentesis wwo imaging CPT 33016 | $3,999.60 | $6,666.00 | $57.87 – $4,631.00 | 41 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $214.72 – $1,256.00 | 20 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $122.58 – $1,438.67 | 39 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $51.34 – $1,553.00 | 39 |
| Peripheral vascular rehab CPT 93668 | not published | not published | $0.40 – $12.66 | 20 |
| Peri-proc device eval icd CPT 93287 | not published | not published | $6.05 – $18.55 | 20 |
| Peri-proc device eval pm CPT 93286 | not published | not published | $4.55 – $16.43 | 20 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $101.90 – $2,842.25 | 39 |
| Peritoneogram rs&i CPT 74190 | $396.00 | $660.00 | $9.50 – $178.54 | 23 |
| Perit-vens shunt pat tst CPT 78291 | $1,295.40 | $2,159.00 | $26.93 – $426.71 | 42 |
| Perphenazine 4mg oral HCPCS Q0175 | $2.47 | $4.11 | $0.55 – $2.98 | 22 |
| Perq art m-thrombect &/nfs CPT 61645 | $20,594.40 | $34,324.00 | $197.74 – $4,631.00 | 22 |
| Perq clsr tcat l atr apndge CPT 33340 | $17,868.00 | $29,780.00 | $195.61 – $4,631.00 | 22 |
| Perq dev breast 1st mr guide CPT 19287 | $4,117.20 | $6,862.00 | $20.91 – $4,391.68 | 22 |
| Perq dev breast 1st strtctc CPT 19283 | $2,305.80 | $3,843.00 | $16.42 – $2,459.52 | 22 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $274.56 – $4,450.23 | 39 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | not published | not published | $186.92 – $4,450.23 | 39 |
| Perq p-art revsc 1 abnor bi CPT 33903 | not published | not published | $792.22 – $8,000.18 | 31 |
| Perq p-art revsc 1 abnor uni CPT 33902 | not published | not published | $672.14 – $11,477.74 | 31 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | not published | not published | $695.93 – $6,960.20 | 31 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | not published | not published | $529.42 – $6,408.37 | 31 |
| Perq p-art revsc each addl CPT 33904 | not published | not published | $265.77 – $265.77 | 11 |
| Perq plmt bile duct stent CPT 47538 | $10,713.00 | $17,855.00 | $94.29 – $4,631.00 | 41 |
| Perq plmt bile duct stent CPT 47539 | $8,719.80 | $14,533.00 | $127.58 – $4,631.00 | 41 |
| Perq plmt bile duct stent CPT 47540 | $16,161.60 | $26,936.00 | $152.29 – $4,631.00 | 41 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $1,018.20 | $1,697.00 | $23.36 – $1,416.85 | 40 |
| Perq skel fix rad/uln dislc CPT 25671 | not published | not published | $102.93 – $1,487.08 | 39 |
| Perq skel fix ulnar styld fx CPT 25651 | not published | not published | $94.17 – $1,487.08 | 39 |
| Perqt bx lung/mediastinum 32405 CPT 32405 | not published | not published | $201.13 – $305.80 | 17 |
| Perq transcath closure each CPT 93592 | not published | not published | $90.71 – $413.64 | 14 |
| Perq transcath closure pda CPT 93582 | $38,928.00 | $64,880.00 | $139.29 – $603.90 | 20 |
| Perq transcath cls aortic CPT 93591 | not published | not published | $205.87 – $939.04 | 14 |
| Perq transcath cls mitral CPT 93590 | not published | not published | $248.07 – $1,131.53 | 14 |
| Perq transcath septal reduxn CPT 93583 | $16,958.40 | $28,264.00 | $157.24 – $672.13 | 20 |
| Perq trluml angp nt/recr coa CPT 33897 | $16,521.00 | $27,535.00 | $134.62 – $4,631.00 | 19 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | not published | not published | $45.82 – $1,487.08 | 39 |
| Perq tx malar fracture CPT 21355 | not published | not published | $63.42 – $1,638.27 | 39 |
| Perq tx mndblr fx xtrnl fixj CPT 21452 | not published | not published | $69.07 – $3,438.65 | 39 |
| Perq tx nasoethmoid fx CPT 21340 | not published | not published | $149.52 – $1,291.25 | 39 |
| Pertussis ag if CPT 87265 | $247.80 | $413.00 | $5.67 – $27.31 | 25 |
| Pertuzumab 30 mg/ml desensitization HCPCS J9306 | $10,118.19 | $16,863.65 | $14.49 – $37.24 | 42 |
| Pet CT skull-mid thgh initial CPT 78815 | $5,895.00 | $9,825.00 | $86.66 – $2,255.47 | 42 |
| Pet CT whole body initial CPT 78816 | $6,190.20 | $10,317.00 | $87.50 – $2,255.47 | 42 |
| Pet fdg brain metoblic eval sb CPT 78608 | $3,504.60 | $5,841.00 | $52.15 – $2,255.47 | 42 |
| Pet image full body CPT 78813 | not published | not published | $71.43 – $2,255.47 | 42 |
| Pet image ltd area CPT 78811 | not published | not published | $56.08 – $2,255.47 | 42 |
| Pet image skull-thigh CPT 78812 | not published | not published | $68.08 – $2,255.47 | 42 |
| Pet image w/ct lmtd CPT 78814 | $5,659.20 | $9,432.00 | $78.64 – $2,255.47 | 42 |
| Pet scan brain perf study CPT 78609 | not published | not published | $0.01 – $2,255.47 | 23 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | not published | not published | $4.34 – $31.00 | 14 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | not published | not published | $6.52 – $46.00 | 14 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | not published | not published | $2.18 – $16.00 | 14 |
| Phalangectomy ea toe 28150 CPT 28150 | not published | not published | $55.96 – $1,487.08 | 39 |
| Pharmacologic management w/psytx CPT 90863 | not published | not published | $30.10 – $47.85 | 14 |
| Ph body fluid CPT 83986 | $99.00 | $165.00 | $1.69 – $8.16 | 25 |
| Phencyclidine (pcp) CPT 83992 | $186.60 | $311.00 | $7.20 – $80.01 | 25 |
| Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr HCPCS J2560 | $135.50 | $225.83 | $27.07 – $109.58 | 22 |
| Phenobarbital therapeutic drug level CPT 80184 | $265.20 | $442.00 | $5.13 – $34.88 | 25 |
| Phentolaine mesylate inj HCPCS J2760 | $881.36 | $1,468.94 | $428.36 – $1,272.81 | 42 |
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.