Ascension St. Vincent Mercy (St. Vincent Madison County Health System, Inc.)
1331 S A St St, Elwood, IN · Ascension · · NPI 1477508596
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 |
|---|---|---|---|---|
| Induced abortion d&c CPT 59840 | not published | not published | $38.33 – $1,553.00 | 38 |
| Induced abortion dilat&evac CPT 59841 | not published | not published | $64.71 – $1,553.00 | 38 |
| Infect ag drug suscept pheno predict CPT 87900 | not published | not published | $64.37 – $297.20 | 22 |
| Infect ag eia chlamydia trachomatis CPT 87320 | not published | not published | $5.75 – $34.20 | 24 |
| Infect ag eia influenza a or b ea CPT 87400 | not published | not published | $5.67 – $32.22 | 24 |
| Infect ag genotype na cytomegalovirus CPT 87910 | $388.20 | $647.00 | $127.14 – $586.99 | 22 |
| Infect ag genotype na dna hepatitis b CPT 87912 | not published | not published | $127.14 – $586.99 | 22 |
| Infect ag genotype na hiv-1 other region CPT 87906 | not published | not published | $63.57 – $293.50 | 22 |
| Infect ag genotype na hiv-1 revr trn/prt CPT 87901 | $1,171.20 | $1,952.00 | $126.40 – $586.99 | 24 |
| Infect ag ia direct hiv-1 antgn CPT 87806 | $172.80 | $288.00 | $13.11 – $74.72 | 22 |
| Infect ag ia optc obs chlamydia trach CPT 87810 | not published | not published | $5.67 – $80.46 | 24 |
| Infect ag ia optc obs influenza CPT 87804 | $210.60 | $351.00 | $15.83 – $37.73 | 22 |
| Infect ag if ea plyvlnt antsrm CPT 87300 | $36.00 | $60.00 | $2.98 – $27.31 | 22 |
| Infect ag if hep delta agent CPT 87380 | not published | not published | $7.77 – $41.86 | 24 |
| Infect ag if influenza a CPT 87276 | not published | not published | $5.67 – $36.64 | 24 |
| Infect ag if influenza b CPT 87275 | not published | not published | $5.67 – $27.93 | 22 |
| Infect ag if legionella pneumophila CPT 87278 | $259.80 | $433.00 | $5.75 – $35.57 | 24 |
| Infect ag if nos ea CPT 87299 | not published | not published | $5.67 – $36.71 | 24 |
| Infect ag if pneumocystis carinii CPT 87281 | not published | not published | $5.92 – $27.31 | 22 |
| Infect ag if varicella zoster CPT 87290 | not published | not published | $5.67 – $30.60 | 24 |
| Infect ag na chlamydia trachomatis qnt CPT 87492 | not published | not published | $13.95 – $121.91 | 22 |
| Infect ag na hep b amp CPT 87516 | $447.00 | $745.00 | $17.13 – $80.01 | 24 |
| Infect ag na herpes simplex quant CPT 87530 | not published | not published | $17.13 – $97.68 | 24 |
| Infect ag na hpv high-risk types CPT 87624 | not published | not published | $19.10 – $80.01 | 22 |
| Infect ag na influenza r/amp 1st 2 types CPT 87502 | $364.80 | $608.00 | $47.90 – $218.42 | 22 |
| Infect ag na influenza revr/amp ea type CPT 87501 | $153.60 | $256.00 | $25.34 – $116.99 | 22 |
| Infect ag na orthopoxvirus amp prb each CPT 87593 | not published | not published | not published | 0 |
| Infect ag na resp virus 12-25 targets CPT 87633 | $1,505.40 | $2,509.00 | $229.16 – $950.26 | 22 |
| Infect ag phenotype na hiv-1 1-10 drugs CPT 87903 | not published | not published | $241.31 – $1,114.14 | 22 |
| Infect ag phenotype na hiv-1 ea addl drg CPT 87904 | not published | not published | $12.87 – $59.44 | 22 |
| Infectious agent antigen immunoassay direct optical observation sars-cov-2 CPT 87811 | not published | not published | $16.55 – $94.35 | 21 |
| Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin CPT 87324 | $282.00 | $470.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans CPT 87327 | not published | not published | $5.92 – $30.60 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step cryptosporidium CPT 87328 | $151.20 | $252.00 | $5.67 – $31.51 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step giardia CPT 87329 | $139.80 | $233.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool CPT 87338 | $218.40 | $364.00 | $6.49 – $32.79 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn CPT 87340 | $195.00 | $325.00 | $4.40 – $23.55 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization CPT 87341 | $129.60 | $216.00 | $5.10 – $23.55 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies CPT 87389 | $198.60 | $331.00 | $8.62 – $54.90 | 22 |
| Infectious agent antigen immunoassay ql/sq multi step legionella urine CPT 87449 | $247.80 | $413.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step rotavirus CPT 87425 | $279.00 | $465.00 | $5.67 – $27.31 | 24 |
| Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin CPT 87427 | $108.00 | $180.00 | $5.67 – $27.31 | 24 |
| Infectious agent nucleic acid amplified probe CPT 87798 | $444.00 | $740.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe chlamydia trachomatis CPT 87491 | $247.80 | $413.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s) CPT 87493 | $200.40 | $334.00 | $17.33 – $84.98 | 22 |
| Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets CPT 87483 | not published | not published | $205.82 – $950.26 | 22 |
| Infectious agent nucleic acid amplified probe hsv-1 CPT 87529 | $383.40 | $639.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus CPT 87641 | $273.60 | $456.00 | $17.33 – $80.01 | 22 |
| Infectious agent nucleic acid amplified probe mycobacteria tuberculosis CPT 87556 | $457.20 | $762.00 | $17.13 – $95.03 | 24 |
| Infectious agent nucleic acid amplified probe neisseria gonorrhoeae CPT 87591 | $249.00 | $415.00 | $16.60 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe sars-cov-2/covid-19 CPT 87635 | $415.20 | $692.00 | $20.52 – $116.99 | 25 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b CPT 87636 | $127.20 | $212.00 | $57.05 – $325.20 | 21 |
| Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv CPT 87637 | not published | not published | $57.05 – $325.20 | 21 |
| Infectious agent nucleic acid amplified probe streptococcus group a CPT 87651 | not published | not published | $17.13 – $80.01 | 24 |
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $175.80 | $293.00 | $19.15 – $80.01 | 22 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $1,060.80 | $1,768.00 | $205.82 – $950.26 | 22 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | not published | not published | $63.35 – $292.50 | 22 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $105.40 – $599.62 | 22 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $604.80 | $1,008.00 | $20.26 – $97.68 | 24 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $841.20 | $1,402.00 | $17.13 – $97.68 | 24 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $938.40 | $1,564.00 | $20.26 – $97.68 | 24 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $991.80 | $1,653.00 | $40.25 – $194.03 | 24 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | not published | not published | $70.54 – $325.20 | 22 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | $23.58 | $39.30 | $32.16 – $37.59 | 30 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | $20.66 | $34.44 | $14.29 – $30.65 | 31 |
| Influenza dna amp prob addl CPT 87503 | $79.20 | $132.00 | $11.69 – $66.62 | 22 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $39.39 – $187.85 | 21 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $24.69 – $64.96 | 14 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $641.40 – $3,720.60 | 19 |
| Infuse radioactive materials CPT 77750 | not published | not published | $19.40 – $254.01 | 41 |
| Ingest challenge ea addl 60 min CPT 95079 | not published | not published | $12.36 – $69.61 | 19 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $13.45 – $81.46 | 19 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $14.02 – $56.08 | 19 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $101.47 – $442.71 | 19 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $19.76 – $121.58 | 19 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | $25.34 – $155.83 | 19 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $14.17 – $84.06 | 19 |
| Initiation & management bipap/cpap initial day CPT 94660 | $891.60 | $1,486.00 | $7.51 – $43.68 | 19 |
| Inj., benralizumab, 1 mg HCPCS J0517 | $8,674.10 | $14,456.83 | $169.50 – $496.92 | 41 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $104.18 | $173.63 | $1.04 – $2.21 | 12 |
| Inj cntr knee arthro incl ct/mri CPT 27369 | $474.00 | $790.00 | $12.59 – $776.94 | 20 |
| Inj disk cerv-thor ea lev CPT 62291 | not published | not published | $34.91 – $223.93 | 19 |
| Inj dupuytren cord w/enzyme CPT 20527 | not published | not published | $18.57 – $62.34 | 38 |
| Inj dx for sinogram CPT 20501 | not published | not published | $10.53 – $80.52 | 19 |
| Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides) CPT 64454 | not published | not published | $20.76 – $592.10 | 39 |
| Injection arthrography hip without anesthesia (both sides) CPT 27093 | $781.80 | $1,303.00 | $18.82 – $833.92 | 21 |
| Injection carpal tunnel therapeutic (both sides) CPT 20526 | not published | not published | $15.09 – $54.61 | 38 |
| Injection during cath supravalvular aortography CPT 93567 | not published | not published | $16.27 – $96.73 | 19 |
| Injection epidural blood patch or clot CPT 62273 | $1,894.80 | $3,158.00 | $23.67 – $1,416.85 | 39 |
| Injection eye drug CPT 67028 | not published | not published | $39.75 – $143.69 | 38 |
| Injection for arthrography wrist (both sides) CPT 25246 | $609.00 | $1,015.00 | $20.27 – $954.45 | 21 |
| Injection for bladder x-ray CPT 51600 | $775.80 | $1,293.00 | $10.09 – $1,285.51 | 20 |
| Injection for hip x-ray CPT 27095 | not published | not published | $21.25 – $209.70 | 20 |
| Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides) CPT 23350 | $766.20 | $1,277.00 | $13.88 – $954.45 | 21 |
| Injection for spleen x-ray CPT 38200 | not published | not published | $39.98 – $192.30 | 19 |
| Injection for tear sac x-ray CPT 68850 | not published | not published | $14.66 – $76.37 | 19 |
| Injection for ureter x-ray CPT 50684 | not published | not published | $11.00 – $75.58 | 19 |
| Injection for ureter x-ray CPT 50690 | not published | not published | $15.85 – $115.14 | 19 |
| Injection, fulvestrant HCPCS J9395 | $1,660.11 | $2,766.85 | $8.45 – $255.08 | 43 |
| Injection into brain canal CPT 61026 | not published | not published | $26.94 – $351.21 | 38 |
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.