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 |
|---|---|---|---|---|
| Leukacyte transfusion CPT 86950 | not published | not published | $18.52 – $249.33 | 24 |
| Leukocyte phagocytosis CPT 86344 | $198.60 | $331.00 | $4.10 – $23.69 | 24 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $9,502.54 | $15,837.56 | $163.21 – $1,375.38 | 43 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $2,530.56 | $4,217.60 | $641.42 – $3,797.11 | 40 |
| Levalbuterol non-comp unit HCPCS J7614 | $20.15 | $33.58 | $0.06 – $1.02 | 18 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $63.61 | $106.02 | $0.03 – $0.29 | 21 |
| Levetiracetam therapeutic drug level CPT 80177 | $294.60 | $491.00 | $6.54 – $30.21 | 22 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $64.88 | $108.13 | $0.40 – $7.13 | 20 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $420.60 | $701.00 | $21.12 – $23.76 | 9 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $260.39 – $633.00 | 11 |
| Lidocaine therapeutic drug level CPT 80176 | $227.40 | $379.00 | $6.61 – $33.49 | 24 |
| Ligate leg veins open CPT 37761 | not published | not published | $161.97 – $1,515.56 | 38 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $160.73 – $1,515.56 | 38 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $18.32 – $107.69 | 19 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $122.86 – $1,515.56 | 38 |
| Ligate/strip short leg vein CPT 37718 | not published | not published | $104.35 – $1,515.56 | 38 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $83.61 – $1,553.00 | 38 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $49.75 – $668.59 | 38 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $64.81 – $1,515.56 | 38 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $184.59 – $504.07 | 19 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $210.93 – $565.85 | 19 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $176.57 – $515.42 | 19 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $95.49 – $461.50 | 19 |
| Ligation major artery neck CPT 37615 | not published | not published | $118.34 – $528.10 | 19 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $130.56 – $1,515.56 | 38 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $332.71 – $1,206.30 | 19 |
| Ligation of femoral vein CPT 37650 | not published | not published | $131.10 – $1,515.56 | 38 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $496.19 – $2,245.90 | 19 |
| Ligation of neck artery CPT 37606 | not published | not published | $138.21 – $600.30 | 19 |
| Ligation of salivary duct CPT 42665 | not published | not published | $47.58 – $1,291.25 | 38 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $187.16 – $1,515.56 | 38 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $66.55 – $1,515.56 | 38 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $97.40 – $1,515.56 | 38 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $164.04 – $1,515.56 | 38 |
| Limb exercise test CPT 95875 | not published | not published | $19.66 – $41.72 | 20 |
| Limited visual field xm CPT 92081 | not published | not published | $6.13 – $18.20 | 19 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $130.49 | $217.48 | $3.30 – $21.21 | 21 |
| Lipase CPT 83690 | $171.00 | $285.00 | $3.26 – $15.71 | 24 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $81.24 – $1,291.25 | 38 |
| Lipoprotein blood high res frac & quant CPT 83701 | $132.00 | $220.00 | $12.45 – $77.20 | 24 |
| Lipoprotein blood quant CPT 83704 | $303.60 | $506.00 | $15.58 – $77.95 | 22 |
| Lipoprotein direct measurement hdl CPT 83718 | $185.40 | $309.00 | $3.87 – $18.67 | 24 |
| Lipoprotein direct measurement ldl CPT 83721 | $160.80 | $268.00 | $3.97 – $23.94 | 24 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $14.02 – $77.95 | 22 |
| Lip surgery procedure CPT 40799 | not published | not published | $0.01 – $87.15 | 17 |
| Listeria monocytogenes CPT 86723 | not published | not published | $5.29 – $30.07 | 24 |
| Lithium therapeutic drug level CPT 80178 | $177.60 | $296.00 | $3.13 – $15.07 | 24 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | not published | not published | $133.22 – $133.22 | 8 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $265.13 – $840.00 | 19 |
| Liver elastography 91200 CPT 91200 | not published | not published | $7.73 – $495.69 | 20 |
| Liver Function Test CPT 80076 | $270.00 | $450.00 | $2.99 – $18.63 | 24 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $314.26 – $998.37 | 19 |
| Liver imaging CPT 78201 | not published | not published | $15.23 – $338.34 | 41 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $17.05 – $366.36 | 41 |
| Liver/spleen imag static only CPT 78215 | $1,792.20 | $2,987.00 | $17.33 – $348.41 | 41 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $18.55 – $249.61 | 41 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $8.36 – $51.12 | 19 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $123.51 – $1,487.08 | 38 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $41.24 | $68.74 | $0.69 – $3.29 | 22 |
| Loudness balance test CPT 92562 | not published | not published | $3.99 – $30.91 | 19 |
| Low back disk surgery CPT 63030 | not published | not published | $196.26 – $3,321.81 | 38 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,417.40 | $4,029.00 | $45.27 – $448.02 | 41 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,014.80 | $3,358.00 | $43.10 – $650.00 | 42 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,611.60 | $2,686.00 | $35.75 – $650.00 | 42 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,687.40 | $4,479.00 | $82.27 – $700.00 | 42 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,239.80 | $3,733.00 | $64.01 – $485.37 | 41 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,791.60 | $2,986.00 | $53.39 – $700.00 | 42 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $245.40 | $409.00 | $4.83 – $250.00 | 23 |
| Lower jaw bone graft CPT 21215 | not published | not published | $217.88 – $3,692.26 | 38 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $17.02 – $700.25 | 19 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $193.98 – $4,445.47 | 38 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $218.48 – $4,445.47 | 38 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $214.87 – $4,445.47 | 38 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $236.36 – $4,445.47 | 38 |
| L/s ratio fetal lung CPT 83661 | $234.00 | $390.00 | $3.97 – $50.14 | 24 |
| Lumbar diskogram s&i CPT 72295 | $2,056.20 | $3,427.00 | $28.23 – $1,298.32 | 22 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $404.06 – $13,239.40 | 38 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $3.99 – $12.50 | 19 |
| Lung Function Test (Spirometry) CPT 94010 | $457.80 | $763.00 | $6.03 – $20.10 | 19 |
| Lung perfusion imaging CPT 78580 | $1,340.40 | $2,234.00 | $24.71 – $415.22 | 41 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $355.87 – $1,901.30 | 13 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $298.13 | $496.88 | $189.26 – $458.10 | 38 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $237.20 | $395.34 | $38.35 – $91.40 | 40 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $9.69 – $51.33 | 13 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $188.90 – $851.20 | 19 |
| Lymphatics/lymph node imaging CPT 78195 | $1,969.20 | $3,282.00 | $37.21 – $609.90 | 41 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $18.06 – $83.36 | 24 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $18.52 – $111.79 | 24 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $19.84 – $432.08 | 24 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $30.81 – $390.80 | 22 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $34.08 – $722.38 | 41 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $29.44 – $1,806.01 | 41 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $37.36 – $439.41 | 22 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $31.07 – $279.43 | 38 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $31.77 – $1,553.00 | 38 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $43.15 – $910.38 | 38 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $2.59 – $17.44 | 22 |
| Macroscopic exam arthropod CPT 87168 | $91.80 | $153.00 | $2.11 – $9.74 | 22 |
| Macroscopic exam parasite CPT 87169 | $104.40 | $174.00 | $2.02 – $9.83 | 22 |
| Magnesium CPT 83735 | $132.00 | $220.00 | $2.73 – $15.28 | 24 |
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.