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 |
|---|---|---|---|---|
| Tc-99m medronate HCPCS A9503 | $69.00 | $115.00 | $15.71 – $35.53 | 15 |
| Tc-99m mertiatide HCPCS A9562 | $465.60 | $776.00 | $2,723.76 – $2,723.76 | 6 |
| Tc-99m non-heu per study dose HCPCS Q9969 | $6.00 | $10.00 | $0.67 – $0.67 | 11 |
| Tc-99m oxidronate HCPCS A9561 | $63.60 | $106.00 | $53.17 – $105.60 | 3 |
| Tc-99m pentetate dtpa HCPCS A9539 | $222.60 | $371.00 | $0.02 – $68.40 | 14 |
| Tc-99m pertechnetate per mci HCPCS A9512 | $17.40 | $29.00 | $1.93 – $3.84 | 11 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $55.80 | $93.00 | $75.00 – $75.00 | 11 |
| Tc-99m sulfur colloid HCPCS A9541 | $239.40 | $399.00 | $224.00 – $323.09 | 13 |
| Tc-99m tilmanocept diag HCPCS A9520 | $1,254.00 | $2,090.00 | $271.70 – $1,488.53 | 14 |
| Tca peel dermal 15789 CPT 15789 | not published | not published | $70.30 – $462.87 | 32 |
| Tcd emboli detect w/inj CPT 93893 | not published | not published | $42.30 – $391.06 | 20 |
| Tcd emboli detect without inj CPT 93892 | not published | not published | $42.07 – $391.06 | 20 |
| Tcd vasoreactivity study CPT 93890 | not published | not published | $36.32 – $391.06 | 20 |
| T-cell depletion of harvest CPT 38210 | not published | not published | $8.40 – $24.56 | 13 |
| T cells absolute cd4/cd8 including ratio CPT 86360 | $375.60 | $626.00 | $19.84 – $107.11 | 24 |
| T cells absolute cd 4 count CPT 86361 | $345.60 | $576.00 | $13.22 – $61.06 | 24 |
| T cells total count CPT 86359 | $303.60 | $506.00 | $10.58 – $86.02 | 24 |
| Tcranial magn stim tx deli CPT 90868 | not published | not published | $40.61 – $531.65 | 20 |
| Tcranial magn stim tx plan CPT 90867 | not published | not published | $176.26 – $970.44 | 20 |
| Tcran magn stim redetemine CPT 90869 | not published | not published | $118.98 – $531.65 | 20 |
| Tdh sdrl/ventr pnxr CPT 61105 | not published | not published | $89.05 – $516.80 | 19 |
| Teaec w/wo patch graft iliofemoral CPT 35355 | not published | not published | $280.06 – $1,423.90 | 19 |
| Team conf without pat by hc pro CPT 99368 | not published | not published | $41.81 – $42.91 | 13 |
| Team conf without pat by phys CPT 99367 | not published | not published | $64.69 – $66.46 | 13 |
| Team conf w/pat by hc prof CPT 99366 | not published | not published | $49.14 – $50.76 | 13 |
| Telethx isodose plan cplx CPT 77307 | not published | not published | $40.85 – $281.24 | 39 |
| Telethx isodose plan simple CPT 77306 | not published | not published | $20.81 – $153.61 | 39 |
| Temperature gradient studies CPT 93740 | not published | not published | $3.28 – $15.20 | 13 |
| Temple bne implnt w/stimulat CPT 69715 | not published | not published | $246.60 – $1,406.50 | 19 |
| Tendon lengthening CPT 26476 | not published | not published | $148.88 – $1,487.08 | 38 |
| Tendon lngth upr a/e ea tdn CPT 24305 | not published | not published | $145.85 – $1,487.08 | 38 |
| Tendon shortening CPT 26477 | not published | not published | $150.49 – $1,487.08 | 38 |
| Tendon transfer with graft CPT 26492 | not published | not published | $224.10 – $1,487.08 | 38 |
| Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial) HCPCS J3101 | $240.21 | $400.35 | $136.92 – $367.69 | 41 |
| Tenodesis biceps tdn at elbw CPT 24340 | not published | not published | $154.96 – $3,321.81 | 38 |
| Tenolysis extensor tendon hand/finger each CPT 26445 | not published | not published | $153.95 – $1,487.08 | 38 |
| Tenolysis triceps CPT 24332 | not published | not published | $150.73 – $1,487.08 | 38 |
| Tenoplasty elbow to sho 1 CPT 24320 | not published | not published | $194.11 – $3,321.81 | 38 |
| Tenosynovectomy radic 26145 CPT 26145 | not published | not published | $127.43 – $801.87 | 38 |
| Tenotomy hip flexor open CPT 27005 | not published | not published | $184.88 – $795.90 | 19 |
| Tenotomy length/rls abductor hallucis musc 28240 CPT 28240 | not published | not published | $80.64 – $1,487.08 | 38 |
| Tenotomy open tndn flxr toe sgl tndn spx CPT 28232 | $2,228.40 | $3,714.00 | $67.49 – $2,376.96 | 40 |
| Terbutaline 1 mg/ml subcutaneous solution HCPCS J3105 | $39.33 | $65.55 | $2.10 – $12.36 | 20 |
| Tert gene targeted seq alys CPT 81345 | not published | not published | $74.08 – $422.26 | 15 |
| Test for chlorohydrocarbons CPT 82441 | not published | not published | $2.97 – $13.70 | 24 |
| Test for porphobilinogen CPT 84106 | not published | not published | $1.32 – $13.27 | 24 |
| Test for urine cystines CPT 82615 | not published | not published | $3.39 – $21.77 | 24 |
| Testicular imaging w/vasc flow CPT 78761 | not published | not published | $23.77 – $357.74 | 41 |
| Testosterone response panel CPT 80414 | not published | not published | $17.19 – $117.74 | 24 |
| Test stress cardiovascular tracing only CPT 93017 | $1,380.60 | $2,301.00 | $17.55 – $80.90 | 19 |
| Test urine for lactose CPT 83633 | not published | not published | $2.65 – $25.65 | 24 |
| Test urine for porphyrins CPT 84119 | not published | not published | $3.59 – $30.46 | 24 |
| Test urine urobilinogen CPT 84578 | not published | not published | $1.32 – $10.19 | 24 |
| Tetanus ig im CPT 90389 | not published | not published | $131.25 – $1,613.56 | 22 |
| Tetanus immune globulin inj HCPCS J1670 | $1,073.02 | $1,788.37 | $479.39 – $1,613.56 | 40 |
| Tezepelumab-ekko 210 mg/1.91 ml (110 mg/ml) subcutaneous syringe HCPCS J2356 | $6,935.61 | $11,559.35 | $18.16 – $40.75 | 37 |
| Tgfbi gene common variants CPT 81333 | not published | not published | $54.80 – $312.36 | 15 |
| Tgsap hl neo 5-50 rna alys CPT 81451 | not published | not published | $303.81 – $303.81 | 11 |
| Tgsap so/hl 51/< rna alys CPT 81456 | not published | not published | $1,167.84 – $1,167.84 | 11 |
| Tgsap so neo 5-50 rna alys CPT 81449 | not published | not published | $239.16 – $239.16 | 11 |
| Thaw cryoprsvrd reprod tiss CPT 89354 | not published | not published | $150.00 – $322.95 | 12 |
| Thawing cryopresrved embryo CPT 89352 | not published | not published | $150.00 – $322.95 | 12 |
| Thawing cryopresrved oocyte CPT 89356 | not published | not published | $150.00 – $322.95 | 12 |
| Thawing cryopresrved sperm CPT 89353 | not published | not published | $25.00 – $111.75 | 12 |
| Thaw preserved stem cells CPT 38208 | not published | not published | $8.79 – $16.80 | 13 |
| Theophylline therapeutic drug level CPT 80198 | $231.60 | $386.00 | $3.97 – $32.24 | 24 |
| Therapeutic procd strg endur HCPCS G0237 | $145.80 | $243.00 | $2.61 – $18.30 | 15 |
| Therapy activation ipnss CPT 93150 | not published | not published | $39.35 – $39.35 | 8 |
| Therapy nutrition individual initial f2f w/patient each 15 minutes CPT 97802 | not published | not published | $5.60 – $24.86 | 19 |
| Therapy nutrition individual reassessment/intervention f2f w/patient each 15 minutes CPT 97803 | not published | not published | $4.93 – $21.34 | 19 |
| Therapy photodnmc lght dstr lsn skn by staff rx per day CPT 96567 | not published | not published | $21.09 – $114.91 | 19 |
| Ther fx nasal inf turbinate CPT 30930 | not published | not published | $27.22 – $1,291.25 | 38 |
| Ther nma rdctj intus/obstrcj CPT 74283 | not published | not published | $26.24 – $214.54 | 41 |
| Ther/proph/diag inj ia CPT 96373 | not published | not published | $3.68 – $21.54 | 19 |
| Ther radiology tx plng cplx CPT 77263 | not published | not published | $21.52 – $792.67 | 22 |
| Ther radiology tx plng intrm CPT 77262 | not published | not published | $14.47 – $385.83 | 22 |
| Ther radiology tx plng smpl CPT 77261 | not published | not published | $9.57 – $256.07 | 22 |
| Thiamine hcl (vitamin b1) 100 mg/ml injection solution HCPCS J3411 | $41.86 | $69.76 | $2.46 – $6.10 | 21 |
| Thorabd diaphr hern repair CPT 43336 | not published | not published | $434.17 – $1,940.15 | 19 |
| Thorabd diaphr hern repair CPT 43337 | not published | not published | $473.26 – $2,118.59 | 19 |
| Thoracentesis pleural space needle/catheter aspiration with imaging guidance (both sides) CPT 32555 | $2,682.00 | $4,470.00 | $32.53 – $1,195.93 | 40 |
| Thoracic aortic graft 33875 CPT 33875 | not published | not published | $510.32 – $3,065.90 | 19 |
| Thoracic duct procedure CPT 38380 | not published | not published | $152.63 – $669.70 | 19 |
| Thoracic duct procedure CPT 38381 | not published | not published | $228.08 – $1,158.40 | 19 |
| Thoracic duct procedure CPT 38382 | not published | not published | $184.29 – $575.86 | 19 |
| Thoracic lymphadenect/thoracotomy 38746 CPT 38746 | not published | not published | $74.94 – $332.50 | 19 |
| Thoracoabdominal graft 33877 CPT 33877 | not published | not published | $886.69 – $4,015.60 | 19 |
| Thoracoscop w/esoph musc exc CPT 32665 | not published | not published | $287.75 – $1,449.20 | 19 |
| Thoracoscopy bilobectomy 32670 CPT 32670 | not published | not published | $463.88 – $1,879.47 | 19 |
| Thoracoscopy diagnostic 32601 CPT 32601 | not published | not published | $75.87 – $485.90 | 19 |
| Thoracoscopy for lvrs CPT 32672 | not published | not published | $440.29 – $1,783.16 | 19 |
| Thoracoscopy lymph node exc CPT 32674 | not published | not published | $62.75 – $252.80 | 19 |
| Thoracoscopy pneumonectomy CPT 32671 | not published | not published | $515.14 – $2,084.37 | 19 |
| Thoracoscopy remove cortex CPT 32651 | not published | not published | $252.48 – $1,242.90 | 19 |
| Thoracoscopy remove segment CPT 32669 | not published | not published | $388.23 – $1,574.27 | 19 |
| Thoracoscopy remov fb/fibrin 32653 CPT 32653 | not published | not published | $244.79 – $1,219.90 | 19 |
| Thoracoscopy resect bullae 32655 CPT 32655 | not published | not published | $225.14 – $1,292.60 | 19 |
| Thoracoscopy surgical 32650 CPT 32650 | not published | not published | $164.42 – $1,020.10 | 19 |
| Thoracoscopy surgical with control of traumatic hemorrhage CPT 32654 | not published | not published | $269.00 – $1,167.80 | 19 |
| Thoracoscopy/thoracic sympathectomy32664 CPT 32664 | not published | not published | $207.44 – $1,275.70 | 19 |
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.