Parkview LaGrange Hospital
207 N Townline Rd, Lagrange, IN · Parkview · · NPI 1679674956
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 |
|---|---|---|---|---|
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $18,563.00 – $18,563.00 | 1 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $95.83 | $191.66 | $1.38 – $2.32 | 4 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $163.97 – $168.79 | 2 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | $67,584.15 | $135,168.30 | $345.99 – $442.98 | 4 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $37.20 | $74.41 | $2.59 – $4.24 | 4 |
| Low back disk surgery CPT 63030 | not published | not published | $34,475.00 – $34,475.00 | 1 |
| Low cost skin substitute app HCPCS C5271 | not published | not published | $3,818.00 – $3,818.00 | 1 |
| Low cost skin substitute app HCPCS C5273 | not published | not published | $5,941.00 – $5,941.00 | 1 |
| Low cost skin substitute app HCPCS C5275 | not published | not published | $3,818.00 – $3,818.00 | 1 |
| Low cost skin substitute app HCPCS C5277 | not published | not published | $3,818.00 – $3,818.00 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $988.00 | $1,976.00 | $361.32 – $412.57 | 4 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $808.50 | $1,617.00 | $757.16 – $864.55 | 4 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $693.00 | $1,386.00 | $222.24 – $253.76 | 4 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $991.00 | $1,982.00 | $757.16 – $864.55 | 4 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $879.00 | $1,758.00 | $757.16 – $864.55 | 4 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $814.50 | $1,629.00 | $462.09 – $527.63 | 4 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $235.50 | $471.00 | $231.00 – $263.76 | 4 |
| Lower jaw bone graft CPT 21215 | not published | not published | $24,928.00 – $24,928.00 | 1 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $23.43 – $24.12 | 2 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $28,218.00 – $28,218.00 | 1 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $37,127.00 – $37,127.00 | 1 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $37,127.00 – $37,127.00 | 1 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $37,127.00 – $37,127.00 | 1 |
| L/s ratio fetal lung CPT 83661 | not published | not published | $42.67 – $48.73 | 4 |
| Lubricant per ounce HCPCS A4402 | not published | not published | $2.77 – $2.77 | 1 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $3,645.02 – $3,645.02 | 1 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $37,127.00 – $37,127.00 | 1 |
| Lumizyme injection HCPCS J0221 | not published | not published | $324.15 – $415.02 | 4 |
| Lung Function Test (Spirometry) CPT 94010 | $418.50 | $837.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,123.50 | $2,247.00 | $780.44 – $780.44 | 1 |
| Lung transplant double CPT 32853 | not published | not published | $39,249.00 – $39,249.00 | 1 |
| Lung transplant single CPT 32851 | not published | not published | $39,249.00 – $39,249.00 | 1 |
| Lung transplant with bypass CPT 32852 | not published | not published | $39,249.00 – $39,249.00 | 1 |
| Lung transplant with bypass CPT 32854 | not published | not published | $39,249.00 – $39,249.00 | 1 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $37,127.00 – $37,127.00 | 1 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $20,101.00 | $40,202.00 | $331.32 – $424.20 | 4 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | $29,735.86 | $59,471.71 | $66.78 – $85.50 | 4 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | not published | not published | $523.65 – $539.04 | 3 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $62,354.64 | $124,709.28 | $399.65 – $428.34 | 3 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $3,818.00 – $3,818.00 | 1 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $38.89 – $44.41 | 4 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $28,218.00 – $28,218.00 | 1 |
| Lymphatics/lymph node imaging CPT 78195 | $1,269.00 | $2,538.00 | $1,000.60 – $1,000.60 | 1 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $70.95 – $81.02 | 4 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $95.12 – $108.61 | 4 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $297.80 – $379.02 | 4 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $92.33 – $105.43 | 4 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $1,336.68 – $1,336.68 | 1 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $3,458.00 – $3,458.00 | 1 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $3,458.00 – $3,458.00 | 1 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $5,875.11 – $5,875.11 | 1 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $3,818.00 – $3,818.00 | 1 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $5,941.00 – $5,941.00 | 1 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $5,941.00 – $5,941.00 | 1 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $8.84 – $30.20 | 4 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $10.18 – $14.44 | 4 |
| Macroscopic exam arthropod CPT 87168 | not published | not published | $8.29 – $9.47 | 4 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $8.29 – $9.47 | 4 |
| Magnesium CPT 83735 | $76.50 | $153.00 | $13.00 – $14.85 | 4 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $96.68 | $193.36 | $0.67 – $0.86 | 4 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $494.04 – $494.04 | 1 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $0.02 – $0.02 | 1 |
| Malaria antibody CPT 86750 | not published | not published | $25.58 – $29.20 | 4 |
| Male sling procedure CPT 53440 | not published | not published | $37,127.00 – $37,127.00 | 1 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $18,563.00 – $18,563.00 | 1 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $5,941.00 – $5,941.00 | 1 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $5,941.00 – $5,941.00 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $139.00 | $278.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $139.00 | $278.00 | not published | 0 |
| Manipulation of hip joint CPT 27275 | not published | not published | $5,941.00 – $5,941.00 | 1 |
| Manipulation of spine CPT 22505 | not published | not published | $5,941.00 – $5,941.00 | 1 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $3,818.00 – $3,818.00 | 1 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $32.28 | $64.55 | not published | 0 |
| Mannitol for inhaler HCPCS J7665 | not published | not published | $1.95 – $10.57 | 3 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $7.98 – $10.14 | 4 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | $5,930.92 | $11,861.85 | $83.21 – $106.54 | 4 |
| Marker biop eviva buckle ss HCPCS A4648 | $1,863.20 | $3,726.40 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | $2,375.72 | $4,751.43 | $2,069.10 – $2,069.10 | 1 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $18,563.00 – $18,563.00 | 1 |
| Mastectomy partial CPT 19301 | not published | not published | $18,563.00 – $18,563.00 | 1 |
| Mast mod rad CPT 19307 | not published | not published | $20,580.00 – $20,580.00 | 1 |
| Mastoidectomy CPT 69501 | not published | not published | $24,928.00 – $24,928.00 | 1 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $24,928.00 – $24,928.00 | 1 |
| Mastoids complete CPT 70130 | not published | not published | $237.61 – $237.61 | 1 |
| Mastoid surgery revision CPT 69603 | not published | not published | $24,928.00 – $24,928.00 | 1 |
| Mastopexy CPT 19316 | not published | not published | $20,580.00 – $20,580.00 | 1 |
| Mast radical CPT 19305 | not published | not published | $20,580.00 – $20,580.00 | 1 |
| Mast rad urban type CPT 19306 | not published | not published | $20,580.00 – $20,580.00 | 1 |
| Mast simple complete CPT 19303 | not published | not published | $20,580.00 – $20,580.00 | 1 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $209.78 – $449.57 | 2 |
| Matrix bone cryomatrix 2.0ml HCPCS Q4162 | not published | not published | $2,948.00 – $4,235.01 | 2 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | not published | not published | $35.67 – $209.78 | 2 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $68.09 – $77.73 | 4 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $42.90 – $54.58 | 4 |
| M.avium-intra dna quant CPT 87562 | not published | not published | $83.09 – $94.88 | 4 |
| Maxillofacial fixation CPT 21100 | not published | not published | $24,928.00 – $24,928.00 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $116.50 | $233.00 | $28.05 – $32.04 | 4 |
| Mayo aathr protein s free CPT 85306 | $88.50 | $177.00 | $29.74 – $33.96 | 4 |
| Mayo activated protein c resistance assay CPT 85307 | $130.50 | $261.00 | $29.74 – $33.96 | 4 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $106.50 | $213.00 | $60.62 – $77.14 | 4 |
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.