Ascension St. Vincent Salem (St. Vincent Salem Hospital, Inc.)
911 N Shelby St, Salem, IN · Ascension · · NPI 1427388982
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 |
|---|---|---|---|---|
| Chromosome analysis 100 CPT 88249 | not published | not published | $79.62 – $394.83 | 24 |
| Chromosome analysis 15-20 cell count CPT 88262 | $1,126.80 | $1,878.00 | $70.62 – $286.12 | 24 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $85.52 – $394.83 | 24 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $85.14 – $342.66 | 24 |
| Chromosome analysis 5 CPT 88261 | $554.40 | $924.00 | $105.74 – $602.70 | 24 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $98.11 – $394.83 | 24 |
| Chromosome analys placenta CPT 88267 | $563.40 | $939.00 | $101.85 – $429.94 | 24 |
| Chromosome banding study CPT 88283 | not published | not published | $38.86 – $156.41 | 24 |
| Chromosome count additional CPT 88285 | not published | not published | $10.76 – $61.35 | 24 |
| Chromosome karyotype study CPT 88280 | $79.20 | $132.00 | $14.22 – $76.31 | 24 |
| Chromosome study additional CPT 88289 | $108.00 | $180.00 | $19.51 – $78.50 | 24 |
| Chronic urticaria - sendout CPT 86343 | $236.40 | $394.00 | $6.15 – $28.41 | 24 |
| Chylomicron screen, bf - sendout CPT 82664 | not published | not published | $7.93 – $140.22 | 24 |
| Cilastatin sodium injection HCPCS J0743 | $119.35 | $198.91 | $4.81 – $16.87 | 20 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $89.67 – $958.01 | 38 |
| Cine/video x-rays CPT 76120 | not published | not published | $9.26 – $148.45 | 22 |
| Cine/video x-rays add-on CPT 76125 | not published | not published | $5.61 – $56.98 | 20 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $62.97 | $104.95 | $1.05 – $4.19 | 15 |
| Circum 28 days or older CPT 54161 | not published | not published | $43.71 – $910.38 | 38 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | not published | not published | $32.10 – $306.66 | 38 |
| Circumcision (newborn) CPT 54150 | not published | not published | $22.55 – $910.38 | 38 |
| C-kit mutation liquid tumor - sendout CPT 81272 | not published | not published | $131.80 – $751.28 | 15 |
| Claviculectomy partial CPT 23120 | not published | not published | $141.65 – $1,487.08 | 38 |
| Claviculectomy total CPT 23125 | not published | not published | $177.82 – $1,487.08 | 38 |
| Clean out mastoid cavity CPT 69222 | not published | not published | $25.10 – $158.73 | 38 |
| Clearance of airways CPT 31720 | not published | not published | $12.89 – $68.86 | 19 |
| Clearance of tear duct CPT 68530 | not published | not published | $61.77 – $339.65 | 38 |
| C-lens fitg corneosclrl lens CPT 92313 | not published | not published | $5.77 – $68.03 | 19 |
| C-lens fitg tech aphakia 1 CPT 92315 | not published | not published | $2.81 – $50.33 | 19 |
| C-lens fitg tech aphakia ou CPT 92316 | not published | not published | $4.47 – $63.06 | 19 |
| C-lens fitg tech corneosclrl CPT 92317 | not published | not published | $2.77 – $52.01 | 19 |
| Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J0736 | $66.73 | $111.22 | $1.90 – $5.56 | 31 |
| Clitoroplasty intersex state CPT 56805 | not published | not published | $264.03 – $1,553.00 | 38 |
| Close bronchial fistula 32815 CPT 32815 | not published | not published | $613.45 – $2,043.40 | 19 |
| Closed carpo/metacarpal disl thumb w/manip CPT 26641 | not published | not published | $77.57 – $378.03 | 38 |
| Closed carpo/metacarpal fx disl thumb w/manip CPT 26645 | not published | not published | $90.42 – $801.87 | 38 |
| Closed treatment of femoral fracture proximal end neck; wi CPT 27232 | not published | not published | $198.13 – $976.00 | 19 |
| Closed tx/acetabululm without manip 27220 CPT 27220 | not published | not published | $119.76 – $581.39 | 38 |
| Closed tx humerus fx with manip 23605 CPT 23605 | not published | not published | $104.29 – $801.87 | 38 |
| Closed tx humerus fx without manip 23600 CPT 23600 | not published | not published | $69.46 – $290.37 | 38 |
| Closed tx humerus fx w/manip 24505 CPT 24505 | not published | not published | $110.64 – $801.87 | 38 |
| Closed tx metatarsophalangeal jnt disl without anes CPT 28630 | not published | not published | $28.24 – $120.07 | 38 |
| Closed tx nose/jaw fx CPT 21345 | not published | not published | $164.22 – $654.38 | 38 |
| Closed tx orbit without manipulj CPT 21400 | not published | not published | $34.56 – $279.43 | 38 |
| Closed tx orbit w/manipulj CPT 21401 | not published | not published | $71.08 – $823.62 | 38 |
| Closed tx post hip arthroplasty disloc w/anes 27266 CPT 27266 | not published | not published | $146.11 – $801.87 | 38 |
| Closed tx septal&nose fx CPT 21337 | not published | not published | $70.07 – $1,291.25 | 38 |
| Closed tx sesamoid fx 28530 CPT 28530 | not published | not published | $25.64 – $109.88 | 38 |
| Closed tx/talus fracture without manip 28430 CPT 28430 | not published | not published | $49.25 – $199.11 | 38 |
| Closed tx vert fx w/manj CPT 22315 | not published | not published | $187.89 – $1,487.08 | 38 |
| Close lac/mouth vest/2.5 cm or < 40830 CPT 40830 | not published | not published | $36.08 – $186.80 | 38 |
| Close mastoid fistula CPT 69700 | not published | not published | $127.96 – $748.10 | 38 |
| Close median sternotomy separation 21750 CPT 21750 | not published | not published | $183.95 – $1,075.40 | 19 |
| Close tear duct opening CPT 68760 | not published | not published | $33.56 – $147.95 | 38 |
| Close tear duct opening CPT 68761 | not published | not published | $27.08 – $113.65 | 38 |
| Close tear system fistula CPT 68770 | not published | not published | $128.57 – $958.01 | 38 |
| Clostridium toxin a w/optic CPT 87803 | not published | not published | $5.67 – $36.48 | 22 |
| Clos txnose fx without stablz 21315 CPT 21315 | not published | not published | $37.02 – $652.86 | 38 |
| Closure enterostomy lg/sm intestine 44620 CPT 44620 | not published | not published | $191.56 – $840.00 | 19 |
| Closure enterostomy lg/sm intestine anast 44626 CPT 44626 | not published | not published | $363.70 – $1,685.60 | 19 |
| Closure enterostomy lg/sm intestine oth/thn 44625 CPT 44625 | not published | not published | $227.62 – $1,085.30 | 19 |
| Closure intestinal cutaneous fistula 44640 CPT 44640 | not published | not published | $316.60 – $1,104.00 | 19 |
| Closure laceration vestibule mouth > 2.5 cm cmplx CPT 40831 | not published | not published | $50.89 – $279.43 | 38 |
| Closure of eyelid by suture CPT 67875 | not published | not published | $22.99 – $514.17 | 38 |
| Closure of salivary fistula CPT 42600 | not published | not published | $81.47 – $1,291.25 | 38 |
| Closure of windpipe lesion 31820 CPT 31820 | not published | not published | $75.71 – $1,291.25 | 38 |
| Closure paravalvlr leak pq CPT 33999 | not published | not published | $0.01 – $0.01 | 11 |
| Clot factor fletcher fact CPT 85292 | not published | not published | $9.35 – $43.16 | 24 |
| Clot factor viii reltd antgn CPT 85244 | not published | not published | $5.95 – $46.56 | 24 |
| Clot factor wght kininogen CPT 85293 | not published | not published | $9.35 – $43.16 | 24 |
| Clot factor xii hageman CPT 85280 | $219.60 | $366.00 | $5.95 – $44.12 | 24 |
| Clot factor xiii fibrin scrn CPT 85291 | $145.80 | $243.00 | $3.97 – $20.77 | 24 |
| Clot factor xiii fibrin stab CPT 85290 | not published | not published | $7.28 – $37.26 | 24 |
| Clotting assay whole blood CPT 85396 | not published | not published | $1.51 – $44.80 | 21 |
| Clsd/shoulder dislo/manip/no anest 23650 CPT 23650 | not published | not published | $64.44 – $306.88 | 38 |
| Clsd tx bimalleol ank fx without manip 27808 CPT 27808 | not published | not published | $69.35 – $350.18 | 38 |
| Clsd tx carpo/metacarpl disl thmb manip ea without anes CPT 26670 | not published | not published | $70.14 – $344.90 | 38 |
| Clsd tx clav dislc without manip 23520 CPT 23520 | not published | not published | $52.46 – $801.87 | 38 |
| Clsd tx clavicle dislocation without manip 23540 CPT 23540 | not published | not published | $50.37 – $253.10 | 38 |
| Clsd tx clavicle fracture w/manip 23505 CPT 23505 | not published | not published | $79.27 – $801.87 | 38 |
| Clsd tx/clavicular fx without manip 23500 CPT 23500 | not published | not published | $49.66 – $210.03 | 38 |
| Clsd tx coccygeal fracture 27200 CPT 27200 | not published | not published | $42.65 – $217.53 | 38 |
| Clsd tx/dis phalan fx without manip/ea 26750 CPT 26750 | not published | not published | $40.28 – $174.87 | 38 |
| Clsd tx dist fib fx w/manip 27788 CPT 27788 | not published | not published | $95.20 – $491.97 | 38 |
| Clsd tx/dis tib/wt bear no manip 27824 CPT 27824 | not published | not published | $70.47 – $286.85 | 38 |
| Clsd tx elbow dislocation child 24640 CPT 24640 | not published | not published | $21.16 – $155.07 | 38 |
| Clsd tx/fem shaft fx/manipulation 27502 CPT 27502 | not published | not published | $201.61 – $969.00 | 38 |
| Clsd tx finger tendon w/wo perq pin 26432 CPT 26432 | not published | not published | $129.77 – $801.87 | 38 |
| Clsd tx fracture of radius 25500 CPT 25500 | not published | not published | $55.51 – $236.55 | 38 |
| Clsd tx/fx grt toe/phalanx/phalang 28490 CPT 28490 | not published | not published | $28.64 – $118.73 | 38 |
| Clsd tx/fx/phalanx/phalang/manip 28515 CPT 28515 | not published | not published | $34.80 – $136.57 | 38 |
| Clsd tx fx radius/ulna dist without manip 25600 CPT 25600 | not published | not published | $60.68 – $294.53 | 38 |
| Clsd tx fx radius/ulna dist w/manip 25605 CPT 25605 | not published | not published | $139.56 – $801.87 | 38 |
| Clsd tx fx radius/ulna without manip 25560 CPT 25560 | not published | not published | $54.81 – $238.51 | 38 |
| Clsd tx fx radius/ulna w/manip 25565 CPT 25565 | not published | not published | $116.05 – $801.87 | 38 |
| Clsd tx/grt hum tube fx without manip 23620 CPT 23620 | not published | not published | $58.22 – $240.93 | 38 |
| Clsd tx hip disloc without anes 27265 CPT 27265 | not published | not published | $99.62 – $470.90 | 38 |
| Clsd tx humeral fract without manip 24530 CPT 24530 | not published | not published | $80.05 – $325.09 | 38 |
| Clsd tx humerus fract without manip 24500 CPT 24500 | not published | not published | $74.06 – $307.75 | 38 |
| Clsd tx iphal jnt disl w/manip req anes CPT 26775 | not published | not published | $80.29 – $326.76 | 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.