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 |
|---|---|---|---|---|
| Cryopreservation sperm CPT 89259 | not published | not published | $125.00 – $322.95 | 12 |
| Cryopreserve stem cells CPT 38207 | not published | not published | $13.80 – $16.80 | 13 |
| Cryopreserve testicular tiss CPT 89335 | not published | not published | $28.60 – $111.75 | 12 |
| Cryosurg ablate fa each CPT 19105 | not published | not published | $33.73 – $2,053.61 | 32 |
| Cryosurgery penis lesion(s) 54056 CPT 54056 | not published | not published | $21.42 – $105.58 | 19 |
| Cryotherapy of acne 17340 CPT 17340 | not published | not published | $7.98 – $46.86 | 13 |
| Cryptococcus abs qn - sendout CPT 86641 | not published | not published | $5.29 – $32.85 | 24 |
| Cryptosporidium antigen CPT 87272 | not published | not published | $5.75 – $27.31 | 24 |
| Crystal identification light microscopy CPT 89060 | $134.40 | $224.00 | $0.84 – $115.06 | 24 |
| C-Section Delivery (full care) CPT 59510 | not published | not published | $348.34 – $2,263.19 | 13 |
| C-section delivery incl p/p care 59515 CPT 59515 | not published | not published | $191.97 – $1,221.10 | 13 |
| Csf leakage imaging CPT 78650 | not published | not published | $21.58 – $859.35 | 41 |
| Csf shunt reprogram 62252 CPT 62252 | not published | not published | $20.50 – $52.50 | 38 |
| Csf ventriculography CPT 78635 | not published | not published | $21.58 – $632.17 | 41 |
| CT 3d report other modality w/workstation CPT 76377 | not published | not published | $17.08 – $650.00 | 21 |
| Cta abdomen without & /or w/contrast CPT 74175 | $2,289.60 | $3,816.00 | $67.86 – $650.00 | 42 |
| Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast CPT 75635 | $2,750.40 | $4,584.00 | $81.79 – $650.00 | 23 |
| Cta lower extremity without & w/contrast (both sides) CPT 73706 | $4,506.00 | $7,510.00 | $66.15 – $561.53 | 41 |
| Cta neck without &/or w/contrast CPT 70498 | $1,772.40 | $2,954.00 | $62.35 – $760.52 | 42 |
| CT Angiogram of Abdomen and Pelvis CPT 74174 | $3,405.00 | $5,675.00 | $77.86 – $875.45 | 40 |
| CT Angiogram of the Chest (for blood clot) CPT 71275 | $1,574.40 | $2,624.00 | $68.24 – $650.00 | 42 |
| CT Angiogram of the Head CPT 70496 | $2,021.40 | $3,369.00 | $62.58 – $725.32 | 42 |
| CT angio hrt w/3d image CPT 75574 | not published | not published | $84.25 – $650.00 | 42 |
| CT angio pelvis CPT 72191 | $2,102.40 | $3,504.00 | $64.55 – $601.75 | 41 |
| Cta upper extremity w &/or without contrast left CPT 73206 | $2,622.60 | $4,371.00 | $62.35 – $650.00 | 42 |
| CT bone density axial CPT 77078 | not published | not published | $8.84 – $203.78 | 41 |
| CT colonography dx CPT 74261 | not published | not published | $53.76 – $650.00 | 35 |
| CT colonography dx w/dye CPT 74262 | not published | not published | $60.34 – $650.00 | 35 |
| CT colonography screening CPT 74263 | not published | not published | $117.69 – $707.69 | 15 |
| CT guidance for needle placement CPT 77012 | $1,264.20 | $2,107.00 | $40.72 – $650.00 | 21 |
| CT guidance for percutaneous drain w/catheter placement supervision & interpretation CPT 75989 | not published | not published | $20.13 – $400.00 | 21 |
| CT guid cryo ablat intramuscular CPT 20999 | not published | not published | $0.01 – $0.01 | 11 |
| CT guid parench tis ablat CPT 77013 | not published | not published | $85.60 – $650.00 | 21 |
| CT heart w/evaluation of calcium without contrast CPT 75571 | $255.60 | $426.00 | $12.02 – $650.00 | 23 |
| CT hrt c+ strux cgen hrt ds CPT 75573 | not published | not published | $58.23 – $650.00 | 42 |
| CT hrt w/3d image CPT 75572 | not published | not published | $40.23 – $650.00 | 42 |
| CT limited or localized follow-up study CPT 76380 | not published | not published | $25.23 – $650.00 | 23 |
| CT lower extremity w/contrast (both sides) CPT 73701 | $2,232.00 | $3,720.00 | $39.91 – $359.66 | 41 |
| CT lower extremity without contrast (both sides) CPT 73700 | $2,359.20 | $3,932.00 | $33.43 – $650.00 | 42 |
| CT lwr extremity w/o&w/dye CPT 73702 | $2,356.80 | $3,928.00 | $43.49 – $473.89 | 41 |
| CT neck soft tissue w/contrast CPT 70491 | $1,356.60 | $2,261.00 | $40.71 – $650.00 | 42 |
| CT neck soft tissue without contrast CPT 70490 | $1,344.60 | $2,241.00 | $34.21 – $650.00 | 42 |
| CT neck soft tissue without & w/contrast CPT 70492 | $1,963.20 | $3,272.00 | $49.21 – $650.00 | 42 |
| CT orbit/sella/fossa w/wo contrast CPT 70482 | $1,939.20 | $3,232.00 | $51.81 – $506.92 | 41 |
| CT orbit/sella/ or posterior outer inner or middle ear w/contrast CPT 70481 | $1,608.00 | $2,680.00 | $45.19 – $650.00 | 42 |
| CT orbit/sella/ or posterior outer inner or middle ear without contrast CPT 70480 | $1,241.40 | $2,069.00 | $38.77 – $650.00 | 42 |
| Ctrl nosebld postir subsq 30906 CPT 30906 | not published | not published | $32.76 – $195.61 | 38 |
| CT scan for therapy guide CPT 77014 | not published | not published | $30.96 – $650.00 | 21 |
| CT Scan of Abdomen and Pelvis (with and without contrast) CPT 74178 | $3,805.80 | $6,343.00 | $71.93 – $650.00 | 42 |
| CT Scan of Abdomen and Pelvis (with contrast) CPT 74177 | $3,012.00 | $5,020.00 | $65.14 – $650.00 | 42 |
| CT Scan of Abdomen and Pelvis (without contrast) CPT 74176 | $2,405.40 | $4,009.00 | $62.32 – $650.00 | 42 |
| CT thoracic spine w/contrast CPT 72129 | $1,285.80 | $2,143.00 | $43.19 – $650.00 | 42 |
| CT thoracic spine without contrast CPT 72128 | $1,258.80 | $2,098.00 | $35.75 – $650.00 | 42 |
| CT thorax low dose for lung screening without contrast CPT 71271 | $562.80 | $938.00 | $21.01 – $315.51 | 19 |
| CT t-spine w /wo contrast CPT 72130 | $1,510.20 | $2,517.00 | $45.27 – $453.76 | 41 |
| CT upper extremity w/contrast (both sides) CPT 73201 | $2,073.60 | $3,456.00 | $39.73 – $353.92 | 41 |
| CT upper extremity without contrast (both sides) CPT 73200 | $2,354.40 | $3,924.00 | $33.43 – $650.00 | 42 |
| CT uppr extremity w/o&w/dye CPT 73202 | $2,450.40 | $4,084.00 | $43.49 – $478.91 | 41 |
| Cultr oocyte/embryo <4 days CPT 89250 | not published | not published | $715.00 – $2,268.60 | 15 |
| Cultr oocyte/embryo <4 days CPT 89251 | not published | not published | $650.00 – $2,359.73 | 15 |
| Cult skin graft fnhfg 15155 CPT 15155 | not published | not published | $119.36 – $1,822.02 | 38 |
| Cult skin grft t/arm/leg CPT 15150 | not published | not published | $111.15 – $926.15 | 38 |
| Culture aerobic additional method definitive id each CPT 87077 | $174.00 | $290.00 | $3.82 – $18.70 | 24 |
| Culture afb any source CPT 87116 | $174.00 | $290.00 | $5.29 – $24.62 | 24 |
| Culture anaerobic additional method definitive id each CPT 87076 | $129.60 | $216.00 | $3.99 – $18.42 | 24 |
| Culture anaerobic except blood CPT 87075 | $168.00 | $280.00 | $3.97 – $21.59 | 24 |
| Culture bact stool aero addl path ea CPT 87046 | $114.00 | $190.00 | $3.12 – $21.52 | 22 |
| Culture body fluid CPT 87070 | $184.80 | $308.00 | $2.65 – $19.65 | 24 |
| Culture fungi definitive id mold CPT 87107 | $129.00 | $215.00 | $5.10 – $23.53 | 22 |
| Culture fungi definitive id yeast CPT 87106 | $135.60 | $226.00 | $4.88 – $23.53 | 24 |
| Culture fungi other (except blood) CPT 87102 | $174.00 | $290.00 | $3.97 – $19.17 | 24 |
| Culture fungi skin/hair/nail CPT 87101 | not published | not published | $3.65 – $17.58 | 24 |
| Culture mycobacteria definitive id each isolate CPT 87118 | not published | not published | $5.29 – $33.31 | 24 |
| Culture mycoplasma any source CPT 87109 | $199.80 | $333.00 | $5.29 – $35.09 | 24 |
| Culture quantitative aerobic other source CPT 87071 | $187.80 | $313.00 | $4.07 – $22.55 | 22 |
| Culture screening strep group a CPT 87081 | $120.60 | $201.00 | $2.65 – $15.12 | 24 |
| Culture typing added method CPT 87158 | not published | not published | $1.32 – $17.65 | 24 |
| Culture typing immunologic CPT 87147 | $96.00 | $160.00 | $2.16 – $11.81 | 24 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $392.40 | $654.00 | $218.06 – $545.15 | 19 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | not published | not published | $11.71 – $80.01 | 22 |
| Culture urine each isolate CPT 87088 | $108.60 | $181.00 | $3.97 – $18.45 | 24 |
| Culture virus isolation CPT 87250 | not published | not published | $7.93 – $44.60 | 24 |
| Curette/treat cornea CPT 65435 | not published | not published | $16.31 – $67.10 | 38 |
| Curette/treat cornea CPT 65436 | not published | not published | $84.39 – $493.47 | 38 |
| Cv line/pic reposition CPT 36597 | not published | not published | $16.49 – $606.20 | 38 |
| Cv stress test i&r only 93018 CPT 93018 | not published | not published | $4.55 – $24.60 | 19 |
| Cv stress test/supervision only 93016 CPT 93016 | not published | not published | $7.04 – $34.00 | 19 |
| Cyanocobalamin unsat binding capacity CPT 82608 | $151.20 | $252.00 | $6.77 – $32.65 | 24 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $42.47 | $70.79 | $1.44 – $4.42 | 21 |
| Cyclic citrullinated peptide antibody CPT 86200 | $199.80 | $333.00 | $6.39 – $29.53 | 24 |
| Cyclosporine 2 hour CPT 80158 | $271.80 | $453.00 | $7.93 – $41.15 | 24 |
| Cyclosporine oral 100 mg HCPCS J7502 | $1,187.49 | $1,979.15 | $1.76 – $5.38 | 14 |
| Cyp2c19 gene com variants CPT 81225 | not published | not published | $111.79 – $664.30 | 15 |
| Cyp2c9 gene com variants CPT 81227 | not published | not published | $59.53 – $398.57 | 15 |
| Cyp2d6 gene com variants CPT 81226 | not published | not published | $144.37 – $1,028.07 | 15 |
| Cyp3a4 gene common variants CPT 81230 | not published | not published | $69.92 – $398.57 | 22 |
| Cyp3a5 gene common variants CPT 81231 | not published | not published | $69.92 – $398.57 | 22 |
| Cystatin c CPT 82610 | $143.40 | $239.00 | $6.65 – $42.23 | 22 |
| Cystic fibrosis cftr CPT 81223 | not published | not published | $199.60 – $1,137.72 | 15 |
| Cystine urine quantitative CPT 82131 | $303.00 | $505.00 | $7.93 – $52.39 | 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.