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 |
|---|---|---|---|---|
| Cysto cgen post urtl valves CPT 52400 | not published | not published | $123.93 – $1,592.02 | 38 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | not published | not published | $9.12 – $250.00 | 23 |
| Cysto insj dev ischmc rmdlg CPT 53865 | not published | not published | $7,351.58 – $7,351.58 | 1 |
| Cystometrogram w/up 51727 CPT 51727 | not published | not published | $67.11 – $280.96 | 38 |
| Cystorrhaphy wound comp 51865 CPT 51865 | not published | not published | $197.59 – $1,225.50 | 19 |
| Cystorrhaphy wound simple 51860 CPT 51860 | not published | not published | $160.79 – $971.80 | 19 |
| Cysto rx balo cath urtl strx CPT 52284 | not published | not published | $149.20 – $3,292.16 | 31 |
| Cystoscopy and biopsy CPT 52007 | not published | not published | $37.40 – $1,592.02 | 38 |
| Cystoscopy and radiotracer CPT 52250 | not published | not published | $54.87 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52214 | not published | not published | $44.88 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $38.43 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $55.97 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $65.75 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $115.19 – $2,419.37 | 38 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $47.42 – $910.38 | 38 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $36.03 – $255.21 | 38 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $60.30 – $910.38 | 38 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $74.14 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $45.39 – $910.38 | 38 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $44.04 – $306.66 | 38 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $55.45 – $910.38 | 38 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $64.08 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $67.03 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $63.60 – $2,419.37 | 38 |
| Cystoscopy and treatment CPT 52310 | not published | not published | $34.29 – $910.38 | 38 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $62.53 – $910.38 | 38 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $56.22 – $1,592.02 | 38 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $60.27 – $1,592.02 | 38 |
| Cystoscopy (Bladder Scope) CPT 52000 | not published | not published | $27.51 – $306.66 | 38 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | $42.98 – $910.38 | 38 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $37.34 – $306.66 | 38 |
| Cystoscopy implant stent CPT 52282 | not published | not published | $76.49 – $1,592.02 | 38 |
| Cystoscopy inject material CPT 52327 | not published | not published | $60.59 – $3,392.95 | 38 |
| Cystoscopy removal of clots CPT 52001 | not published | not published | $65.20 – $1,592.02 | 38 |
| Cystoscopy & revise urethra CPT 52270 | not published | not published | $41.22 – $910.38 | 38 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $56.53 – $910.38 | 38 |
| Cystoscopy stone removal CPT 52325 | not published | not published | $73.26 – $2,419.37 | 38 |
| Cystoscopy & ureter catheter CPT 52005 | not published | not published | $29.74 – $910.38 | 38 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | not published | not published | $64.40 – $910.38 | 38 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $102.40 – $1,592.02 | 38 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $175.74 – $1,592.02 | 38 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $71.33 – $1,592.02 | 38 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $94.86 – $1,592.02 | 38 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $89.12 – $2,419.37 | 38 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $106.35 – $2,419.37 | 38 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $104.57 – $2,419.37 | 38 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $96.45 – $2,419.37 | 38 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $112.46 – $2,419.37 | 38 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $83.73 – $1,592.02 | 38 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $100.61 – $1,592.02 | 38 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $61.47 – $1,592.02 | 38 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | not published | not published | $34.93 – $910.38 | 38 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $31.59 – $910.38 | 38 |
| Cystourethro w/addl implant 52442 CPT 52442 | not published | not published | $15.46 – $642.63 | 19 |
| Cystourethro w/implant CPT 52441 | not published | not published | $57.81 – $843.58 | 19 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $87.99 – $1,592.02 | 38 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $79.94 – $1,592.02 | 38 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $74.26 – $1,592.02 | 38 |
| Cytogenetics 25-99 CPT 88274 | $424.80 | $708.00 | $19.72 – $96.63 | 24 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $16.28 – $92.80 | 24 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $464.00 – $2,644.80 | 22 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $32.77 – $2,052.00 | 22 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $168.00 | $280.00 | $5.29 – $32.81 | 24 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $178.80 | $298.00 | $6.61 – $38.42 | 24 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $5.92 – $30.60 | 22 |
| Cyto/molecular report CPT 88291 | $120.00 | $200.00 | $3.54 – $75.92 | 24 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $12.10 – $57.84 | 24 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $5.86 – $33.40 | 24 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $8.21 – $85.93 | 24 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $251.40 | $419.00 | $13.57 – $112.72 | 22 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $140.40 | $234.00 | $14.32 – $60.67 | 24 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $118.80 | $198.00 | $11.48 – $46.19 | 24 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $223.20 | $372.00 | $8.90 – $100.09 | 24 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $113.40 | $189.00 | $7.43 – $85.93 | 24 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | not published | not published | $3.17 – $32.02 | 22 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | not published | not published | $6.51 – $87.00 | 24 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $292.80 | $488.00 | $16.66 – $213.17 | 24 |
| Cytopath smear other source CPT 88160 | not published | not published | $6.48 – $100.48 | 24 |
| Cytopath smear other source CPT 88162 | not published | not published | $9.71 – $119.39 | 24 |
| Cytopath smear oth prep screen & interp CPT 88161 | not published | not published | $7.08 – $113.98 | 24 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $5.29 – $36.30 | 24 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $13.22 – $179.32 | 24 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $9.26 – $67.67 | 24 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $830.40 | $1,384.00 | $20.88 – $195.84 | 22 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $2.18 | $3.64 | $0.04 – $0.52 | 19 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $3,300.15 | $5,500.25 | $2.93 – $23.58 | 43 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $51.78 – $281.34 | 13 |
| D&c after delivery 59160 CPT 59160 | not published | not published | $33.91 – $1,553.00 | 38 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $49.43 – $1,553.00 | 38 |
| Dch glucoscan CPT 82948 | $42.00 | $70.00 | $1.32 – $11.49 | 24 |
| Dch pulmonary stress test CPT 94621 | not published | not published | $31.36 – $68.40 | 19 |
| Dch validity tests CPT 81002 | $42.60 | $71.00 | $1.32 – $7.93 | 24 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | not published | not published | $116.48 – $878.95 | 38 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $324.11 – $1,950.60 | 38 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $60.81 – $878.95 | 38 |
| D&c of cervical stump CPT 57558 | not published | not published | $25.81 – $1,553.00 | 38 |
| Deamidated gliadin antibody iga CPT 86258 | $21.60 | $36.00 | $11.53 – $28.83 | 19 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $126.71 – $878.91 | 19 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | not published | not published | $5.80 – $37.59 | 38 |
| Debridement (>20 cm) charge pt CPT 97598 | $586.20 | $977.00 | $9.80 – $23.43 | 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.