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 |
|---|---|---|---|---|
| Frenulotomy of penis CPT 54164 | not published | not published | $42.03 – $910.38 | 38 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $342.60 | $571.00 | $30.00 – $70.89 | 13 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $206.40 | $344.00 | $30.00 – $70.38 | 13 |
| Fresh frozen plasma thawing ea un CPT 86927 | $56.40 | $94.00 | $3.97 – $145.00 | 24 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $29.09 – $214.87 | 24 |
| Frozen blood prep CPT 86930 | not published | not published | $24.20 – $252.65 | 24 |
| Frozen blood thaw CPT 86931 | not published | not published | $27.77 – $195.00 | 24 |
| Frozen cell preparation CPT 88241 | not published | not published | $4.62 – $27.57 | 24 |
| Fructosamine glycated protein CPT 82985 | $112.80 | $188.00 | $6.46 – $38.21 | 24 |
| Ftl cgen abnor four anal CPT 81511 | $754.80 | $1,258.00 | $46.48 – $349.98 | 15 |
| Full field erg w/i&r CPT 92273 | not published | not published | $17.79 – $984.01 | 20 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $5.80 – $250.00 | 23 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | not published | not published | $141.91 – $926.15 | 38 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $104.06 – $926.15 | 38 |
| Full thick gft/scalp/arm/leg/add 20sqcm 15221 CPT 15221 | not published | not published | $12.65 – $93.41 | 19 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | not published | not published | $131.24 – $926.15 | 38 |
| Fundus photography with i&r 92250 CPT 92250 | not published | not published | $8.60 – $46.17 | 19 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $682.01 – $2,246.28 | 19 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $241.81 – $1,175.30 | 19 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $186.98 – $1,487.08 | 38 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $210.66 – $4,552.07 | 38 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $269.12 – $9,099.42 | 38 |
| Fusion of big toe joint CPT 28750 | not published | not published | $155.14 – $4,643.54 | 38 |
| Fusion of big toe joint CPT 28755 | not published | not published | $88.46 – $3,321.81 | 38 |
| Fusion of finger joint CPT 26860 | not published | not published | $145.72 – $1,487.08 | 38 |
| Fusion of finger tendons CPT 26471 | not published | not published | $158.86 – $1,487.08 | 38 |
| Fusion of finger tendons CPT 26474 | not published | not published | $153.53 – $801.87 | 38 |
| Fusion of foot bones CPT 28730 | not published | not published | $216.78 – $9,387.58 | 38 |
| Fusion of foot bones CPT 28735 | not published | not published | $207.75 – $9,290.64 | 38 |
| Fusion of foot bones CPT 28740 | not published | not published | $162.71 – $4,785.61 | 38 |
| Fusion of hand joint CPT 26843 | not published | not published | $189.21 – $3,321.81 | 38 |
| Fusion of knuckle CPT 26850 | not published | not published | $179.89 – $3,321.81 | 38 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $182.45 – $1,908.65 | 38 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $212.28 – $1,487.08 | 38 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $212.92 – $3,321.81 | 38 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $204.53 – $3,321.81 | 38 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $166.12 – $974.57 | 38 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $240.39 – $1,592.02 | 38 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $174.00 – $1,487.08 | 38 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $165.95 – $1,487.08 | 38 |
| Fusion of thumb CPT 26841 | not published | not published | $190.18 – $3,321.81 | 38 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $177.43 – $8,020.24 | 38 |
| Fusion of toes CPT 28280 | not published | not published | $98.10 – $1,487.08 | 38 |
| G6pc gene CPT 81250 | not published | not published | $23.40 – $133.36 | 15 |
| G6pd full gene sequence CPT 81249 | not published | not published | $240.00 – $1,368.00 | 15 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $69.92 – $398.57 | 15 |
| G6pd known familial variant CPT 81248 | not published | not published | $150.10 – $855.57 | 15 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $4.59 | $7.65 | $0.34 – $0.86 | 15 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $2.70 | $4.50 | $0.13 – $0.41 | 15 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $25.56 | $42.60 | $14.74 – $35.38 | 14 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $9.26 – $48.04 | 24 |
| Galactokinase - sendout CPT 82759 | not published | not published | $7.93 – $48.97 | 24 |
| Galactose transferase test CPT 82776 | $35.40 | $59.00 | $2.65 – $26.77 | 24 |
| Galectin-3 CPT 82777 | not published | not published | $7.12 – $100.89 | 15 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $163.63 – $2,648.76 | 38 |
| Gammaglobulin iga CPT 82784 | $127.80 | $213.00 | $2.65 – $21.20 | 24 |
| Gammaglobulin ige CPT 82785 | $288.60 | $481.00 | $6.61 – $37.53 | 24 |
| Gamma glutamyltransferase CPT 82977 | $96.00 | $160.00 | $2.65 – $16.42 | 24 |
| Gardner vag dna quant CPT 87512 | not published | not published | $17.13 – $95.21 | 24 |
| Gastric analy w/ph ea spec CPT 82930 | $31.80 | $53.00 | $2.69 – $15.30 | 22 |
| Gastric emptying imag study CPT 78265 | $1,509.60 | $2,516.00 | $34.51 – $733.70 | 39 |
| Gastric emptying imag study CPT 78266 | $1,509.60 | $2,516.00 | $38.24 – $878.09 | 39 |
| Gastric motility studies CPT 91020 | not published | not published | $29.60 – $54.50 | 19 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $24.87 – $446.11 | 41 |
| Gastrin test CPT 82938 | not published | not published | $8.74 – $40.33 | 24 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $23.41 – $432.45 | 41 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $36.49 – $177.07 | 19 |
| Gastrojejunostomy;w/o vagotomy 43820 CPT 43820 | not published | not published | $285.66 – $954.90 | 19 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $126.87 – $608.30 | 19 |
| Gated heart multiple CPT 78473 | not published | not published | $47.07 – $448.98 | 41 |
| Gba gene CPT 81251 | not published | not published | $28.35 – $107.73 | 22 |
| General health panel CPT 80050 | $427.80 | $713.00 | $14.55 – $195.16 | 24 |
| Genetic tstg severe inh cond CPT 81443 | not published | not published | $979.42 – $5,582.72 | 15 |
| Genioplasty augmentation CPT 21120 | not published | not published | $124.39 – $2,702.95 | 38 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $212.01 – $1,291.25 | 38 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $160.50 – $1,965.95 | 38 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $178.99 – $3,404.27 | 38 |
| Genome sequence analysis CPT 81425 | not published | not published | $846.27 – $11,471.14 | 15 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $38.83 | $64.72 | $0.85 – $6.17 | 21 |
| Gentamicin peak therapeutic drug level CPT 80170 | $233.40 | $389.00 | $8.09 – $37.35 | 24 |
| G-esoph reflx tst w/electrod CPT 91035 | not published | not published | $59.62 – $367.71 | 38 |
| Ghs abscess perianal iandd CPT 46050 | not published | not published | $20.33 – $464.17 | 38 |
| Ghs abscess postoperative iandd complex CPT 10180 | not published | not published | $30.23 – $1,132.89 | 38 |
| Ghs acetylcholinesterase, rbc CPT 82482 | $27.00 | $45.00 | $3.92 – $22.37 | 24 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $153.60 | $256.00 | $7.93 – $39.01 | 24 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | not published | not published | $40.90 – $233.15 | 22 |
| Ghs analysis neurostim without reprogramming CPT 95970 | not published | not published | $4.56 – $196.17 | 20 |
| Ghs antibodies (torch) igm CPT 86694 | $138.60 | $231.00 | $5.29 – $32.81 | 24 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $8.95 – $58.88 | 38 |
| Ghs bladder cath - complex-foley CPT 51703 | not published | not published | $18.18 – $126.36 | 38 |
| Ghs bleeding time (ivy) CPT 85002 | not published | not published | $2.13 – $10.99 | 24 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | not published | not published | $19.52 – $93.10 | 38 |
| Ghs central line insert < age 5, failed CPT 36555 | $2,968.80 | $4,948.00 | $33.17 – $4,631.00 | 40 |
| Ghs change cysto/gastrost CPT 43762 | not published | not published | $10.71 – $125.52 | 32 |
| Ghs chemo >8 hrs CPT 96416 | $259.20 | $432.00 | $21.11 – $256.15 | 20 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $22.01 – $315.50 | 20 |
| Ghs chemo IV push, ea addtl CPT 96411 | $223.20 | $372.00 | $8.28 – $107.28 | 20 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | not published | not published | $17.13 – $80.01 | 24 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | not published | not published | $57.39 – $247.33 | 38 |
| Ghs closed reduction ankle dislocation CPT 27840 | not published | not published | $86.91 – $401.90 | 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.