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 |
|---|---|---|---|---|
| Lumbar diskogram s&i CPT 72295 | not published | not published | $28.23 – $1,298.32 | 22 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $404.06 – $13,239.40 | 38 |
| Lung function test (mbc/mvv) CPT 94200 | not published | not published | $3.99 – $12.50 | 19 |
| Lung Function Test (Spirometry) CPT 94010 | not published | not published | $6.03 – $20.10 | 19 |
| Lung perfusion imaging CPT 78580 | $1,153.80 | $1,923.00 | $24.71 – $415.22 | 41 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $355.87 – $1,901.30 | 13 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $9.69 – $51.33 | 13 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $188.90 – $851.20 | 19 |
| Lymphatics/lymph node imaging CPT 78195 | not published | not published | $37.21 – $609.90 | 41 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $18.06 – $83.36 | 24 |
| Lymphocyte transformation mitogen CPT 86353 | not published | not published | $18.52 – $111.79 | 24 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $19.84 – $432.08 | 24 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $30.81 – $390.80 | 22 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $34.08 – $722.38 | 41 |
| Lymph vessel x-ray trunk CPT 75805 | not published | not published | $29.44 – $1,806.01 | 41 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $37.36 – $439.41 | 22 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $31.07 – $279.43 | 38 |
| Lysis of labial adhesions CPT 56441 | not published | not published | $31.77 – $1,553.00 | 38 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $43.15 – $910.38 | 38 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $2.59 – $17.44 | 22 |
| Macroscopic exam arthropod CPT 87168 | $88.80 | $148.00 | $2.11 – $9.74 | 22 |
| Macroscopic exam parasite CPT 87169 | $48.00 | $80.00 | $2.02 – $9.83 | 22 |
| Magnesium CPT 83735 | $126.60 | $211.00 | $2.73 – $15.28 | 24 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $64.61 | $107.68 | $0.05 – $1.51 | 21 |
| Magnetic image bone marrow CPT 77084 | not published | not published | $57.47 – $632.63 | 41 |
| Malaria antibody CPT 86750 | not published | not published | $5.29 – $30.07 | 24 |
| Male sling procedure CPT 53440 | not published | not published | $193.44 – $9,871.23 | 38 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $686.54 – $2,269.00 | 19 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $76.07 – $801.87 | 38 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $97.33 – $801.87 | 38 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | not published | not published | $3.64 – $23.70 | 19 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | not published | not published | $4.20 – $29.50 | 19 |
| Manipulation of hip joint CPT 27275 | not published | not published | $45.77 – $801.87 | 38 |
| Manipulation of spine CPT 22505 | not published | not published | $31.90 – $801.87 | 38 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $22.74 – $80.84 | 38 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $40.12 | $66.86 | $2.20 – $5.87 | 14 |
| Manual diff wbc count b-coat CPT 85009 | $79.80 | $133.00 | $1.76 – $11.56 | 24 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $44.57 – $71.30 | 19 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $45.97 – $165.04 | 19 |
| Map tachycard site(s) CPT 93609 | not published | not published | $66.00 – $130.10 | 19 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $247.25 – $829.70 | 19 |
| Mastectomy partial CPT 19301 | not published | not published | $100.04 – $1,438.67 | 38 |
| Mast mod rad CPT 19307 | not published | not published | $192.23 – $2,482.82 | 38 |
| Mastoidectomy CPT 69501 | not published | not published | $133.53 – $2,702.95 | 38 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $176.91 – $2,702.95 | 38 |
| Mastoids complete CPT 70130 | $637.20 | $1,062.00 | $6.67 – $83.81 | 22 |
| Mastoid surgery revision CPT 69603 | not published | not published | $232.90 – $2,702.95 | 38 |
| Mastopexy CPT 19316 | not published | not published | $133.14 – $2,482.82 | 38 |
| Mast simple complete CPT 19303 | not published | not published | $154.46 – $2,482.82 | 38 |
| M.avium-intra dna amp prob CPT 87561 | not published | not published | $17.13 – $80.01 | 24 |
| M.avium-intra dna dir prob CPT 87560 | not published | not published | $9.64 – $62.22 | 24 |
| Maxillofacial fixation CPT 21100 | not published | not published | $99.06 – $2,702.95 | 38 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $205.20 | $342.00 | $5.29 – $32.97 | 24 |
| Mayo aathr protein s free CPT 85306 | $291.00 | $485.00 | $6.61 – $34.93 | 24 |
| Mayo activated protein c resistance assay CPT 85307 | $253.20 | $422.00 | $6.61 – $34.93 | 24 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | not published | not published | $15.43 – $87.94 | 22 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | not published | not published | $5.11 – $30.71 | 13 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | not published | not published | $4.46 – $51.87 | 15 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $52.20 | $87.00 | $6.61 – $33.70 | 24 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | not published | not published | $8.21 – $51.87 | 15 |
| Mayo alpha 1 antitrypsin CPT 82103 | $151.20 | $252.00 | $5.29 – $30.64 | 24 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $199.80 | $333.00 | $7.44 – $34.38 | 24 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | not published | not published | $5.18 – $29.64 | 13 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | not published | not published | $4.03 – $51.87 | 15 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | not published | not published | $60.06 – $277.32 | 22 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $657.60 | $1,096.00 | $43.83 – $208.98 | 22 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | not published | not published | $54.80 – $312.36 | 20 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $2,158.20 | $3,597.00 | $540.00 – $2,644.80 | 22 |
| Mayo androstenedione CPT 82157 | $277.20 | $462.00 | $10.58 – $66.76 | 24 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $213.00 | $355.00 | $6.61 – $33.29 | 24 |
| Mayo antithrombin iii antigen CPT 85301 | $259.20 | $432.00 | $5.34 – $24.65 | 24 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $36.00 | $60.00 | $5.29 – $34.31 | 24 |
| Mayo avwpr vw factor activity CPT 85397 | $55.80 | $93.00 | $9.42 – $70.36 | 22 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | not published | not published | $14.04 – $136.85 | 16 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | not published | not published | $4.32 – $51.87 | 15 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $110.40 | $184.00 | $5.02 – $23.21 | 24 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $428.40 | $714.00 | $60.88 – $330.24 | 21 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | not published | not published | $85.85 – $489.33 | 21 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $148.80 | $248.00 | $3.97 – $29.41 | 24 |
| Mayo bnzu sedative hypnotics definitive urine CPT 80368 | not published | not published | $4.18 – $51.87 | 15 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $36.00 | $60.00 | $3.97 – $30.07 | 24 |
| Mayo brcmg brucella antibody igm CPT 86622 | $30.60 | $51.00 | $3.97 – $20.36 | 24 |
| Mayo c1 esterase inhibitor CPT 83883 | $178.80 | $298.00 | $2.65 – $31.01 | 24 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | not published | not published | $5.33 – $51.87 | 15 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $187.20 | $312.00 | $1.70 – $38.46 | 24 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | not published | not published | $13.09 – $61.06 | 22 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | not published | not published | $60.36 – $278.66 | 15 |
| Mayo ceruloplasmin CPT 82390 | $104.40 | $174.00 | $5.08 – $24.49 | 24 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $194.40 | $324.00 | $5.29 – $32.19 | 24 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $184.80 | $308.00 | $5.29 – $29.37 | 24 |
| Mayo chlap chlamydia pneumoniae antibody igg CPT 86631 | not published | not published | $3.97 – $26.95 | 24 |
| Mayo chlap chlamydia pneumoniae antibody igm CPT 86632 | not published | not published | $3.97 – $28.91 | 24 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $173.40 | $289.00 | $59.26 – $265.60 | 24 |
| Mayo chromium CPT 82495 | $151.20 | $252.00 | $9.60 – $46.24 | 24 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | not published | not published | $4.90 – $51.87 | 15 |
| Mayo coccidioides antibody CPT 86635 | $150.00 | $250.00 | $3.97 – $26.15 | 24 |
| Mayo cocou cortisone urine CPT 82542 | $242.40 | $404.00 | $8.31 – $54.93 | 24 |
| Mayo cortisol free CPT 82530 | $208.80 | $348.00 | $7.91 – $38.10 | 24 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $84.60 | $141.00 | $16.85 – $102.60 | 25 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | not published | not published | $3.97 – $27.63 | 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.