Ascension St. Vincent Williamsport (St. Vincent Williamsport Hospital, Inc.)
412 N Monroe St, Williamsport, IN · Ascension · · NPI 1518913565
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 |
|---|---|---|---|---|
| X-ray bone survey complete CPT 77075 | $1,020.00 | $1,700.00 | $12.16 – $250.00 | 23 |
| X-ray bone survey infant CPT 77076 | $792.00 | $1,320.00 | $10.92 – $250.00 | 23 |
| X-ray cervical spine 2-3 views CPT 72040 | $378.00 | $630.00 | $4.59 – $250.00 | 23 |
| X-ray cervical spine 4-5 views CPT 72050 | $505.20 | $842.00 | $6.56 – $250.00 | 23 |
| X-ray cervical spine >= 6 views CPT 72052 | $631.20 | $1,052.00 | $8.22 – $250.00 | 23 |
| X-ray clavicle complete (both sides) CPT 73000 | $594.00 | $990.00 | $3.49 – $250.00 | 23 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | not published | not published | $16.76 – $253.34 | 23 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | not published | not published | $22.91 – $351.77 | 23 |
| X-ray consultation CPT 76140 | not published | not published | $10.00 – $10.00 | 11 |
| X-ray elbow 2 views (both sides) CPT 73070 | $410.40 | $684.00 | $3.44 – $250.00 | 23 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $561.60 | $936.00 | $4.24 – $250.00 | 23 |
| Xray endovasc thor ao repr CPT 75956 | not published | not published | $135.30 – $279.91 | 21 |
| Xray endovasc thor ao repr CPT 75957 | not published | not published | $165.42 – $281.39 | 21 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | not published | not published | $10.39 – $250.00 | 23 |
| X-ray exam entire spi 4/5 vw CPT 72083 | $484.20 | $807.00 | $9.11 – $158.11 | 39 |
| X-ray exam entire spi 6/> vw CPT 72084 | $629.40 | $1,049.00 | $10.88 – $185.17 | 39 |
| X-ray exam of arm infant CPT 73092 | $270.00 | $450.00 | $3.49 – $250.00 | 23 |
| X-ray exam of eye sockets CPT 70200 | $336.60 | $561.00 | $5.66 – $60.81 | 22 |
| X-ray exam of femur 1 CPT 73551 | $270.00 | $450.00 | $3.75 – $250.00 | 21 |
| X-ray exam of jaw joint CPT 70328 | not published | not published | $3.74 – $45.73 | 22 |
| X-ray exam of jaw joint CPT 70332 | not published | not published | $11.95 – $213.54 | 22 |
| X-ray exam of mastoids CPT 70120 | not published | not published | $4.29 – $55.07 | 22 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $5.97 – $76.62 | 22 |
| X-ray exam of penis CPT 74445 | not published | not published | $12.96 – $136.74 | 22 |
| X-ray exam of perineum CPT 74775 | not published | not published | $11.23 – $148.30 | 41 |
| X-ray exam of salivary gland CPT 70380 | not published | not published | $4.66 – $59.39 | 22 |
| X-ray exam of sinuses CPT 70210 | $235.20 | $392.00 | $3.91 – $45.01 | 22 |
| X-ray exam of tear duct CPT 70170 | not published | not published | $6.60 – $178.54 | 22 |
| X-ray exam of teeth CPT 70300 | not published | not published | $1.87 – $23.66 | 22 |
| X-ray exam of teeth CPT 70310 | not published | not published | $3.91 – $61.54 | 22 |
| X-ray exam si joints CPT 72200 | not published | not published | $3.69 – $42.86 | 22 |
| X-ray exam thorac spine4/>vw CPT 72074 | $486.00 | $810.00 | $5.79 – $250.00 | 23 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $463.20 | $772.00 | $3.46 – $42.86 | 22 |
| X-ray facial bones complete > 3 views CPT 70150 | $369.00 | $615.00 | $5.46 – $250.00 | 23 |
| X-ray fallopian tube CPT 74742 | not published | not published | $19.37 – $226.78 | 20 |
| X-ray femur >=2 views (both sides) CPT 73552 | $538.80 | $898.00 | $4.37 – $250.00 | 21 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $376.80 | $628.00 | $3.38 – $250.00 | 23 |
| X-ray foot 2 views (both sides) CPT 73620 | $451.20 | $752.00 | $3.40 – $250.00 | 23 |
| X-ray forearm 2 views (both sides) CPT 73090 | $550.80 | $918.00 | $3.49 – $250.00 | 23 |
| X-ray hand 2 views (both sides) CPT 73120 | $537.60 | $896.00 | $3.45 – $250.00 | 23 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $2.76 – $34.97 | 22 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $477.60 | $796.00 | $3.35 – $250.00 | 23 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $406.20 | $677.00 | $6.95 – $74.47 | 20 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $296.40 | $494.00 | $5.33 – $250.00 | 21 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $406.20 | $677.00 | $6.59 – $250.00 | 21 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $517.80 | $863.00 | $7.64 – $80.94 | 20 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $186.60 | $311.00 | $4.00 – $250.00 | 21 |
| X-ray humerus >= 2 views left CPT 73060 | $544.80 | $908.00 | $3.82 – $250.00 | 23 |
| X-ray joint survey 1 view CPT 77077 | not published | not published | $6.13 – $47.18 | 22 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $475.20 | $792.00 | $3.64 – $250.00 | 23 |
| X-ray knee 3 views (both sides) CPT 73562 | $643.20 | $1,072.00 | $4.24 – $250.00 | 23 |
| X-ray knee ap standing bilateral CPT 73565 | $415.80 | $693.00 | $3.74 – $52.92 | 22 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $412.80 | $688.00 | $3.49 – $250.00 | 23 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $375.60 | $626.00 | $6.03 – $58.67 | 22 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $505.80 | $843.00 | $6.74 – $250.00 | 23 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $486.00 | $810.00 | $8.73 – $96.75 | 22 |
| X-ray male genital tract CPT 74440 | not published | not published | $9.95 – $136.74 | 22 |
| X-ray mandible complete > 4 views CPT 70110 | $351.00 | $585.00 | $4.90 – $55.80 | 22 |
| X-ray mandible ltd <4 views CPT 70100 | $210.00 | $350.00 | $3.84 – $52.20 | 22 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $6.15 – $58.90 | 22 |
| X-ray nasal bones complete > 3 views CPT 70160 | $247.80 | $413.00 | $3.92 – $250.00 | 23 |
| X-ray neck soft tissue CPT 70360 | $212.40 | $354.00 | $3.36 – $250.00 | 23 |
| X-ray nose to rectum for foreign body child CPT 76010 | $279.60 | $466.00 | $3.60 – $250.00 | 23 |
| X-ray of mammary ducts CPT 77054 | not published | not published | $16.30 – $178.54 | 22 |
| X-ray optic foramina CPT 70190 | not published | not published | $4.49 – $52.20 | 22 |
| X-ray pelvis 1-2 views CPT 72170 | $234.00 | $390.00 | $3.46 – $250.00 | 23 |
| X-ray pelvis complete > 3 views CPT 72190 | $306.00 | $510.00 | $4.87 – $250.00 | 23 |
| Xray place dist ext thor ao CPT 75959 | not published | not published | $96.37 – $192.40 | 21 |
| Xray place prox ext thor ao CPT 75958 | not published | not published | $110.20 – $208.18 | 21 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | not published | not published | $12.99 – $250.00 | 42 |
| X-ray ribs 2 views left CPT 71100 | $278.40 | $464.00 | $4.17 – $250.00 | 23 |
| X-ray ribs 3 views bilateral CPT 71110 | $361.20 | $602.00 | $5.37 – $250.00 | 23 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $308.40 | $514.00 | $5.05 – $250.00 | 23 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $380.40 | $634.00 | $6.61 – $250.00 | 23 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $320.40 | $534.00 | $4.44 – $250.00 | 23 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $288.60 | $481.00 | $3.86 – $250.00 | 23 |
| X-ray scapula complete (both sides) CPT 73010 | $603.60 | $1,006.00 | $3.64 – $250.00 | 23 |
| X-ray sella turcica CPT 70240 | not published | not published | $3.56 – $42.86 | 22 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $417.60 | $696.00 | $3.07 – $34.97 | 22 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $345.60 | $576.00 | $5.17 – $250.00 | 23 |
| X-ray sinus tract/fistula/abscess CPT 76080 | not published | not published | $8.35 – $250.00 | 23 |
| X-ray skull < 4 views CPT 70250 | $315.00 | $525.00 | $4.56 – $50.78 | 22 |
| X-ray skull > 4 views complete CPT 70260 | $414.60 | $691.00 | $6.34 – $250.00 | 23 |
| X-ray slg plne bdy sect without urogr CPT 76100 | not published | not published | $14.84 – $140.56 | 22 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | not published | not published | $11.78 – $250.00 | 42 |
| X-ray small intestine follow-through study CPT 74248 | not published | not published | $11.34 – $128.50 | 20 |
| X-ray spine single view CPT 72020 | $232.20 | $387.00 | $3.02 – $250.00 | 23 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $277.20 | $462.00 | $4.78 – $53.65 | 22 |
| X-ray sternum > 2 views CPT 71120 | $262.80 | $438.00 | $4.35 – $44.31 | 22 |
| X-ray surgical specimen CPT 76098 | not published | not published | $2.70 – $316.07 | 23 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | not published | not published | $10.94 – $250.00 | 42 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $466.20 | $777.00 | $5.86 – $74.47 | 22 |
| X-ray thoracic spine 2 views CPT 72070 | $290.40 | $484.00 | $4.41 – $250.00 | 23 |
| X-ray thoracic spine 3 views CPT 72072 | $390.00 | $650.00 | $4.92 – $250.00 | 23 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $337.80 | $563.00 | $4.55 – $250.00 | 23 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $270.00 | $450.00 | $5.27 – $250.00 | 21 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $469.80 | $783.00 | $8.38 – $250.00 | 21 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $559.20 | $932.00 | $3.55 – $250.00 | 23 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $362.40 | $604.00 | $3.28 – $250.00 | 23 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | not published | not published | $14.76 – $194.44 | 41 |
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.