Ascension St. Vincent Randolph (St. Vincent Randolph Hospital, Inc.)
473 SE Greenville Ave, Winchester, IN · Ascension · · NPI 1609826783
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 |
|---|---|---|---|---|
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $64.63 – $1,515.56 | 38 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $93.03 – $1,515.56 | 38 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $164.04 – $1,515.56 | 38 |
| Limb exercise test CPT 95875 | not published | not published | $19.66 – $41.72 | 20 |
| Limited visual field xm CPT 92081 | not published | not published | $5.63 – $18.20 | 19 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $130.49 | $217.48 | $3.30 – $21.21 | 20 |
| Lipase CPT 83690 | $191.40 | $319.00 | $3.23 – $15.71 | 24 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $81.24 – $1,291.25 | 38 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $12.45 – $77.20 | 24 |
| Lipoprotein blood quant CPT 83704 | $269.40 | $449.00 | $15.58 – $77.95 | 22 |
| Lipoprotein direct measurement hdl CPT 83718 | $196.80 | $328.00 | $3.87 – $18.67 | 24 |
| Lipoprotein direct measurement ldl CPT 83721 | $185.40 | $309.00 | $3.97 – $23.94 | 24 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $14.02 – $77.95 | 22 |
| Lip surgery procedure CPT 40799 | not published | not published | $0.01 – $87.15 | 17 |
| Listeria monocytogenes CPT 86723 | $95.40 | $159.00 | $5.29 – $30.07 | 24 |
| Lithium therapeutic drug level CPT 80178 | $208.80 | $348.00 | $3.13 – $15.07 | 24 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | not published | not published | $133.22 – $133.22 | 8 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $265.13 – $840.00 | 19 |
| Liver elastography 91200 CPT 91200 | not published | not published | $5.22 – $495.69 | 20 |
| Liver Function Test CPT 80076 | $294.00 | $490.00 | $2.99 – $18.63 | 24 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $314.26 – $998.37 | 19 |
| Liver imaging CPT 78201 | not published | not published | $15.23 – $338.34 | 41 |
| Liver imag w/vasclr flow CPT 78202 | not published | not published | $17.05 – $366.36 | 41 |
| Liver/spleen imag static only CPT 78215 | not published | not published | $17.33 – $348.41 | 41 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $18.25 – $249.61 | 41 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $8.36 – $51.12 | 19 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $91.66 – $1,487.08 | 38 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $2.57 | $4.29 | $0.84 – $3.51 | 20 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $43.95 | $73.25 | $0.69 – $3.29 | 22 |
| Loudness balance test CPT 92562 | not published | not published | $3.99 – $30.91 | 19 |
| Low back disk surgery CPT 63030 | not published | not published | $196.26 – $3,321.81 | 38 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $2,834.40 | $4,724.00 | $45.27 – $448.02 | 41 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $2,362.80 | $3,938.00 | $43.10 – $650.00 | 42 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,890.00 | $3,150.00 | $35.75 – $650.00 | 42 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,995.20 | $4,992.00 | $59.65 – $700.00 | 42 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $2,496.60 | $4,161.00 | $50.49 – $485.37 | 41 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,996.80 | $3,328.00 | $35.16 – $700.00 | 42 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $397.80 | $663.00 | $4.83 – $250.00 | 23 |
| Lower jaw bone graft CPT 21215 | not published | not published | $178.70 – $3,692.26 | 38 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $2.21 – $700.25 | 19 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $141.40 – $4,445.47 | 38 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $163.58 – $4,445.47 | 38 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $161.62 – $4,445.47 | 38 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $178.04 – $4,445.47 | 38 |
| L/s ratio fetal lung CPT 83661 | $318.60 | $531.00 | $3.97 – $50.14 | 24 |
| Lumbar diskogram s&i CPT 72295 | not published | not published | $18.75 – $1,298.32 | 22 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $309.95 – $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 | $339.60 | $566.00 | $5.93 – $20.10 | 19 |
| Lung perfusion imaging CPT 78580 | not published | not published | $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 | $6.43 – $51.33 | 13 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $131.92 – $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 | $27.26 – $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 | $109.80 | $183.00 | $2.11 – $9.74 | 22 |
| Macroscopic exam parasite CPT 87169 | not published | not published | $2.02 – $9.83 | 22 |
| Magnesium CPT 83735 | $162.00 | $270.00 | $2.73 – $15.28 | 24 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $118.81 | $198.01 | $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 | $161.59 – $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 | $64.42 – $801.87 | 38 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $80.33 – $801.87 | 38 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $149.40 | $249.00 | $3.64 – $23.70 | 19 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $141.60 | $236.00 | $4.20 – $29.50 | 19 |
| Manipulation of hip joint CPT 27275 | not published | not published | $35.40 – $801.87 | 38 |
| Manipulation of spine CPT 22505 | not published | not published | $25.01 – $801.87 | 38 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $14.54 – $80.84 | 38 |
| Mannitol 12.5 gm/50 ml inj HCPCS J2150 | $40.12 | $66.86 | $2.20 – $5.87 | 15 |
| Manual diff wbc count b-coat CPT 85009 | not published | not published | $1.76 – $11.56 | 24 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $43.90 – $71.30 | 19 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $25.92 – $165.04 | 19 |
| Map tachycard site(s) CPT 93609 | not published | not published | $66.00 – $130.10 | 19 |
| Marker biop eviva buckle ss HCPCS A4648 | $248.40 | $414.00 | $200.00 – $200.00 | 11 |
| 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 | $186.23 – $2,482.82 | 38 |
| Mastoidectomy CPT 69501 | not published | not published | $111.76 – $2,702.95 | 38 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $148.20 – $2,702.95 | 38 |
| Mastoids complete CPT 70130 | $638.40 | $1,064.00 | $6.67 – $83.81 | 22 |
| Mastoid surgery revision CPT 69603 | not published | not published | $193.42 – $2,702.95 | 38 |
| Mastopexy CPT 19316 | not published | not published | $120.38 – $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 | $96.71 – $2,702.95 | 38 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $211.80 | $353.00 | $5.29 – $32.97 | 24 |
| Mayo aathr protein s free CPT 85306 | $648.60 | $1,081.00 | $6.61 – $34.93 | 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.