Ascension St. Vincent Salem
Salem, IN · Critical Access Hospital
Posts prices for 36 of the 66 common shoppable procedures we track. Price file retrieved 2026-10-01.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| CT head/brain without contrast (70450) | $1,252.80 | $2,088 | 11.3× |
| MRI brain without contrast (70551) | $1,638 | $2,730 | 6.5× |
| MRI brain with contrast (70552) | $2,412.60 | $4,021 | 6.5× |
| MRI brain without and with contrast (70553) | $2,489.40 | $4,149 | 6.7× |
| X-ray lower spine, 4+ views (72110) | $500.40 | $834 | 4.5× |
| MRI lumbar spine without contrast (72148) | $1,845.60 | $3,076 | 7.3× |
| CT pelvis with contrast (72193) | $1,433.40 | $2,389 | 7.7× |
| MRI lower-extremity joint without contrast (73721) range across 2 matching MRF lines |
$1,949.40–$3,898.80 | $3,249–$6,498 | varies |
| CT abdomen and pelvis with contrast (74177) | $3,012 | $5,020 | 8.2× |
| Ultrasound, abdomen complete (76700) | $742.80 | $1,238 | 6.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $506.40 | $844 | 4.6× |
| Ultrasound, transvaginal (76830) | $421.20 | $702 | 3.8× |
| Mammography, one breast (diagnostic) (77065) | $228 | $380 | 2.6× |
| Mammography, both breasts (diagnostic) (77066) | $324 | $540 | 2.9× |
| Mammography, screening (bilateral) (77067) | $206.40 | $344 | 2.3× |
| Basic metabolic panel (80048) | $232.20 | $387 | 27.4× |
| Comprehensive metabolic panel (80053) | $268.80 | $448 | 25.5× |
| Obstetric panel (80055) | $398.40 | $664 | 8.3× |
| Lipid panel (80061) | $282.60 | $471 | 21.1× |
| Renal function panel (80069) | $322.20 | $537 | 37.1× |
| Hepatic function panel (80076) | $231 | $385 | 28.3× |
| Urinalysis, non-automated, without microscopy (81002) range across 2 matching MRF lines |
$9–$42.60 | $15–$71 | varies |
| PSA, total (84153) range across 2 matching MRF lines |
$56.40–$206.40 | $94–$344 | varies |
| Thyroid stimulating hormone (TSH) (84443) range across 2 matching MRF lines |
$90.60–$236.40 | $151–$394 | varies |
| CBC with automated differential (85025) range across 2 matching MRF lines |
$24–$117 | $40–$195 | varies |
| CBC, automated (85027) range across 2 matching MRF lines |
$19.20–$93 | $32–$155 | varies |
| Prothrombin time (PT) (85610) range across 2 matching MRF lines |
$11.40–$93 | $19–$155 | varies |
| Partial thromboplastin time (PTT) (85730) range across 2 matching MRF lines |
$18.60–$120.60 | $31–$201 | varies |
| Psychotherapy, 30 minutes (90832) | $205.80 | $343 | 1.1× |
| Psychotherapy, 45 minutes (90834) | $256.80 | $428 | 1.4× |
| Psychotherapy, 60 minutes (90837) | $283.80 | $473 | 1.5× |
| Family psychotherapy, without patient (50 min) (90846) | $204.60 | $341 | 1.1× |
| Family psychotherapy, with patient (50 min) (90847) | $204.60 | $341 | 1.1× |
| Group psychotherapy (90853) | $241.80 | $403 | 2.2× |
| Sleep study (attended polysomnography) (95810) | $4,037.40 | $6,729 | 4.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) | $93.60 | $156 | 3.2× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
As a Critical Access Hospital, Medicare pays this facility about 101% of its own costs. The × Medicare column compares the cash price against that cost-based benchmark, not a standard rate.
More prices at this hospital
- Imaging: 233 codes with posted prices and Medicare benchmarks
- Lab & pathology: 636 codes with posted prices and Medicare benchmarks
- Visits & medical services: 98 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 49 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 14 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (ZIP, 23.6 MB) ↓ — captured 2026-10-01
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.