Visits & medical services prices at Ascension St. Vincent Salem
Salem, IN · every code in this section with a posted price and a Medicare benchmark.
98 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Admn Sarscov2 Vacc 1 Dose (90480) range across 31 matching MRF lines |
$79.80–$108.60 | $133–$181 | varies |
| Airway Inhalation Treatment (94640) range across 2 matching MRF lines |
$67.80–$108.60 | $113–$181 | varies |
| Appl Modality 1/> Areas Ultrasound Ea 15 Min (97035) | $79.20 | $132 | 5.5× |
| Brncdilat rspse spmtry pre&post-brncdilat admn (94060) | $534 | $890 | 1.4× |
| Cardiac Stress Tst,Tracing Only (93017) | $1,161 | $1,935 | 5.1× |
| Cardiopulmonary resuscitation (92950) | $797.40 | $1,329 | 3.5× |
| Cardioversion (92960) range across 2 matching MRF lines |
$2,242.20–$2,262.60 | $3,737–$3,771 | varies |
| Cbt 1st hour (94644) | $226.20 | $377 | 1.6× |
| Chemo IV infusion addl hr (96415) | $318 | $530 | 4.2× |
| Chemo IV push addl drug (96411) | $223.20 | $372 | 2.9× |
| Chemother Prolong Infuse W/Pump (96416) | $259.20 | $432 | 0.7× |
| Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) | $534 | $890 | 7.0× |
| Chemotx admn IV nfs tq up 1 hr 1/1st sbst/drug (96413) | $582.60 | $971 | 1.7× |
| Chemotx admn IV push tq 1/1st sbst/drug (96409) | $282 | $470 | 0.8× |
| Color/duplex Doppler, complete (93975) | $1,425.60 | $2,376 | 5.6× |
| Color/duplex Doppler, limited (93976) | $998.40 | $1,664 | 9.0× |
| Cpap Ventilation Cpap Initiation&Mgmt (94660) | $679.20 | $1,132 | 2.9× |
| Critical care first hour (99291) | $1,923 | $3,205 | 2.2× |
| Debridement Open Wound 20 Sq Cm< (97597) range across 2 matching MRF lines |
$170.40–$378 | $284–$630 | varies |
| Dup-scan aorta ivc iliac vascl/bpgs uni/lmtd (93979) | $891 | $1,485 | 8.1× |
| Dup-scan lxtr art/artl bpgs compl bi study (93925) | $1,456.80 | $2,428 | 5.8× |
| Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) | $979.20 | $1,632 | 8.9× |
| Dup-Scan Xtr Veins Complete Bilateral Study (93970) | $1,554.60 | $2,591 | 6.2× |
| Dup-scan xtr veins unilateral/limited study (93971) | $1,077.60 | $1,796 | 9.7× |
| Duplex up extrem art bilat (93930) | $1,402.80 | $2,338 | 5.6× |
| Duplex up extrem art unilat/ltd (93931) | $986.40 | $1,644 | 8.9× |
| Echo Heart Xthoracic,Limited (93308) | $888.60 | $1,481 | 3.5× |
| Echo transesophageal (93312) | $3,094.20 | $5,157 | 5.4× |
| Echo Transesophageal - Congenital Tee Complete (93315) | $2,796 | $4,660 | 4.8× |
| Echo tthrc r-t 2d w/wo m-mode rest&strs cont ECG (93351) | $2,912.40 | $4,854 | 5.0× |
| Electrical Stimulation Ea 15 Min (97032) | $61.20 | $102 | 4.2× |
| Electrocardiogram Tracing (93005) | $273.60 | $456 | 4.4× |
| Emergency Dept Visit Level 2 (99282) | $450 | $750 | 2.8× |
| Emergency Dept Visit Level 3 (99283) | $688.20 | $1,147 | 2.4× |
| Emergency Dept Visit Level 4 (99284) | $1,060.80 | $1,768 | 2.4× |
| Er level 1 (99281) range across 3 matching MRF lines |
$216.60–$251.40 | $361–$419 | varies |
| Er level v (99285) | $1,492.20 | $2,487 | 2.4× |
| Exercise test for bronchospasm (94617) | $312 | $520 | 2.2× |
| External ECG rec>48hr<7d recording (93242) | $298.80 | $498 | 7.6× |
| External ECG rec>7d<15d recording (93246) | $595.80 | $993 | 15.1× |
| External Ecg Scanning Analysis Report (93226) range across 2 matching MRF lines |
$456–$912 | $760–$1,520 | varies |
| Extracranial Bilat Study (93880) | $1,141.20 | $1,902 | 4.5× |
| Holter monitor recording (93225) range across 2 matching MRF lines |
$321.60–$643.20 | $536–$1,072 | varies |
| Immunization administration (90471) | $79.80 | $133 | 1.0× |
| Iontophoresis 15 min (97033) | $98.40 | $164 | 5.2× |
| Irrig Drug Delivery Device (96523) | $171.60 | $286 | 2.7× |
| IV infusion hydration each additional hour (96361) | $337.80 | $563 | 6.8× |
| IV infusion hydration initial 31 min-1 hour (96360) | $443.40 | $739 | 2.0× |
| IV infusion ther proph addl sequential to 1 hr (96367) | $160.80 | $268 | 2.1× |
| IV infusion therapy prophylaxis/dx ea hour (96366) | $107.40 | $179 | 2.2× |
| IV push initial (96374) | $160.80 | $268 | 0.7× |
| Lwr Xtr Vasc Stdy Bilat (93924) | $1,006.80 | $1,678 | 4.4× |
| Med Nutr Ther, Subsq, Indiv, Ea 15 Min (97803) | $35.40 | $59 | 1.1× |
| Medical nutrition assmt&ivntj indiv each 15 mi (97802) | $35.40 | $59 | 1.0× |
| Multiple Sleep Latency Test (95805) | $3,264 | $5,440 | 3.6× |
| Neuromuscular Reeducation (97112) | $89.40 | $149 | 2.7× |
| Orthc/Prostc Mgmt Sbsq Enc (97763) | $77.40 | $129 | 1.5× |
| Orthotics Mgmt & Trainj Initial Enctr Ea 15 Mins (97760) range across 2 matching MRF lines |
$95.40–$97.80 | $159–$163 | varies |
| Ot eval high complexity (97167) | $284.40 | $474 | 2.8× |
| Ot Eval Low Complex (97165) | $171.60 | $286 | 1.7× |
| Ot Eval Moderate Complexity (97166) | $171.60 | $286 | 1.7× |
| Ot manual therapy 15 min (97140) | $88.80 | $148 | 3.2× |
| Ot paraffin bath (97018) | $46.80 | $78 | 7.8× |
| Ot Prosthetic Training, Each 15 Min (97761) range across 2 matching MRF lines |
$80.40–$93 | $134–$155 | varies |
| Ot Re-Eval Est Plan Care (97168) | $150 | $250 | 2.2× |
| Outpatient Cardiac Rehab W/Cont Ecg Monitoring (93798) | $288.60 | $481 | 2.1× |
| Phlebotomy therapeutic (99195) | $287.40 | $479 | 2.0× |
| Phys/qhp svcs op pulm rehab w/cont oximtry mntr (94626) | $231 | $385 | 3.7× |
| Phys/qhp svcs op pulm rehab wo cont oximtry mntr (94625) | $231 | $385 | 3.7× |
| Physical Performance Test (97750) | $61.20 | $102 | 1.8× |
| Plethysmography (94726) | $369.60 | $616 | 0.9× |
| Polysom 6/>Yrs Sleep W/Cpap 4/> Addl Param Attnd (95811) | $4,670.40 | $7,784 | 5.1× |
| Psychiatric diagnostic evaluation (90791) | $222.60 | $371 | 1.2× |
| Pt Eval High Complex (97163) | $301.20 | $502 | 3.1× |
| Pt eval low complex 20 min (97161) | $171.60 | $286 | 1.8× |
| Pt Eval Mod Complex (97162) | $171.60 | $286 | 1.8× |
| Pt gait training 15 min (97116) | $69.60 | $116 | 2.4× |
| Pt mechanical traction (97012) | $86.40 | $144 | 6.0× |
| Pt Re-Eval Est Plan Care (97164) | $165.60 | $276 | 2.5× |
| Pulmonary service/procedure (94799) | $102.60 | $171 | 0.8× |
| Pulmonary Stress Testing (94618) | $291 | $485 | 2.1× |
| Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) | $154.80 | $258 | 0.7× |
| Self Care Mngment Training (97535) | $67.20 | $112 | 2.1× |
| Sleep study unattended (95806) | $781.20 | $1,302 | 3.4× |
| Temp transcutaneous pacing (92953) range across 2 matching MRF lines |
$1,284.60–$1,303.80 | $2,141–$2,173 | varies |
| Ther Ivntj Cog Funcj Cntct 1st 15 Minutes (97129) | $91.80 | $153 | 4.1× |
| Ther Ivntj Ea Addl 15 Min (97130) | $79.80 | $133 | 3.8× |
| Ther Px 1/> Areas Each 15 Minutes Massage (97124) | $69.60 | $116 | 2.3× |
| Ther/Proph/Diag Inj Sc/Im (96372) range across 2 matching MRF lines |
$99.60–$125.40 | $166–$209 | varies |
| Ther/Proph/Diag Iv Inf Init (96365) | $627.60 | $1,046 | 2.8× |
| Therapeutic Activities (97530) | $81.60 | $136 | 2.3× |
| Tobacco Use Cessation Intermediate 3-10 Minutes (99406) | $79.80 | $133 | 2.0× |
| Tte w/doppler, complete (93306) | $2,909.40 | $4,849 | 5.0× |
| Tx/Pro/Dx Inj New Drug Addon (96375) | $144 | $240 | 2.9× |
| Upr/L Xtremity Art 2 Levels (93922) range across 3 matching MRF lines |
$328.80–$657.60 | $548–$1,096 | varies |
| Upr/Lxtr Art Stdy 3+ Lvls (93923) | $997.80 | $1,663 | 4.4× |
| Vital capacity, total (94150) | $96 | $160 | 0.7× |
| Wheelchair Mgmt Ea 15 Min (97542) | $60.60 | $101 | 2.0× |
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.