Ascension St Vincent Salem

911 N Shelby St, Salem, IN 47167 · (812) 883-5881

Critical Access HospitalsVoluntary non-profit - PrivateLouisville/Jefferson County, KY-IN metro Part of St Vincent Health · 2 hospitals Website ↗Website taken from the domain of its price file

Price file

Prices published

File dated 2026-01-01

4,584 price rows for 68 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 2 lines · metro median $83

$232

cash

$3 to $19

56 negotiated rates

$387

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 2 lines · metro median $1,781

$3,012

cash

$222 to $3,677

108 negotiated rates

$5,020

list

CT scan of the head, no contrast

CPT 70450 · lowest of 2 lines · metro median $967

$1,253

cash

$67 to $1,529

108 negotiated rates

$2,088

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 2 lines · metro median $973

$1,433

cash

$111 to $1,750

108 negotiated rates

$2,389

list

Cataract surgery with lens implant

CPT 66984

—

cash

$459 to $1,257

43 negotiated rates

—

list

Cesarean delivery with prenatal and postpartum care

CPT 59510

—

cash

$2,263 to $2,488

15 negotiated rates

—

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$7,940 to $19,901

33 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 4 lines · metro median $107

$107

cash

$17 to $80

83 negotiated rates

$179

list

Colonoscopy (diagnostic)

CPT 45378

—

cash

$268 to $464

43 negotiated rates

—

list

Colonoscopy with biopsy

CPT 45380

—

cash

$319 to $599

43 negotiated rates

—

list

Colonoscopy with polyp removal

CPT 45385

—

cash

$361 to $599

43 negotiated rates

—

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 4 lines · metro median $24

$24

cash

$4 to $18

83 negotiated rates

$40

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 2 lines · metro median $115

$269

cash

$5 to $24

56 negotiated rates

$448

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 4 lines · metro median $191

$324

cash

$103 to $327

115 negotiated rates

$540

list

Electrocardiogram (ECG) with interpretation

CPT 93000

—

cash

$11 to $32

24 negotiated rates

—

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 4 lines · metro median $133

$452

cash

$100 to $141

92 negotiated rates

$753

list

Family psychotherapy with the patient

CPT 90847 · lowest of 2 lines · metro median $590

$205

cash

$82 to $154

39 negotiated rates

$341

list

Family psychotherapy without the patient

CPT 90846 · lowest of 2 lines · metro median $606

$205

cash

$79 to $128

38 negotiated rates

$341

list

Gallbladder removal (laparoscopic)

CPT 47562

—

cash

$453 to $2,649

43 negotiated rates

—

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 4 lines · metro median $107

$107

cash

$17 to $80

83 negotiated rates

$179

list

Group psychotherapy

CPT 90853 · lowest of 2 lines · metro median $313

$242

cash

$20 to $43

39 negotiated rates

$403

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$7,940 to $19,901

33 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$7,940 to $19,901

33 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$7,940 to $19,901

33 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505

—

cash

$358 to $1,588

43 negotiated rates

—

list

Knee arthroscopy with meniscus repair

CPT 29881

—

cash

$376 to $1,487

43 negotiated rates

—

list

Laser treatment after cataract surgery (YAG)

CPT 66821

—

cash

$233 to $493

43 negotiated rates

—

list

Left heart catheterization

CPT 93452

—

cash

$345 to $14,592

45 negotiated rates

—

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 2 lines · metro median $143

$283

cash

$6 to $31

56 negotiated rates

$471

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $84

$231

cash

$3 to $19

57 negotiated rates

$385

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 4 lines · metro median $2,163

$2,489

cash

$233 to $3,039

164 negotiated rates

$4,149

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 4 lines · metro median $3,258

$1,949

cash

$148 to $4,760

165 negotiated rates

$3,249

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 2 lines · metro median $1,337

$1,846

cash

$167 to $2,253

110 negotiated rates

$3,076

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 2 lines · metro median $1,462

$1,850

cash

$167 to $2,259

109 negotiated rates

$3,084

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$7,940 to $19,901

33 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483

—

cash

$103 to $463

43 negotiated rates

—

list

New patient office visit (about 30 minutes)

CPT 99203

—

cash

$74 to $106

24 negotiated rates

—

list

New patient office visit (about 45 minutes)

CPT 99204

—

cash

$115 to $162

24 negotiated rates

—

list

New patient office visit (about 60 minutes)

CPT 99205

—

cash

$143 to $201

24 negotiated rates

—

list

PSA test (prostate)

CPT 84153 · lowest of 4 lines · metro median $78

$56

cash

$10 to $42

85 negotiated rates

$94

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 4 lines · metro median $49

$19

cash

$3 to $14

85 negotiated rates

$31

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 4 lines · metro median $94

$94

cash

$22 to $40

78 negotiated rates

$156

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 2 lines · metro median $289

$506

cash

$67 to $618

109 negotiated rates

$844

list

Preventive visit, new patient age 18 to 39

CPT 99385

—

cash

$92 to $131

24 negotiated rates

—

list

Preventive visit, new patient age 40 to 64

CPT 99386

—

cash

$106 to $161

24 negotiated rates

—

list

Prostate biopsy

CPT 55700 · lowest of 2 lines · metro median $1,836

$4,687

cash

$114 to $6,693

90 negotiated rates

$7,811

list

Prostate removal (laparoscopic)

CPT 55866

—

cash

$1,225 to $2,792

24 negotiated rates

—

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 4 lines · metro median $27

$11

cash

$3 to $10

84 negotiated rates

$19

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 2 lines · metro median $312

$206

cash

$49 to $86

39 negotiated rates

$343

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 2 lines · metro median $606

$257

cash

$65 to $129

39 negotiated rates

$428

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 2 lines · metro median $560

$284

cash

$98 to $194

38 negotiated rates

$473

list

Removal of a breast lump (biopsy by excision)

CPT 19120

—

cash

$336 to $1,439

43 negotiated rates

—

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 2 lines · metro median $154

$206

cash

$85 to $270

73 negotiated rates

$344

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

$123 to $1,224

24 negotiated rates

—

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 2 lines · metro median $4,037

$4,037

cash

$420 to $3,560

43 negotiated rates

$6,729

list

Spinal injection, lower back, no imaging guidance

CPT 62322

—

cash

$85 to $463

34 negotiated rates

—

list

Spinal injection, lower back, with imaging guidance

CPT 62323

—

cash

$98 to $1,471

44 negotiated rates

—

list

TSH test (thyroid)

CPT 84443 · lowest of 4 lines · metro median $91

$91

cash

$8 to $38

84 negotiated rates

$151

list

Tonsils and adenoids removal (under age 12)

CPT 42820

—

cash

$207 to $2,703

43 negotiated rates

—

list

Transvaginal ultrasound

CPT 76830 · lowest of 2 lines · metro median $434

$421

cash

$67 to $514

110 negotiated rates

$702

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 2 lines · metro median $743

$743

cash

$67 to $907

109 negotiated rates

$1,238

list

Upper endoscopy (EGD)

CPT 43235

—

cash

$154 to $460

43 negotiated rates

—

list

Upper endoscopy with biopsy

CPT 43239

—

cash

$270 to $460

43 negotiated rates

—

list

Urinalysis with microscope

CPT 81001 · lowest of 2 lines · metro median $40

$95

cash

$2 to $7

56 negotiated rates

$158

list

Vaginal delivery after a previous cesarean

CPT 59610

—

cash

$2,313 to $2,324

15 negotiated rates

—

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$7,940 to $19,901

33 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400

—

cash

$2,198 to $2,263

15 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 2 lines · metro median $500

$500

cash

$33 to $556

56 negotiated rates

$834

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/in-csv/270847538_st-vincent-salem-hospital-inc_standardcharges.csv
Ascension St. Vincent Salem (St. Vincent Salem Hospital, Inc.) · parsed · tall v3.0.0 · file dated 2026-01-01 · 22.5 MB · 4584 price rows read · read Nov 2026