St. Vincent Salem Hospital, Inc.
St. Vincent Salem Hospital, Inc. in Salem, IN publishes cash prices for 40 common procedures listed here, from its own machine-readable price file updated —. Click a procedure to compare it with other hospitals nearby.
911 N Shelby St Salem IN 47167 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS W/C | $3,012.00 | $5,020.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN AND PELVIS W/C | $3,012.00 | $5,020.00 | 40% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN AND PELVIS W/C | $3,012.00 | $5,020.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO/C | $1,252.80 | $2,088.00 | 40% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN WO/C | $1,252.80 | $2,088.00 | 40% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN WO/C | $1,252.80 | $2,088.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/C | $1,433.40 | $2,389.00 | 40% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/C | $1,433.40 | $2,389.00 | 40% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/C | $1,433.40 | $2,389.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO FFD W/WO CAD DX BI | $324.00 | $540.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI | $324.00 | $540.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO FFD W/WO CAD DX BI | $324.00 | $540.00 | 40% |
| Diagnostic mammogram, both breasts both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI | $324.00 | $540.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO ADDL FFD W/WO CAD DX BI | $324.00 | $540.00 | 40% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 MAMMO FFD W/WO CAD DX BI | $324.00 | $540.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO FFD W/WO CAD DX UNI | $228.00 | $380.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO FFD W/WO CAD DX UNI | $228.00 | $380.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI | $228.00 | $380.00 | 40% |
| Diagnostic mammogram, one breast CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI | $228.00 | $380.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO FFD W/WO CAD DX UNI | $228.00 | $380.00 | 40% |
| Diagnostic mammogram, one breast inpatient CPT 77065 MAMMO ADDL FFD W/WO CAD DX UNI | $228.00 | $380.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI LOW EXTR ANY JNT W/O BI | $3,898.80 | $6,498.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye both sides CPT 73721 MRI LOW EXTR ANY JNT W/O BI | $3,898.80 | $6,498.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTR ANY JNT W/O UNI | $1,949.40 | $3,249.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI LOW EXTR ANY JNT W/O UNI | $1,949.40 | $3,249.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient both sides CPT 73721 MRI LOW EXTR ANY JNT W/O BI | $3,898.80 | $6,498.00 | 40% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI LOW EXTR ANY JNT W/O UNI | $1,949.40 | $3,249.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI LOW EXTR ANY JNT WO/WC BI | $4,604.40 | $7,674.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye both sides CPT 73723 MRI LOW EXTR ANY JNT WO/WC BI | $4,604.40 | $7,674.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTR ANY JNT WO/WC UNI | $2,302.20 | $3,837.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI LOW EXTR ANY JNT WO/WC UNI | $2,302.20 | $3,837.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient both sides CPT 73723 MRI LOW EXTR ANY JNT WO/WC BI | $4,604.40 | $7,674.00 | 40% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI LOW EXTR ANY JNT WO/WC UNI | $2,302.20 | $3,837.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C | $1,638.00 | $2,730.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY OR IAC WO/C(-XU) | $1,638.00 | $2,730.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI PITUITARY OR IAC WO/C(-XU) | $1,638.00 | $2,730.00 | 40% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN WO/C | $1,638.00 | $2,730.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI PITUITARY OR IAC WO/C(-XU) | $1,638.00 | $2,730.00 | 40% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN WO/C | $1,638.00 | $2,730.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/WC | $2,489.40 | $4,149.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN WO/WC | $2,489.40 | $4,149.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU) | $2,489.40 | $4,149.00 | 40% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU) | $2,489.40 | $4,149.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN WO/WC | $2,489.40 | $4,149.00 | 40% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI PITUITRY OR IAC WO/WC(-XU) | $2,489.40 | $4,149.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO/C | $1,845.60 | $3,076.00 | 40% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE WO/C | $1,845.60 | $3,076.00 | 40% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI LUMBAR SPINE WO/C | $1,845.60 | $3,076.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER>=14WK SNG/1STGEST | $506.40 | $844.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTER>=14WK SNG/1STGEST | $506.40 | $844.00 | 40% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTER>=14WK SNG/1STGEST | $506.40 | $844.00 | 40% |
| Screening mammogram, both breasts CPT 77067 MAMMO FFD W/WO CAD SCREENING | $206.40 | $344.00 | 40% |
| Screening mammogram, both breasts CPT 77067 MAMMO FFD W/WO CAD SCREENING | $206.40 | $344.00 | 40% |
| Screening mammogram, both breasts inpatient CPT 77067 MAMMO FFD W/WO CAD SCREENING | $206.40 | $344.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STAGING 4+ PARAM 6YR/> | $4,037.40 | $6,729.00 | 40% |
| Sleep study in a lab (polysomnography) CPT 95810 SLEEP STAGING 4+ PARAM 6YR/> | $4,037.40 | $6,729.00 | 40% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 SLEEP STAGING 4+ PARAM 6YR/> | $4,037.40 | $6,729.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC | $421.20 | $702.00 | 40% |
| Transvaginal pelvic ultrasound CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC | $421.20 | $702.00 | 40% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 ULS TRANSVAGINAL NON-OBSTETRIC | $421.20 | $702.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD B-SCAN+/OR REAL T COMP | $742.80 | $1,238.00 | 40% |
| Ultrasound of the abdomen, complete CPT 76700 US ABD B-SCAN+/OR REAL T COMP | $742.80 | $1,238.00 | 40% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABD B-SCAN+/OR REAL T COMP | $742.80 | $1,238.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS | $500.40 | $834.00 | 40% |
| X-ray of the lower back, 4 or more views CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS | $500.40 | $834.00 | 40% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 XR SPINE LUMBOSACRAL 4+ VIEWS | $500.40 | $834.00 | 40% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $232.20 | $387.00 | 40% |
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $232.20 | $387.00 | 40% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $232.20 | $387.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $282.60 | $471.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $282.60 | $471.00 | 40% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $282.60 | $471.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 #CBC+DIFF WBC;CMPLT AUTO | $24.00 | $40.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 #CBC+DIFF WBC;CMPLT AUTO | $24.00 | $40.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC+DIFF WBC; CMPLT AUTO | $117.00 | $195.00 | 40% |
| Complete blood count (CBC) with differential CPT 85025 CBC+DIFF WBC; CMPLT AUTO | $117.00 | $195.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 #CBC+DIFF WBC;CMPLT AUTO | $24.00 | $40.00 | 40% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC+DIFF WBC; CMPLT AUTO | $117.00 | $195.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL | $19.20 | $32.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL | $19.20 | $32.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT | $93.00 | $155.00 | 40% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT | $93.00 | $155.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 #CBC AUTM HGB-HCT-RBC-WBC-PLTL | $19.20 | $32.00 | 40% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTM HGB-HCT-RBC-WBC-PLTLT | $93.00 | $155.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $268.80 | $448.00 | 40% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $268.80 | $448.00 | 40% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPREHENSIVE METABOLIC PANEL | $268.80 | $448.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $322.20 | $537.00 | 40% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $322.20 | $537.00 | 40% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNCTION PANEL | $322.20 | $537.00 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $231.00 | $385.00 | 40% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $231.00 | $385.00 | 40% |
| Liver function blood test panel inpatient CPT 80076 HEPATIC FUNCTION PANEL | $231.00 | $385.00 | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $398.40 | $664.00 | 40% |
| Obstetric blood test panel CPT 80055 OBSTETRIC PANEL | $398.40 | $664.00 | 40% |
| Obstetric blood test panel inpatient CPT 80055 OBSTETRIC PANEL | $398.40 | $664.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE | $63.60 | $106.00 | 40% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE | $63.60 | $106.00 | 40% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 #PROSTATE SPECIFIC AG/PSA;FREE | $63.60 | $106.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL | $56.40 | $94.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL | $56.40 | $94.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL | $206.40 | $344.00 | 40% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL | $206.40 | $344.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 #PROSTATE SPECIFIC AG(PSA);TTL | $56.40 | $94.00 | 40% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PROSTATE SPECIFIC AG(PSA);TTL | $206.40 | $344.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD | $18.60 | $31.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD | $18.60 | $31.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA | $120.60 | $201.00 | 40% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA | $120.60 | $201.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 #THROMBOPLAST PTT;PLSM/WHL BLD | $18.60 | $31.00 | 40% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 THROMBOPLASTIN TIME PTT;PLASMA | $120.60 | $201.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 #PROTHROMBIN TIME | $11.40 | $19.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 #PROTHROMBIN TIME | $11.40 | $19.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $93.00 | $155.00 | 40% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $93.00 | $155.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 #PROTHROMBIN TIME | $11.40 | $19.00 | 40% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $93.00 | $155.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 #THYROID STIMULAT HORMONE(TSH) | $90.60 | $151.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 #THYROID STIMULAT HORMONE(TSH) | $90.60 | $151.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULAT HORMONE(TSH) | $236.40 | $394.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULAT HORMONE(TSH) | $236.40 | $394.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 #THYROID STIMULAT HORMONE(TSH) | $90.60 | $151.00 | 40% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULAT HORMONE(TSH) | $236.40 | $394.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALS DIPSTICK AUTO W/MICR | $94.80 | $158.00 | 40% |
| Urinalysis with microscope exam, automated CPT 81001 URINALS DIPSTICK AUTO W/MICR | $94.80 | $158.00 | 40% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALS DIPSTICK AUTO W/MICR | $94.80 | $158.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 #URINALYSIS DIP STICK;AUTO | $7.20 | $12.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 #URINALYSIS DIP STICK;AUTO | $7.20 | $12.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALS DIPSTICK AUTO WO/MICR | $93.00 | $155.00 | 40% |
| Urinalysis without microscope exam, automated CPT 81003 URINALS DIPSTICK AUTO WO/MICR | $93.00 | $155.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 #URINALYSIS DIP STICK;AUTO | $7.20 | $12.00 | 40% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALS DIPSTICK AUTO WO/MICR | $93.00 | $155.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 #URINALYSIS DIP STICK;NON-AUTO | $9.00 | $15.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 #URINALYSIS DIP STICK;NON-AUTO | $9.00 | $15.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI | $42.60 | $71.00 | 40% |
| Urinalysis without microscope exam, manual CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI | $42.60 | $71.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 #URINALYSIS DIP STICK;NON-AUTO | $9.00 | $15.00 | 40% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 URINALS DIPSTICK NON-AUTOWO/MI | $42.60 | $71.00 | 40% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Prostate biopsy CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE | $4,686.60 | $7,811.00 | 40% |
| Prostate biopsy CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE | $4,686.60 | $7,811.00 | 40% |
| Prostate biopsy inpatient CPT 55700 BX PROSTATE; NDL/PUNCH SINGLE | $4,686.60 | $7,811.00 | 40% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/ PATIENT | $204.60 | $341.00 | 40% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/ PATIENT | $204.60 | $341.00 | 40% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYTX W/ PATIENT | $204.60 | $341.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT | $204.60 | $341.00 | 40% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PATIENT | $204.60 | $341.00 | 40% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYTX W/O PATIENT | $204.60 | $341.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $241.80 | $403.00 | 40% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $241.80 | $403.00 | 40% |
| Group psychotherapy session inpatient CPT 90853 GROUP PSYCHOTHERAPY | $241.80 | $403.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISES 1-15 | $93.60 | $156.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT TX EXERCISES EA 15MIN | $93.60 | $156.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT TX EXERCISES EA 15MIN | $93.60 | $156.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUTIC EXERCISES 1-15 | $93.60 | $156.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT TX EXERCISES EA 15MIN | $93.60 | $156.00 | 40% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUTIC EXERCISES 1-15 | $93.60 | $156.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUTES | $205.80 | $343.00 | 40% |
| Psychotherapy session, 30 minutes CPT 90832 PSYTX PT&/FAMILY 30 MINUTES | $205.80 | $343.00 | 40% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYTX PT&/FAMILY 30 MINUTES | $205.80 | $343.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTES | $256.80 | $428.00 | 40% |
| Psychotherapy session, 45 minutes CPT 90834 PSYTX PT&/FAMILY 45 MINUTES | $256.80 | $428.00 | 40% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYTX PT&/FAMILY 45 MINUTES | $256.80 | $428.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTES | $283.80 | $473.00 | 40% |
| Psychotherapy session, 60 minutes CPT 90837 PSYTX PT&/FAMILY 60 MINUTES | $283.80 | $473.00 | 40% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYTX PT&/FAMILY 60 MINUTES | $283.80 | $473.00 | 40% |