▸ Hospital · IN · CCN 151307

Ascension St. Vincent Williamsport

412 NORTH MONROE, WILLIAMSPORT, IN, 47993

16 bedsCritical Access Hospitals1

Compliance grade

100/100

Rates published

74,033

last crawl 2026-05-23

Procedures tracked

198

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All IN hospitals JSON

Source MRF: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/in-csv/350784551_st-vincent-williamsport-hospital-inc_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	16	—	—	$1,124	$13,400	$19,901
Psychiatric diagnostic evaluation	CPT	90791	7	—	—	$101.42	$115.91	$203.36
Psychiatric eval with medical services	CPT	90792	7	—	—	$109.4	$128.8	$210.5
Psychotherapy 30 minutes	CPT	90832	7	—	—	$49.13	$66.81	$85.78
Psychotherapy 45 minutes	CPT	90834	7	—	—	$65.16	$82.39	$128.83
Psychotherapy 60 minutes	CPT	90837	7	—	—	$97.58	$124.27	$194.22
Crisis psychotherapy 60 minutes	CPT	90839	7	—	—	$22.72	$121.83	$283.38
emergency
ED visit level 1	CPT	99281	7	$531	$318.6	$3.45	$26.06	$33.3
ED visit level 2	CPT	99282	7	$839	$503.4	$6.73	$49.16	$60.5
ED visit level 3	CPT	99283	7	$1,526	$915.6	$10.08	$78.77	$102.81
ED visit level 4	CPT	99284	7	$2,891	$1,734.6	$19.14	$146.03	$174.23
ED visit level 5	CPT	99285	7	$3,888	$2,332.8	$28.23	$217.84	$252.81
Critical care, first hour	CPT	99291	7	$4,961	$2,976.6	$36.28	$272.02	$330.48
imaging
CT head without contrast	CPT	70450	20	$2,191	$1,314.6	$23.94	$66.53	$1,460.96
CT head with contrast	CPT	70460	20	$2,738	$1,642.8	$33.31	$111.2	$1,464.83
CT head with and without contrast	CPT	70470	20	$3,284	$1,970.4	$39.5	$111.2	$1,756.94
CT neck with contrast	CPT	70491	20	$2,853	$1,711.8	$40.71	$119.1	$1,902.38
MRI brain without contrast	CPT	70551	20	$3,430	$2,058	$36.33	$148.3	$2,287.12
MRI brain with contrast	CPT	70552	20	$4,287	$2,572.2	$50.29	$250.13	$2,858.57
MRI brain with and without contrast	CPT	70553	20	$5,144	$3,086.4	$59.48	$232.74	$2,752.04
Chest X-ray single view	CPT	71045	18	$282	$169.2	$2.74	$19.01	$250
Chest X-ray 2 views	CPT	71046	18	$414	$248.4	$4.17	$29.77	$276.06
Chest X-ray 3 views	CPT	71047	7	$418	$250.8	$5.33	$22.96	$242.27
CT chest without contrast	CPT	71250	20	$2,068	$1,240.8	$36.28	$94.83	$1,378.94
CT chest with contrast	CPT	71260	20	$2,583	$1,549.8	$43.3	$119.58	$1,722.34
CT chest with and without contrast	CPT	71270	20	$3,255	$1,953	$49.1	$148.65	$2,170.43
MRI chest without contrast	CPT	71550	20	$3,404	$2,042.4	$52.07	$232.03	$2,269.79
MRI chest with contrast	CPT	71551	20	$4,254	$2,552.4	$61.83	$335.35	$2,836.57
MRI chest with and without contrast	CPT	71552	20	$5,106	$3,063.6	$80.61	$324.3	$3,404.68
Lumbosacral spine X-ray	CPT	72100	10	$556	$333.6	$4.83	$24.05	$370.74
CT cervical spine without contrast	CPT	72125	20	$2,827	$1,696.2	$36.4	$96.03	$1,512.45
CT thoracic spine without contrast	CPT	72128	20	$2,607	$1,564.2	$35.75	$95.55	$1,738.35
CT lumbar spine without contrast	CPT	72131	20	$2,594	$1,556.4	$35.75	$95.07	$1,729.68
MRI cervical spine without contrast	CPT	72141	20	$3,328	$1,996.8	$35.32	$167.02	$2,219.11
MRI thoracic spine without contrast	CPT	72146	20	$3,938	$2,362.8	$35.32	$166.62	$2,625.86
MRI lumbar spine without contrast	CPT	72148	20	$3,412	$2,047.2	$35.16	$167.79	$2,275.12
MRI lumbar spine with and without contrast	CPT	72149	20	$4,265	$2,559	$50.49	$250.13	$2,843.9
MRI cervical spine with and without contrast	CPT	72156	20	$4,991	$2,994.6	$59.76	$232.74	$3,328
MRI lumbar spine with contrast	CPT	72158	20	$5,117	$3,070.2	$59.65	$232.74	$2,737.6
CT pelvis without contrast	CPT	72192	20	$2,176	$1,305.6	$30.12	$70.2	$1,450.96
CT pelvis with contrast	CPT	72193	20	$2,719	$1,631.4	$41.27	$119.58	$1,813.03
Shoulder X-ray	CPT	73030	10	$878	$526.8	$3.87	$19.58	$585.45
Humerus X-ray	CPT	73060	10	$908	$544.8	$3.82	$19.58	$605.45
Hand X-ray 3 views	CPT	73130	10	$1,042	$625.2	$3.88	$18.91	$694.81
MRI upper extremity joint without contrast	CPT	73221	20	$6,180	$3,708	$37.14	$161.35	$4,120.82
MRI upper extremity joint with and without contrast	CPT	73223	20	$9,266	$5,559.6	$73.57	$330.92	$6,178.57
Hip X-ray 2 views	CPT	73510	6	—	—	$14.1	$21.3	$35.4
Knee X-ray 1-2 views	CPT	73560	10	$792	$475.2	$3.64	$18.22	$528.11
Ankle X-ray 3 views	CPT	73610	10	$1,012	$607.2	$3.88	$19.25	$674.8
MRI lower extremity joint without contrast	CPT	73721	20	$5,992	$3,595.2	$37.19	$174.63	$3,995.47
MRI lower extremity joint with and without contrast	CPT	73723	20	$8,984	$5,390.4	$73.85	$331.88	$5,990.53
CT abdomen without contrast	CPT	74150	20	$2,219	$1,331.4	$30.88	$77.1	$1,187.16
CT abdomen with contrast	CPT	74160	20	$2,774	$1,664.4	$44.89	$119.1	$1,484.09
CT abdomen with and without contrast	CPT	74170	20	$3,329	$1,997.4	$50.02	$140.01	$1,781.02
CT abdomen and pelvis without contrast	CPT	74176	20	$4,394	$2,636.4	$62.32	$147.3	$2,929.92
CT abdomen and pelvis with contrast	CPT	74177	20	$5,495	$3,297	$65.14	$232.74	$2,939.83
CT abdomen and pelvis with and without contrast	CPT	74178	20	$6,594	$3,956.4	$71.93	$232.74	$4,396.88
MRI abdomen without contrast	CPT	74181	20	$2,430	$1,458	$52.07	$178.45	$1,620.32
MRI abdomen with and without contrast	CPT	74183	20	$4,862	$2,917.2	$79.46	$275.04	$2,601.17
Abdominal ultrasound complete	CPT	76700	20	$1,335	$801	$23.01	$68.16	$890.18
Abdominal ultrasound limited	CPT	76705	20	$968	$580.8	$17.16	$66.53	$645.46
Retroperitoneal ultrasound complete	CPT	76770	20	$1,062	$637.2	$21.28	$66.53	$708.14
Obstetric ultrasound first trimester	CPT	76801	20	—	—	$23.2	$66.53	$400
Obstetric ultrasound after first trimester	CPT	76805	20	—	—	$26.71	$66.53	$400
Obstetric ultrasound with fetal anatomy	CPT	76811	20	—	—	$34.45	$129.05	$400
Transvaginal ultrasound	CPT	76830	20	$850	$510	$22.28	$66.53	$454.75
Pelvic ultrasound complete	CPT	76856	20	$1,004	$602.4	$20.59	$66.53	$669.47
Scrotal ultrasound	CPT	76870	10	$983	$589.8	$12.73	$51.12	$655.46
Diagnostic mammography unilateral	CPT	77065	20	$522	$313.2	$21.32	$85.87	$255.68
Diagnostic mammography bilateral	CPT	77066	20	$632	$379.2	$27.03	$109.51	$327.17
Screening mammography bilateral	CPT	77067	20	$514	$308.4	$21.77	$100.4	$270.19
EKG complete	CPT	93000	7	—	—	$2.81	$24.45	$32.45
EKG tracing only	CPT	93005	7	$491	$294.6	$1.36	$15.78	$19.71
EKG interpretation only	CPT	93010	7	$94	$56.4	$1.45	$8.67	$12.74
Transthoracic echocardiogram complete	CPT	93306	7	$4,388	$2,632.8	$45.57	$156.02	$557.6
Transthoracic echocardiogram	CPT	93307	7	$2,254	$1,352.4	$26.63	$90.45	$377.78
Stress echocardiogram	CPT	93350	7	—	—	$49.07	$110.96	$395.51
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	16	—	—	$7,939.93	$13,833	$19,901
COPD w MCC	MS-DRG	190	16	—	—	$7,939.93	$13,833	$19,901
COPD w CC	MS-DRG	191	16	—	—	$7,939.93	$13,833	$19,901
COPD w/o CC/MCC	MS-DRG	192	16	—	—	$7,939.93	$13,833	$19,901
Simple pneumonia & pleurisy w CC	MS-DRG	194	16	—	—	$7,939.93	$13,833	$19,901
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	16	—	—	$7,939.93	$13,833	$19,901
AMI discharged alive w MCC	MS-DRG	280	16	—	—	$7,939.93	$13,833	$19,901
AMI discharged alive w CC	MS-DRG	281	16	—	—	$7,939.93	$13,833	$19,901
AMI discharged alive w/o CC/MCC	MS-DRG	282	16	—	—	$7,939.93	$13,833	$19,901
Heart failure & shock w MCC	MS-DRG	291	16	—	—	$7,939.93	$13,833	$19,901
Heart failure & shock w CC	MS-DRG	292	16	—	—	$7,939.93	$13,833	$19,901
Heart failure & shock w/o CC/MCC	MS-DRG	293	16	—	—	$7,939.93	$13,833	$19,901
Cardiac arrhythmia w MCC	MS-DRG	308	16	—	—	$7,939.93	$13,833	$19,901
Cardiac arrhythmia w CC	MS-DRG	309	16	—	—	$7,939.93	$13,833	$19,901
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	16	—	—	$7,939.93	$13,833	$19,901
GI hemorrhage w CC	MS-DRG	378	16	—	—	$7,939.93	$13,833	$19,901
GI hemorrhage w/o CC/MCC	MS-DRG	379	16	—	—	$7,939.93	$13,833	$19,901
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	16	—	—	$7,939.93	$13,833	$19,901
Fractures of femur w/o MCC	MS-DRG	533	16	—	—	$7,939.93	$13,833	$19,901
Kidney/UTI w MCC	MS-DRG	689	16	—	—	$7,939.93	$13,833	$19,901
Kidney/UTI w/o MCC	MS-DRG	690	16	—	—	$7,939.93	$13,833	$19,901
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	16	—	—	$7,939.93	$13,833	$19,901
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	16	—	—	$7,939.93	$13,833	$19,901
Initial hospital care, low complexity	CPT	99221	7	—	—	$15.87	$97.63	$116.87
Initial hospital care, moderate complexity	CPT	99222	7	—	—	$21.81	$139.44	$158.41
Initial hospital care, high complexity	CPT	99223	7	—	—	$32.08	$205.76	$234.59
Hospital discharge, <30 min	CPT	99238	7	—	—	$11.73	$76.1	$85.42
Hospital discharge, >30 min	CPT	99239	7	—	—	$17.21	$108.35	$124.03
lab
Basic metabolic panel (BMP)	CPT	80048	19	$286	$171.6	$3.47	$8.46	$19.29
General health panel	CPT	80050	10	$542	$325.2	$14.55	$21.75	$195.16
Electrolyte panel	CPT	80051	19	$250	$150	$2.14	$7.01	$15.98
Comprehensive metabolic panel	CPT	80053	19	$439	$263.4	$5	$10.56	$24.08
Lipid panel	CPT	80061	19	$359	$215.4	$6.02	$13.39	$30.53
Renal function panel	CPT	80069	19	$421	$252.6	$4.11	$8.68	$19.79
Hepatic function panel	CPT	80076	19	$324	$194.4	$2.99	$8.17	$18.63
Urinalysis non-automated	CPT	81002	19	$80	$48	$1.32	$3.48	$7.93
Urinalysis automated	CPT	81003	19	$138	$82.8	$1.32	$2.25	$5.13
Glucose quantitative	CPT	82947	19	$96	$57.6	$1.94	$3.93	$8.96
Hemoglobin A1c	CPT	83036	19	$252	$151.2	$3.97	$9.71	$22.14
Thyroid stimulating hormone (TSH)	CPT	84443	19	$374	$224.4	$5.29	$16.8	$38.3
Complete blood count with automated differential	CPT	85025	19	$189	$113.4	$3.68	$7.77	$17.72
Complete blood count without differential	CPT	85027	19	$167	$100.2	$3.06	$6.47	$14.75
Urine culture bacterial	CPT	87086	19	$279	$167.4	$2.65	$8.07	$18.4
Urine culture identification	CPT	87088	19	$154	$92.4	$3.97	$8.09	$18.45
Tissue exam by pathologist level IV	CPT	88305	10	$796	$477.6	$10.55	$45.95	$277.37
maternity
Fetal non-stress test	CPT	59025	18	—	—	$8.25	$26.4	$61.67
Routine obstetric care including vaginal delivery	CPT	59400	5	—	—	$307.69	$2,263.19	$2,381.76
Vaginal delivery only	CPT	59409	7	—	—	$130.63	$794.3	$989.23
Vaginal delivery with postpartum	CPT	59410	5	—	—	$159.53	$1,089.77	$1,189.65
Routine obstetric care with C-section	CPT	59510	5	—	—	$348.34	$2,263.19	$2,637.16
C-section delivery only	CPT	59514	7	—	—	$146.94	$860.52	$1,169.6
C-section with postpartum	CPT	59515	5	—	—	$191.97	$1,221.1	$1,441.93
office
Office visit, new patient, 15-29 min	CPT	99202	7	—	—	$7.89	$57.26	$73.29
Office visit, new patient, 30-44 minutes	CPT	99203	7	—	—	$12.11	$87.49	$106.19
Office visit, new patient, 45-59 min	CPT	99204	7	—	—	$20.23	$147.33	$162.17
Office visit, new patient, 60-74 min	CPT	99205	7	—	—	$26.31	$191.56	$201.3
Office visit, established patient, 5 min	CPT	99211	7	$378	$226.8	$1.5	$13.74	$19.98
Office visit, established patient, 10-19 min	CPT	99212	7	$726	$435.6	$4.08	$29.97	$43
Office visit, established patient, 20-29 minutes	CPT	99213	7	$899	$539.4	$7.82	$57.54	$71.77
Office visit, established patient, 30-39 minutes	CPT	99214	7	$1,076	$645.6	$12.21	$89.1	$105.54
Office visit, established patient, 40-54 min	CPT	99215	7	$1,652	$991.2	$17.49	$126.82	$141.38
preventive
Upper GI endoscopy diagnostic	CPT	43235	18	—	—	$33.84	$214.9	$460.37
Upper GI endoscopy with biopsy	CPT	43239	18	—	—	$40.24	$274.3	$460.37
Sigmoidoscopy diagnostic	CPT	45330	18	—	—	$14.46	$150.92	$318.54
Sigmoidoscopy with biopsy	CPT	45331	18	—	—	$17.35	$111.99	$464.17
Colonoscopy diagnostic	CPT	45378	18	—	—	$50.85	$297.75	$528.94
Colonoscopy with biopsy	CPT	45380	18	—	—	$61.03	$358.77	$599.32
Colonoscopy with polyp removal	CPT	45385	18	—	—	$72.43	$425.99	$725.61
surgery
Total shoulder arthroplasty	CPT	23472	18	—	—	$285.69	$1,673.9	$13,700
Hip hemiarthroplasty	CPT	27125	7	—	—	$221.89	$1,461.9	$2,043.94
Total hip replacement	CPT	27130	18	—	—	$266	$1,975	$9,045.08
Total knee replacement	CPT	27447	18	—	—	$265.93	$2,089.4	$8,859.71
Knee revision arthroplasty single component	CPT	27486	7	—	—	$275.8	$1,887.3	$2,586.47
Knee revision arthroplasty all components	CPT	27487	7	—	—	$345.06	$2,439.3	$3,268.72
Shoulder arthroscopy with decompression	CPT	29826	7	—	—	$34.65	$940.3	$1,224.04
Shoulder arthroscopy with rotator cuff repair	CPT	29827	18	—	—	$207.73	$1,294.1	$3,321.81
Knee arthroscopy with meniscectomy	CPT	29881	18	—	—	$105.81	$791.7	$1,487.08
ACL reconstruction	CPT	29888	18	—	—	$193.11	$1,381.2	$4,403.04
Major small/large bowel procedures w MCC	MS-DRG	329	16	—	—	$7,939.93	$13,833	$19,901
Major small/large bowel procedures w CC	MS-DRG	330	16	—	—	$7,939.93	$13,833	$19,901
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	16	—	—	$7,939.93	$13,833	$19,901
CABG single arterial graft	CPT	33533	7	—	—	$457.57	$2,187.05	$3,552.71
CABG 2 arterial grafts	CPT	33534	7	—	—	$538.42	$2,829	$4,097.66
CABG 3 arterial grafts	CPT	33535	7	—	—	$600.5	$3,090.2	$4,517.63
CABG 4+ arterial grafts	CPT	33536	7	—	—	$647.54	$3,350.5	$4,834.88
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	16	—	—	$7,939.93	$13,833	$19,901
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	16	—	—	$7,939.93	$13,833	$19,901
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	16	—	—	$7,939.93	$13,833	$19,901
Open appendectomy	CPT	44950	7	—	—	$143.8	$685.7	$1,734.57
Laparoscopic appendectomy	CPT	44970	7	—	—	$131.4	$673	$1,620.38
Major joint replacement w MCC	MS-DRG	469	16	—	—	$7,939.93	$13,833	$19,901
Major joint replacement w/o MCC	MS-DRG	470	16	—	—	$7,939.93	$13,833	$19,901
Laparoscopic cholecystectomy	CPT	47562	18	—	—	$163.63	$892	$2,648.76
Lap cholecystectomy with cholangiography	CPT	47563	18	—	—	$168.66	$965.28	$10,581
Hip & femur procedures except major joint w MCC	MS-DRG	480	16	—	—	$7,939.93	$13,833	$19,901
Hip & femur procedures except major joint w CC	MS-DRG	481	16	—	—	$7,939.93	$13,833	$19,901
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	16	—	—	$7,939.93	$13,833	$19,901
Open umbilical hernia repair	CPT	49560	7	—	—	$165.01	$782.3	$1,988.48
Umbilical hernia repair age 5+	CPT	49585	7	—	—	$96.3	$472.8	$1,196.31
Lap inguinal hernia repair	CPT	49650	18	—	—	$94.14	$516.4	$2,648.76
Lap incisional hernia repair	CPT	49652	7	—	—	$194.34	$1,191.29	$2,006.09
Total abdominal hysterectomy	CPT	58150	7	—	—	$199.64	$1,202.18	$1,616.16
Vaginal hysterectomy	CPT	58260	18	—	—	$162.85	$1,039.67	$2,090.81
Lap-assisted vaginal hysterectomy	CPT	58550	18	—	—	$173.88	$1,213.6	$2,648.76
Lap-assisted vaginal hysterectomy >250g	CPT	58552	18	—	—	$194.63	$1,327.01	$4,445.47
Lap salpingo-oophorectomy	CPT	58661	18	—	—	$128.06	$856.61	$2,648.76
OR procedure for obesity w MCC	MS-DRG	619	17	—	—	$7,939.93	$13,965	$19,901
OR procedure for obesity w CC	MS-DRG	620	17	—	—	$7,939.93	$13,965	$19,901
OR procedure for obesity w/o CC/MCC	MS-DRG	621	17	—	—	$7,939.93	$13,965	$19,901
Complex cataract surgery	CPT	66982	18	—	—	$149.37	$1,085.3	$1,768.72
Cataract surgery with lens implant	CPT	66984	18	—	—	$119.97	$766.16	$1,257.21
Intravitreal injection	CPT	67028	18	—	—	$18.84	$72.77	$283.93
Vitrectomy mechanical	CPT	67042	18	—	—	$216.77	$1,559.34	$2,464.05
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	16	—	—	$7,939.93	$13,833	$19,901
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	16	—	—	$7,939.93	$13,833	$19,901
PCI single major coronary artery	CPT	92920	18	—	—	$113.54	$796.79	$9,845.53
PCI with drug-eluting stent	CPT	92928	18	—	—	$126.02	$884.66	$15,991
PCI bypass graft	CPT	92937	7	—	—	$125.94	$763.59	$15,991
Left heart catheterization	CPT	93452	19	—	—	$178.63	$611.42	$14,592
Coronary angiography with cath	CPT	93455	18	—	—	$208.63	$711.57	$2,261.57
Coronary angiography with bypass cath	CPT	93458	18	—	—	$217.44	$752.13	$2,340.29

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Payer mix (top 30)

Payer	Codes covered	Median rate
encore exclusive	198	$311.13
Anthem BCBS	198	$176.17
UnitedHealthcare	197	$126.7
patoka valley tier 2	158	$201.16
patoka valley tier 1	158	$201.16
mhs care connect	153	$97.35
Medicaid	153	$97.35
Aetna	141	$250.13
Humana	136	$464.17
smarthealth ppo/hdhp 20161001	109	$232.77
personalized care	94	$148.3
immergrun	94	$148.3
secure horizons-pacificare	94	$148.3
Medicare	94	$148.3
Medicare Advantage	94	$148.3
corizon	94	$148.3
CareSource	79	$167.79
Ambetter	79	$167.79
ascension complete mcr	76	$232.74
smarthealth ppo	72	$34.97
unified group services	41	$18,572
Cigna	40	$17,562
encore	40	$13,400
advantage 360	40	$11,850
one health plan	40	$11,500
prohealth	40	$7,939.93
sagamore plus drg	40	$19,607
siho ppo	40	$15,000
suburban/sho	40	$7,939.93
unified zionsville	40	$14,464

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