MULTICARE GOOD SAMARITAN HOSPITAL
Hospital
Procedure Prices at MULTICARE GOOD SAMARITAN HOSPITAL
Blood Draw From Vein Using Needle
CPT 36415
$3
Lab Test - Complete Blood Cell Count With White Blood Cell Percentage
CPT 85025
$5
Lab Test - Comprehensive Metabolic Panel
CPT 80053
$7.9
Therapeutic Exercises
CPT 97110
$16.9
Chest X-Ray (2 views)
CPT 71046
$18.13
EKG
CPT 93000
$18.92
EKG Tracing
CPT 93005
$20.11
Therapeutic Activities
CPT 97530
$21.59
Chest X-Ray (1 view)
CPT 71045
$42.81
Outpatient Clinic Visit Established Patient Level III
CPT 99213
$50
Abdominal Ultrasound — Limited
CPT 76705
$52.27
OB Ultrasound
CPT 76805
$76.47
Abdominal Ultrasound
CPT 76700
$97.14
Retroperitoneal Ultrasound
CPT 76770
$111.26
Diagnostic Mammogram (unilateral)
CPT 77065
$114.28
CT Chest
CPT 71250
$118.91
ER Visit — Low-Moderate Complexity
CPT 99283
$119.96
Screening Mammogram (bilateral)
CPT 77067
$120.81
Individual Psychotherapy Session 60 Minutes
CPT 90837
$123.2
Thoracic Spine X-Ray
CPT 72072
$128.51
Diagnostic Mammogram (bilateral)
CPT 77066
$146.11
ER Visit — Moderate Complexity
CPT 99284
$165.95
MRI Joint of Lower Extremity
CPT 73721
$199.43
ER Visit — High Complexity
CPT 99285
$240.35
MRI Brain w/o Contrast
CPT 70551
$251.12
CT Abdomen & Pelvis
CPT 74177
$253.8
MRI Brain w/ Contrast
CPT 70553
$311.07
Echocardiogram w/ Doppler
CPT 93306
$330.92
Upper GI Endoscopy w/ Biopsy
CPT 43239
$351.8
Colonoscopy
CPT 45378
$406.88
Colonoscopy w/ Biopsy
CPT 45380
$432.2
Injection of Drug Into Lower Spinal Nerve Root With Imaging Guidance
CPT 64483
$622.77
Knee Arthroscopy
CPT 29881
$1,149.64
Cataract Surgery
CPT 66984
$1,210.4
Repair of Shoulder Rotator Cuff Using Arthroscope
CPT 29827
$2,079.37
Tonsillectomy & Adenoidectomy (under 12)
CPT 42820
$2,159.45
Inguinal Hernia Repair
CPT 49505
$2,617.73
Laparoscopic Hernia Repair
CPT 49650
$2,682.61
Laparoscopic Cholecystectomy
CPT 47562
$2,903.31
Recurrent Inguinal Hernia Repair
CPT 49520
$3,040.28
Knee Replacement
CPT 27447
$6,609.34
Hip Replacement
CPT 27130
$6,623.13
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Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.