MEDSTAR GOOD SAMARITAN HOSPITAL

45 CFR § 180 compliance

B · 85

This hospital published most of what § 180 requires.

●Machine-readable file published

●Gross / standard charges

●Discounted cash price

●Payer-specific negotiated rates

○Min / max negotiated charges

●Free, public, no login required

Procedures listed

68,611

Insurances with rates

CPT / HCPCS codes

Source MRF

csv ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
63638449	OBECABTAGENE AUTOLEUCEL INJ	$892,101	$874,259	—	—	19
63637235	LIFILEUCEL IV SUSP	$875,129	$857,626	—	—	19
63636591	CILTACABTAGENE AUTOLEUCEL 70ML	$813,870	$797,592	—	—	19
63636609	CILTACABTAGENE AUTOLEUCEL 30ML	$813,870	$797,592	—	—	19
63635148	IDECABTAGENE (ABECMA) 50ML INJ	$712,848	$698,591	—	—	19
63635155	IDECABTAGENE (ABECMA) 250MLINJ	$712,848	$698,591	—	—	19
63635163	IDECABTAGENE (ABECMA) 500MLINJ	$712,848	$698,591	—	—	19
63635130	LISOCABTAGENE (BREYANZI) INJ	$697,214	$683,270	—	—	19
63633689	AXICABTAGENE 68ML INJ	$633,831	$621,155	—	—	19
63634505	BREXUCABTAGENE (TECARTUS) 68ML	$633,831	$621,155	—	—	19
63634513	TISAGENLECLEUCEL (KYMRIAH) INJ	$633,831	$621,155	—	—	19
62570163	KIT HEARTMATE 3 IMPLANT COMMER	$176,077	$172,556	—	—	19
62092408	IMPLANT KIT HEARTMATE II LVAD	$142,763	$139,908	—	—	19
62535448	IMPLANT HEARTMATE II PUMP ONLY	$139,026	$136,246	—	—	19
64010739	KIT HF MONT CORDELLA BL	$135,516	$132,805	—	—	19
64010887	KIT START UP HF CORDELLA BL	$135,516	$132,805	—	—	19
62432323	PUMP HEARTWARE	$122,090	$119,648	—	—	19
63638670	GEMCITABINE 225MG INTRAVESICAL	$117,248	$114,903	—	—	19
63637375	ADSTILADRIN BLADDER SUSP 75ML	$101,957	$99,918	—	—	19
64011059	SYS TMVR LP29L TENDYNE	$98,238	$96,273	—	—	19
64011067	SYS TMVR LP29S TENDYNE	$98,238	$96,273	—	—	19
64011075	SYS TMVR LP33S TENDYNE	$98,238	$96,273	—	—	19
64011083	SYS TMVR LP35M TENDYNE	$98,238	$96,273	—	—	19
64011091	SYS TMVR LP39M TENDYNE	$98,238	$96,273	—	—	19
63625016	SIPULEUCEL-T 250ML INJ	$89,571	$87,780	—	—	19
62985320	KIT APREVO LVL-5 CARLSMED	$87,719	$85,965	—	—	19
62985312	KIT APREVO LVL-4 CARLSMED	$77,193	$75,649	—	—	19
63624183	HISTRELIN 50MG IMPLANT	$76,772	$75,237	—	—	19
62984372	VLV TRANSCATHETER 44MM EVOQUE	$75,439	$73,930	—	—	19
62984380	VLV TRANSCATHETER 49MM EVOQUE	$75,439	$73,930	—	—	19
62984398	VLV TRANSCATHETER 52MM EVOQUE	$75,439	$73,930	—	—	19
62984604	VLV TRANSCATH 56MM EVOQUE	$75,439	$73,930	—	—	19
62153481	KIT IMPELLA 5.5 W/SMART ASSIST	$71,930	$70,491	—	—	19
63633226	CARMUSTINE 7.7MG IMPLANT 8/BOX	$71,777	$70,342	—	—	19
28514867	PLUG 251-270 12MM IMPEDE-FX	$70,168	$68,765	—	—	19
64011646	PLUG 251-270 12MM IMPEDE-FX	$70,168	$68,765	—	—	19
62985304	KIT APREVO LVL-3 CARLSMED	$66,667	$65,333	—	—	19
28514859	PLUG 231-250 12MM IMPEDE-FX	$65,783	$64,467	—	—	19
64011638	PLUG 231-250 12MM IMPEDE-FX	$65,783	$64,467	—	—	19
25302555	SYS TMPLT REGN DRML 250 SQCM	$64,032	$62,751	—	—	19
62194519	SYS TRICLIP G4 W/GUIDE 3 CLIPS	$63,158	$61,895	—	—	19
64009988	SYS TRICLIP VLV REPAIR G5	$63,157	$61,893	—	—	19
62145446	GFT ARTC PLEXUS 150CMX32X40MM	$61,404	$60,175	—	—	19
62145453	GFT ARTC PLEXUS 150CMX30X40MM	$61,404	$60,175	—	—	19
62145461	GFT ARTC PLEXUS 150CMX30X38MM	$61,404	$60,175	—	—	19
62145479	GFT ARTC PLEXUS 150CMX30X36MM	$61,404	$60,175	—	—	19
62145487	GFT ARTC PLEXUS 150CMX30X34MM	$61,404	$60,175	—	—	19
62145495	GFT ARTC PLEXUS 150CMX30X32MM	$61,404	$60,175	—	—	19
62145503	GFT ARTC PLEXUS 150CMX28X30MM	$61,404	$60,175	—	—	19
62145511	GFT ARTC PLEXUS 150CMX26X28MM	$61,404	$60,175	—	—	19

Showing top 50 of 68,611 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.