GOOD SAMARITAN HOSPITAL

CCN 360134

45 CFR § 180 compliance
F · 50
This hospital published little 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
30,959
Insurances with rates
8
CPT / HCPCS codes
11,293
Source MRF

Most expensive procedures (gross)

RX-196165
$1,342,800
TISAGENLECLEUCEL 600000000 CELLS IV SUSP
Gross
$1,790,400
RX-181102
$395,007
NUSINERSEN 12 MG/5ML IT SOLN
Gross
$526,676
RX-167804
$116,729
GLUCARPIDASE 1000 UNITS IV SOLR
Gross
$155,639
RX-141608
$99,747
IPILIMUMAB 200 MG/40ML IV SOLN
Gross
$132,996
RX-139647
$83,006
PEGLOTICASE 8 MG/ML IV SOLN
Gross
$110,675
SUP-145927
$67,500
GENERATOR OPTIMIZER IPG
Gross
$90,000
RX-184231
$65,865
INOTUZUMAB OZOGAMICIN 0.9 MG IV SOLR
Gross
$87,819
PX-3610290
$60,293
HC Mech Thromb Pulmonary Bil
Gross
$80,390
PX-2781502
$56,250
HC Implant Mitral Clip W Accessories
Gross
$75,000
SUP-133613
$56,250
INTERVENTIONAL CATHETER MITRACLIP GUIDE & CLIP
Gross
$75,000
RX-191981
$53,266
POLATUZUMAB VEDOTIN-PIIQ 140 MG IV SOLR
Gross
$71,021
SUP-149153
$51,563
IPG REMEDE EL CSA 1100
Gross
$68,750
RX-183703
$51,368
FLUOCINOLONE ACETONIDE 0.59 MG IZ IMPL
Gross
$68,490
SUP-147443
$50,625
KIT IMPELLA CP 14F W SHEATH
Gross
$67,500
SUP-145485
$47,813
IPG REMEDE CSA 1001
Gross
$63,750
SUP-129085
$46,875
KIT IMPELLA CP 14F 0048-0003
Gross
$62,500
RX-208524
$45,387
EPCORITAMAB-BYSP 48 MG/0.8ML SC SOLN
Gross
$60,516
PX-3420003
$44,609
HC Samarium 153 Lexidronamm per Tx Dose A9604
Gross
$59,479
SUP-145929
$43,125
GENERATOR SMART MINI
Gross
$57,500
PX-2780008
$42,188
HC Device Pulmonary Pressure Sensor
Gross
$56,250
PX-6240004
$42,188
HC Cupid Device Impella
Gross
$56,250
RX-212899
$40,500
TARLATAMAB-DLLE 10 MG IV SOLR
Gross
$54,000
SUP-142820
$40,313
SYSTEM CARDIOMEMS PA SENSOR
Gross
$53,750
PX-4812930
$40,196
HC Stent/Ptca Coronary/Branches 2+ Vessels
Gross
$53,594
PX-3617271
$40,195
HC Sf Ather/Pta Fem/Pop Uni Incl All Img/Vessl Sel
Gross
$53,594
PX-3617273
$40,195
HC Cplx Athr/Pta Fem/Pop Uni Incl All Img/Vessel Sel.
Gross
$53,594
PX-3617275
$40,195
HC Sf Stent/Ather/Pta Fem/Pop Uni Incl All Img/Vessl Sel
Gross
$53,594
PX-3617277
$40,195
HC Cplx Stent/Ather/Pta Fem/Pop Uni Incl All Img/Vessel Sel.
Gross
$53,594
PX-3617284
$40,195
HC Sf Stent Tibial/Peroneal Uni Incl All Img/Vessl Sel
Gross
$53,594
PX-3617286
$40,195
HC Cplx Stent Tibial/Peroneal Uni Incl All Img/Vessel Sel.
Gross
$53,594
PX-3617288
$40,195
HC Sf Ather/Pta Tibial/Peroneal Uni Incl All Img/Vessl Sel
Gross
$53,594
PX-3617290
$40,195
HC Cplx Athr/Pta Tibial/Peroneal Uni Incl All Img/Vessel Sel.
Gross
$53,594
PX-3617292
$40,195
HC Sf Stent/Ather/Pta Tibial/Peroneal Uni Incl All Img/Vessl Sel
Gross
$53,594
PX-3617294
$40,195
HC Cplx Stent/Ather/Pta Tibial/Peroneal Uni Incl All Img/Vessel Sel.
Gross
$53,594
PX-3610603
$40,195
HC Embolization Intracranial
Gross
$53,593
PX-3440002
$39,938
HC Yttrium 90 Microsphere
Gross
$53,250
RX-116198
$39,744
CABAZITAXEL 60 MG/1.5ML IV SOLN
Gross
$52,991
PX-3617322
$37,969
HC Sf Pta Inframalleolar Uni Incl All Img/Vessl Sel
Gross
$50,625
PX-4811100
$37,125
HC Insert/Replc Subq Icd W Elect
Gross
$49,500
SUP-131376
$36,572
ICD BIV QUADRA ASSURA DF4
Gross
$48,763
SUP-115872
$36,563
ICD BIV CONTAK RENEWAL 3 H170
Gross
$48,750
SUP-123226
$36,563
ICD BIV LIVIAN H220
Gross
$48,750
PX-4810110
$35,324
HC Comp Ep Eval W Abl a-Fib W Transptl/3d Map
Gross
$47,098
RX-104753
$34,695
COAGULATION FACTOR VIIA RECOMB 5 MG IV SOLR
Gross
$46,260
PX-4810108
$34,506
HC Comp Ep Eval W Ablation Vt/3d Mapping/Lv Pace/Rec
Gross
$46,008
SUP-126023
$34,506
ICD BIV D274TRK
Gross
$46,008
PX-3615276
$34,437
HC Insert Phrenic Nerve Stim System Gen/Leads
Gross
$45,916
SUP-131388
$34,247
ICD BIV PROTECTA D334TRG
Gross
$45,663
RX-216757
$33,696
NIPOCALIMAB-AAHU 1200 MG/6.5ML IV SOLN
Gross
$44,928
RX-178871
$32,230
ATEZOLIZUMAB 1200 MG/20ML IV SOLN
Gross
$42,973
Showing top 50 of 30,959 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.