WELLSPAN GOOD SAMARITAN HOSPITAL

45 CFR § 180 compliance

C · 70

This hospital published part 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

3,059

Insurances with rates

CPT / HCPCS codes

1,797

Source MRF

csv ↗

Most expensive procedures (gross)

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
33270	Insertion or Replacement of Defibrillator With Electrode	$91,012	$72,810	—	—	34
33225	Insertion of Left Lower Heart Electrode for Pacemaker or Defibrillator	$90,070	$72,056	—	—	13
33249	Insertion of Implantable Defibrillator System	$89,311	$71,449	—	—	34
33264	Removal and Replacement of Multiple Lead Defibrillator	$81,010	$64,808	—	—	34
33214	Insertion of 2 Chamber Pacemaker System	$68,475	$54,780	—	—	34
33263	Removal and Replacement of Dual Lead Defibrillator	$61,300	$49,040	—	—	34
481	Insert Catheters for Recording and Pacing of Right Heart Chambers Rhythm	$60,618	$48,494	—	—	80
33207	Insertion of Pacemaker and Lower Heart Chamber Electrode	$59,061	$47,249	—	—	39
33206	Insertion of Pacemaker and Upper Heart Chamber Electrode	$47,146	$37,717	—	—	34
33208	Insertion of Pacemaker and Upper and Lower Heart Chamber Electrode	$46,351	$37,081	—	—	39
37244	Occlusion of Artery or Vein Bleeding With Review by Radiologist	$45,560	$36,448	—	—	39
33228	Removal and Replacement of Dual Lead Permanent Pacemaker	$41,823	$33,458	—	—	34
33229	Removal and Replacement of Multiple Lead Permanent Pacemaker	$41,823	$33,458	—	—	34
36906	Remove/Dissole Bloodclot Hemodialysis Circuit/Balloon Stent, Radiology Revw	$41,459	$33,167	—	—	40
33227	Removal and Replacement of Single Lead Permanent Pacemaker	$38,131	$30,505	—	—	35
37242	Occlusion of Artery With Review by Radiologist	$37,041	$29,633	—	—	39
33235	Removal of Dual Electrodes From Right Heart	$33,881	$27,105	—	—	35
33285	Insertion of Heart Rhythm Monitor Under Skin	$32,139	$25,711	—	—	35
37221	Insertion of Stent in Groin Artery, Initial Vessel	$28,060	$22,448	—	—	40
37238	Insertion of Stent in Vein With Review by Radiologist, Initial Vein	$28,060	$22,448	—	—	39
37236	Insert Stent Artery With Radiology Review, Initial Artery	$28,060	$22,448	—	—	39
36903	Insert Needle/Tube Into Hemodialysis Circuit/Stent With Radiology Review	$27,202	$21,762	—	—	40
36905	Remove/Disolve Bloodclot Hemodialysis Circuit/Balloon Tube W Radiology Revw	$27,201	$21,761	—	—	40
33210	Insertion of Temporary Pacemaker Lead in Single Heart Chamber	$26,945	$21,556	—	—	40
37241	Occlusion of Vein With Review by Radiologist	$26,220	$20,976	—	—	39
33262	Removal and Replacement of Single Lead Defibrillator	$24,890	$19,912	—	—	34
37226	Insertion of Stent in Arteries of Leg	$20,162	$16,130	—	—	39
33234	Removal of Single Electrode From Right Heart	$19,956	$15,965	—	—	35
36907	Balloon Dilation of Dialysis Segment With Review by Radiologist	$19,839	$15,871	—	—	19
93460	Insert Tube in Right and Left Heart Chambers and Coronary Artery	$18,531	$14,825	—	—	35
J0597	C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS SOLUTION	$17,483	$13,987	—	—	38
C2621	PACEMAKER CARDIAC VALITUDE PACESAFE RIGHTRATE EASYVIEW 3D .75CM 16.2CU CM SPIRAL 4.45X6.13	$17,370	$13,896	—	—	21
93451	Insertion of Tube in Right Heart Chambers for Measurement	$17,027	$13,622	—	—	35
93454	Insert Tube in Coronary Artery for Diagnosis W Review by Radiologist	$17,027	$13,622	—	—	35
93455	Insertion of Tube in Bypass Graft for Diagnosis With Review by Radiologist	$17,027	$13,622	—	—	35
93456	Insert Tube in Right Heart Chambers and Coronary Artery	$17,027	$13,622	—	—	35
93457	Insert Tube in Right Heart Chambers, Coronary Artery, and Bypass Graft	$17,027	$13,622	—	—	35
93459	Insert Tube in Left Lower Heart Chamber, Coronary Artery and Bypass Graft	$17,027	$13,622	—	—	35
93461	Insert Tube in Right and Left Heart Chambers, Coronary Artery, Bypass Graft	$17,027	$13,622	—	—	35
93458	Insert Tube in Left Lower Heart Chamber and Coronary Artery	$17,019	$13,615	—	—	35
790	Extracorporeal Shock Wave Lithotripsy Procedure	$16,281	$13,025	—	—	12
C1764	MONITOR CARDIAC BIOMONITOR IV INJECTABLE	$16,212	$12,970	—	—	22
37248	Balloon Dilation of Vein With Review by Radiologist, Initial Vein	$16,058	$12,846	—	—	40
C1900	LEAD CARDIOVERTER DEFIBRILLATOR QUARTET STEROID ELUTING WIDE ELECTRODE 4.7FR 16MM X 86CM	$15,829	$12,663	—	—	21
C1896	ELECTRODE DEFIBRILLATOR 45CM 11.5FR EMBLEM S-ICD SUBCUTANEOUS TRIPOLAR	$15,440	$12,352	—	—	21
93503	Insertion of Tube in Pulmonary Artery for Monitoring	$15,419	$12,335	—	—	35
33216	Insertion of 1 Electrode for Permanent Pacemaker or Defibrillator	$15,020	$12,016	—	—	40
22514	Treatment of Broken Lower Spine Bone With Placement of Stabilizing Device	$14,685	$11,748	—	—	35
C1724	SYSTEM ATHERECTOMY 135CM DIAMONDBACK 360 1.25MM CORONARY CROWN ELECTRIC POWER HANDLE	$14,649	$11,719	—	—	22
22513	Treat Broken Middle Spine With Place Stabilizing Device Using Image Guide	$14,509	$11,607	—	—	35

Showing top 50 of 3,059 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.