GOOD SAMARITAN HOSPITAL

CCN 050380

45 CFR § 180 compliance
D · 65
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
21,388
Insurances with rates
0
CPT / HCPCS codes
1
Source MRF

Most expensive procedures (gross)

ABLT ATRIA X10SV ENDO
$300,428
ABLT ATRIA X10SV ENDO
Gross
$300,428
0J9309
$216,870
POLATUZUMAB 140 MG INJ
Gross
$216,870
093656
$199,694
COM EP REPO CTH TX AFIB
Gross
$199,694
TAVR CAR PUL BY PERCUT
$197,155
TAVR CAR PUL BY PERCUT
Gross
$197,155
TAVR CAR PUL BY OPEN
$197,155
TAVR CAR PUL BY OPEN
Gross
$197,155
TAVR CAR PUL BY CENTRAL
$197,155
TAVR CAR PUL BY CENTRAL
Gross
$197,155
0J9999
$194,089
CARMUSTINE WAFERS 8/BOX
Gross
$194,089
TAVR/TAVI TRANS EXPOSR
$193,308
TAVR/TAVI TRANS EXPOSR
Gross
$193,308
TAVR/TAVI TRANS AORTIC
$191,674
TAVR/TAVI TRANS AORTIC
Gross
$191,674
TAVR/TAVI OPEN AXL APRCH
$191,385
TAVR/TAVI OPEN AXL APRCH
Gross
$191,385
TAVR/TAVI OPEN ILIAC
$191,385
TAVR/TAVI OPEN ILIAC
Gross
$191,385
0C1895
$187,443
LEAD SPRNT FDLS 694958
Gross
$187,443
0C1721
$187,443
DEFIB CARD 51X64MM
Gross
$187,443
0C1896
$187,443
LEAD SPRNT QTRO 694465
Gross
$187,443
0C1722
$187,443
ICD 1CHMBR 6.8X5.3X1.5
Gross
$187,443
0C1817
$187,443
OCCLUDER PFO RT25/LT18MM
Gross
$187,443
0C1882
$187,443
ICD ENERGEN CRT DF4 N140
Gross
$187,443
0C2621
$187,443
PCMKR INTUA 270 CRTP IS1
Gross
$187,443
IMPL ENVL GNTR 2.9X3.3IN
$187,443
IMPL ENVL GNTR 2.9X3.3IN
Gross
$187,443
ICD DR 2CH 6.5X5.5X1.2
$187,443
ICD DR 2CH 6.5X5.5X1.2
Gross
$187,443
ICD DS 2 CHMBR VRT
$187,443
ICD DS 2 CHMBR VRT
Gross
$187,443
ICD 5.9X6.5CM 1 CHMBR
$187,443
ICD 5.9X6.5CM 1 CHMBR
Gross
$187,443
DVC REVASC 4MM 31MM
$184,060
DVC REVASC 4MM 31MM
Gross
$184,060
DVC REVASC 6MM 31MM
$184,060
DVC REVASC 6MM 31MM
Gross
$184,060
DVC REVASC 6MM 42MM
$184,060
DVC REVASC 6MM 42MM
Gross
$184,060
CATH GUIDE .018IN 180CM
$184,060
CATH GUIDE .018IN 180CM
Gross
$184,060
SET PUMP ASST 2.5IN
$184,060
SET PUMP ASST 2.5IN
Gross
$184,060
SYSTEM CTH TREVO PROVUE4
$184,060
SYSTEM CTH TREVO PROVUE4
Gross
$184,060
KIT EX FIX CLAMP STRL
$184,060
KIT EX FIX CLAMP STRL
Gross
$184,060
ACTUATOR LIMB 12.5X65MM
$184,060
ACTUATOR LIMB 12.5X65MM
Gross
$184,060
SET VNTRC 17.4X13.8IN
$184,060
SET VNTRC 17.4X13.8IN
Gross
$184,060
FIXATOR EX FIX ELB
$184,060
FIXATOR EX FIX ELB
Gross
$184,060
FRAME ASSY EXFX 160
$184,060
FRAME ASSY EXFX 160
Gross
$184,060
KIT DEVICE GUIDED 3CM
$184,060
KIT DEVICE GUIDED 3CM
Gross
$184,060
RETRIEVER ENDO 6X25MM
$184,060
RETRIEVER ENDO 6X25MM
Gross
$184,060
SYSTEM MECH THRMB
$184,060
SYSTEM MECH THRMB
Gross
$184,060
CANN W DILATOR STRGT TIP
$184,060
CANN W DILATOR STRGT TIP
Gross
$184,060
SP UNLST PROC CARD SURG
$182,201
SP UNLST PROC CARD SURG
Gross
$182,201
TAVR/TAVI PERC FEM APRCH
$182,058
TAVR/TAVI PERC FEM APRCH
Gross
$182,058
TAVR/TAVI OPEN FEMORAL
$182,058
TAVR/TAVI OPEN FEMORAL
Gross
$182,058
0C1777
$178,333
LEAD PCNG DF4 59CM 282
Gross
$178,333
DVC REVASC 4MM 26MM
$178,231
DVC REVASC 4MM 26MM
Gross
$178,231
SYSTEM EMBL 20% 1.5ML
$177,548
SYSTEM EMBL 20% 1.5ML
Gross
$177,548
MODEL IPS CRANL W/MRKNG
$177,411
MODEL IPS CRANL W/MRKNG
Gross
$177,411
DVC REVASC 6MM 180CM
$174,816
DVC REVASC 6MM 180CM
Gross
$174,816
DVC REVASC 4MM 180CM
$174,816
DVC REVASC 4MM 180CM
Gross
$174,816
DVC REVASC 6X40MM 200CM
$174,816
DVC REVASC 6X40MM 200CM
Gross
$174,816
DVC REVASC 3X20MM 200C
$174,816
DVC REVASC 3X20MM 200C
Gross
$174,816
093653
$170,763
EP REPOS ELE SVT SGL
Gross
$170,763
093654
$170,763
EP REPOS ELE VT 3D MAP
Gross
$170,763
Showing top 50 of 21,388 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.