WELLSPAN GOOD SAMARITAN HOSPITAL

CCN 390066

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
22
CPT / HCPCS codes
1,797
Source MRF

Most expensive procedures (gross)

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