MedStar Good Samaritan Hospital

Baltimore, MD · CMS ID: 210056

This hospital has pricing data for 30 procedures.

Procedures (30)

Chest X-Ray 1 View

71045

Cash Price

(No Insurance)

—

Gross Charge

$69

No payer-negotiated rates available

Chest X-Ray 2 Views

71046

Cash Price

(No Insurance)

—

Gross Charge

$115

No payer-negotiated rates available

Complete Blood Count (CBC)

85025

Cash Price

(No Insurance)

—

Gross Charge

$32

No payer-negotiated rates available

Comprehensive Metabolic Panel

80053

Cash Price

(No Insurance)

—

Gross Charge

$48

No payer-negotiated rates available

CT Abdomen/Pelvis with Contrast

74177

Cash Price

(No Insurance)

—

Gross Charge

$235

No payer-negotiated rates available

CT Abdomen/Pelvis without Contrast

74176

Cash Price

(No Insurance)

—

Gross Charge

$121

No payer-negotiated rates available

CT Chest Low Dose

71271

Cash Price

(No Insurance)

—

Gross Charge

$136

No payer-negotiated rates available

CT Chest with Contrast

71260

Cash Price

(No Insurance)

—

Gross Charge

$178

No payer-negotiated rates available

ER Visit Level 3

99283

Cash Price

(No Insurance)

—

Gross Charge

$268

No payer-negotiated rates available

ER Visit Level 4

99284

Cash Price

(No Insurance)

—

Gross Charge

$537

No payer-negotiated rates available

ER Visit Level 5

99285

Cash Price

(No Insurance)

—

Gross Charge

$939

No payer-negotiated rates available

Hemoglobin A1C

83036

Cash Price

(No Insurance)

—

Gross Charge

$63

No payer-negotiated rates available

Knee X-Ray

73560

Cash Price

(No Insurance)

—

Gross Charge

$276

No payer-negotiated rates available

Lipid Panel

80061

Cash Price

(No Insurance)

—

Gross Charge

$60

No payer-negotiated rates available

Mammogram Diagnostic

77066

Cash Price

(No Insurance)

—

Gross Charge

$783

No payer-negotiated rates available

Mammogram Screening

77067

Cash Price

(No Insurance)

—

Gross Charge

$391

No payer-negotiated rates available

MRI Brain

70551

Cash Price

(No Insurance)

—

Gross Charge

$247

No payer-negotiated rates available

MRI Brain with Contrast

70553

Cash Price

(No Insurance)

—

Gross Charge

$702

No payer-negotiated rates available

MRI Cervical Spine

72141

Cash Price

(No Insurance)

—

Gross Charge

$237

No payer-negotiated rates available

MRI Knee

73721

Cash Price

(No Insurance)

—

Gross Charge

$266

No payer-negotiated rates available

MRI Lumbar Spine

72148

Cash Price

(No Insurance)

—

Gross Charge

$237

No payer-negotiated rates available

MRI Shoulder

73221

Cash Price

(No Insurance)

—

Gross Charge

$892

No payer-negotiated rates available

Office Visit Level 3

99213

Cash Price

(No Insurance)

—

Gross Charge

$242

No payer-negotiated rates available

Office Visit Level 4

99214

Cash Price

(No Insurance)

—

Gross Charge

$302

No payer-negotiated rates available

Shoulder X-Ray

73030

Cash Price

(No Insurance)

—

Gross Charge

$230

No payer-negotiated rates available

TSH (Thyroid)

84443

Cash Price

(No Insurance)

—

Gross Charge

$48

No payer-negotiated rates available

Ultrasound Abdomen

76700

Cash Price

(No Insurance)

—

Gross Charge

$529

No payer-negotiated rates available

Ultrasound Pelvis

76856

Cash Price

(No Insurance)

—

Gross Charge

$483

No payer-negotiated rates available

Ultrasound Transvaginal

76830

Cash Price

(No Insurance)

—

Gross Charge

$576

No payer-negotiated rates available

Urinalysis

81001

Cash Price

(No Insurance)

—

Gross Charge

$29

No payer-negotiated rates available