MultiCare Good Samaritan Hospital
401 15th Avenue Southeast, Puyallup, WA · Multicare · · NPI 1841231461
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| X-ray abdomen 2 views CPT 74019 | $275.60 | $689.00 | $40.64 – $501.84 | 15 |
| X-ray abdomen >=3 views CPT 74021 | not published | not published | $40.64 – $501.84 | 14 |
| X-ray abdomen complete acute series including spine erect and/or decubitus single view chest CPT 74022 | $383.60 | $959.00 | $40.64 – $501.84 | 15 |
| X-ray acromioclavicular joints without or w/weighted distraction bilateral CPT 73050 | $250.40 | $626.00 | $40.64 – $417.74 | 15 |
| X-ray ankle 2 views (both sides) CPT 73600 | $250.40 | $626.00 | $40.64 – $417.74 | 15 |
| X-ray arthrogram shoulder supervision & interpretation (both sides) CPT 73040 | $942.40 | $2,356.00 | $85.70 – $1,705.83 | 15 |
| X-ray assay calculus CPT 82370 | not published | not published | $8.63 – $24.54 | 14 |
| X-ray bone age studies CPT 77072 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray bone length studies CPT 77073 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray bone survey complete CPT 77075 | $386.40 | $966.00 | $85.70 – $501.84 | 15 |
| X-ray bone survey infant CPT 77076 | $386.40 | $966.00 | $40.64 – $501.84 | 15 |
| X-ray cervical spine 2-3 views CPT 72040 | $250.40 | $626.00 | $40.64 – $417.74 | 15 |
| X-ray cervical spine 4-5 views CPT 72050 | $364.40 | $911.00 | $40.64 – $501.84 | 15 |
| X-ray cervical spine >= 6 views CPT 72052 | $364.40 | $911.00 | $40.64 – $501.84 | 15 |
| X-ray clavicle complete (both sides) CPT 73000 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray colon abdominal radiograph(s) & delayed images single contrast study CPT 74270 | $604.00 | $1,510.00 | $85.70 – $841.97 | 15 |
| X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study CPT 74280 | $647.60 | $1,619.00 | $85.70 – $841.97 | 15 |
| X-ray elbow 2 views (both sides) CPT 73070 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray elbow >= 3 views (both sides) CPT 73080 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray esophogram chest radiograph(s) & delayed images single contrast study CPT 74220 | $568.40 | $1,421.00 | $40.64 – $841.97 | 15 |
| X-ray exam entire spi 4/5 vw CPT 72083 | not published | not published | $40.64 – $501.84 | 14 |
| X-ray exam entire spi 6/> vw CPT 72084 | not published | not published | $40.64 – $501.84 | 14 |
| X-ray exam of arm infant CPT 73092 | $289.20 | $723.00 | $40.64 – $501.84 | 15 |
| X-ray exam of eye sockets CPT 70200 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray exam of femur 1 CPT 73551 | not published | not published | $40.64 – $417.74 | 14 |
| X-ray exam of jaw joint CPT 70328 | $232.00 | $580.00 | $40.64 – $417.74 | 15 |
| X-ray exam of jaw joint CPT 70332 | $828.00 | $2,070.00 | $85.70 – $1,145.33 | 15 |
| X-ray exam of mastoids CPT 70120 | $244.00 | $610.00 | $40.64 – $501.84 | 15 |
| X-ray exam of middle ear CPT 70134 | not published | not published | $40.64 – $2,622.93 | 14 |
| X-ray exam of penis CPT 74445 | not published | not published | $85.70 – $501.84 | 14 |
| X-ray exam of perineum CPT 74775 | not published | not published | $85.70 – $1,145.33 | 14 |
| X-ray exam of salivary gland CPT 70380 | $236.40 | $591.00 | $40.64 – $417.74 | 15 |
| X-ray exam of sinuses CPT 70210 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray exam of tear duct CPT 70170 | $474.00 | $1,185.00 | $85.70 – $1,145.33 | 15 |
| X-ray exam of teeth CPT 70300 | not published | not published | $40.64 – $417.74 | 14 |
| X-ray exam of teeth CPT 70310 | not published | not published | $40.64 – $1,145.33 | 14 |
| X-ray exam si joints CPT 72200 | $269.20 | $673.00 | $40.64 – $501.84 | 15 |
| X-ray exam thorac spine4/>vw CPT 72074 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray eye detection foreign body (both sides) CPT 70030 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray facial bones complete > 3 views CPT 70150 | $287.20 | $718.00 | $40.64 – $501.84 | 15 |
| X-ray fallopian tube CPT 74742 | not published | not published | $127.62 – $137.83 | 5 |
| X-ray femur >=2 views (both sides) CPT 73552 | $226.00 | $565.00 | $40.64 – $417.74 | 15 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $227.60 | $569.00 | $40.64 – $417.74 | 15 |
| X-ray foot 2 views (both sides) CPT 73620 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray forearm 2 views (both sides) CPT 73090 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray hand 2 views (both sides) CPT 73120 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray head for orthodontia CPT 70350 | not published | not published | $40.64 – $417.74 | 14 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $324.40 | $811.00 | $40.64 – $501.84 | 15 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $287.20 | $718.00 | $40.64 – $501.84 | 15 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $323.60 | $809.00 | $40.64 – $501.84 | 15 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $387.20 | $968.00 | $40.64 – $501.84 | 15 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $226.00 | $565.00 | $40.64 – $417.74 | 15 |
| X-ray humerus >= 2 views left CPT 73060 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray joint survey 1 view CPT 77077 | $224.00 | $560.00 | $40.64 – $501.84 | 15 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray knee 3 views (both sides) CPT 73562 | $250.40 | $626.00 | $40.64 – $417.74 | 15 |
| X-ray knee ap standing bilateral CPT 73565 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $250.40 | $626.00 | $40.64 – $417.74 | 15 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $287.20 | $718.00 | $40.64 – $501.84 | 15 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $364.40 | $911.00 | $40.64 – $501.84 | 15 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $364.40 | $911.00 | $40.64 – $501.84 | 15 |
| X-ray male genital tract CPT 74440 | not published | not published | $85.70 – $1,145.33 | 14 |
| X-ray mandible complete > 4 views CPT 70110 | $287.20 | $718.00 | $40.64 – $501.84 | 15 |
| X-ray mandible ltd <4 views CPT 70100 | not published | not published | $40.64 – $417.74 | 14 |
| X-ray measurement of pelvis CPT 74710 | not published | not published | $269.02 – $402.25 | 2 |
| X-ray nasal bones complete > 3 views CPT 70160 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray neck soft tissue CPT 70360 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray nose to rectum for foreign body child CPT 76010 | $258.00 | $645.00 | $40.64 – $417.74 | 15 |
| X-ray of mammary ducts CPT 77054 | $828.00 | $2,070.00 | $85.70 – $1,145.33 | 15 |
| X-ray optic foramina CPT 70190 | not published | not published | $40.64 – $417.74 | 14 |
| X-ray pelvis 1-2 views CPT 72170 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray pelvis complete > 3 views CPT 72190 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $1,015.20 | $2,538.00 | $85.70 – $1,705.83 | 15 |
| X-ray ribs 2 views left CPT 71100 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray ribs 3 views bilateral CPT 71110 | $287.20 | $718.00 | $40.64 – $501.84 | 15 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $287.20 | $718.00 | $40.64 – $501.84 | 15 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $364.40 | $911.00 | $40.64 – $501.84 | 15 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray scapula complete (both sides) CPT 73010 | $248.00 | $620.00 | $40.64 – $501.84 | 15 |
| X-ray sella turcica CPT 70240 | $200.00 | $500.00 | $40.64 – $417.74 | 15 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $250.40 | $626.00 | $40.64 – $417.74 | 15 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $960.40 | $2,401.00 | $85.70 – $2,622.93 | 15 |
| X-ray skull < 4 views CPT 70250 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray skull > 4 views complete CPT 70260 | $364.40 | $911.00 | $40.64 – $501.84 | 15 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $398.40 | $996.00 | $40.64 – $501.84 | 15 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $581.20 | $1,453.00 | $85.70 – $841.97 | 15 |
| X-ray small intestine follow-through study CPT 74248 | $315.20 | $788.00 | $85.70 – $92.55 | 5 |
| X-ray spine single view CPT 72020 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray sternum > 2 views CPT 71120 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray surgical specimen CPT 76098 | $581.60 | $1,454.00 | $85.70 – $2,622.93 | 15 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $566.00 | $1,415.00 | $85.70 – $841.97 | 15 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $247.20 | $618.00 | $40.64 – $417.74 | 15 |
| X-ray thoracic spine 2 views CPT 72070 | $282.00 | $705.00 | $40.64 – $501.84 | 15 |
| X-ray thoracic spine 3 views CPT 72072 | $287.20 | $718.00 | $40.64 – $501.84 | 15 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $244.00 | $610.00 | $40.64 – $417.74 | 15 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $226.00 | $565.00 | $40.64 – $417.74 | 15 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.