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 |
|---|---|---|---|---|
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $10.14 | $25.35 | not published | 0 |
| Acetaminophen 120 mg rectal suppository HCPCS A9270 | $3.20 | $8.00 | $0.07 – $0.07 | 1 |
| Acetaminophen level CPT 80143 | $13.20 | $33.00 | $7.45 – $36.53 | 14 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $89.18 | $222.95 | not published | 0 |
| Acetone qualitative CPT 82009 | $11.60 | $29.00 | $3.47 – $8.86 | 15 |
| Acetylcholine receptor modulating antibody CPT 86043 | $23.20 | $58.00 | $7.40 – $23.62 | 14 |
| Acetylcholinesterase assay CPT 82013 | $28.00 | $70.00 | $8.63 – $24.09 | 15 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $2.02 | $5.04 | not published | 0 |
| Acetylcysteine non-comp unit HCPCS J7608 | not published | not published | $11.41 – $20.04 | 2 |
| Acid perfusion of esophagus CPT 91030 | not published | not published | $426.79 – $2,238.28 | 14 |
| Acne surgery 10040 CPT 10040 | $442.40 | $1,106.00 | $116.08 – $963.09 | 15 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | not published | not published | $174.89 – $770.43 | 12 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | not published | not published | $138.59 – $602.55 | 12 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | not published | not published | $116.19 – $487.67 | 12 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | not published | not published | $73.56 – $79.44 | 5 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | not published | not published | $203.01 – $852.02 | 12 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $419.60 | $1,049.00 | $48.48 – $639.07 | 15 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | not published | not published | $42.85 – $179.84 | 12 |
| Aco med nutria tx/group, ea 30 min 97804aco CPT 97804 | $32.00 | $80.00 | $9.70 – $72.18 | 15 |
| Acoustic immitance testing CPT 92570 | $153.20 | $383.00 | $58.00 – $673.34 | 15 |
| Acoustic refl threshold tst CPT 92568 | $104.40 | $261.00 | $24.57 – $179.28 | 15 |
| Acromp/acromionectomy prtl CPT 23130 | not published | not published | $3,167.51 – $15,706.36 | 14 |
| Acth stimulation panel CPT 80402 | not published | not published | $22.98 – $170.44 | 14 |
| Acth stimulation panel CPT 80406 | not published | not published | $22.98 – $153.39 | 14 |
| Actigraphy testing CPT 95803 | $254.40 | $636.00 | $48.48 – $283.18 | 15 |
| Actinotherapy uv light CPT 96900 | $105.60 | $264.00 | $22.93 – $179.28 | 15 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $66.00 | $165.00 | $33.08 – $138.82 | 13 |
| Acup 1/> w/estim ea addl 15 CPT 97814 | $55.60 | $139.00 | not published | 0 |
| Acup 1/> without estim ea add 15 CPT 97811 | $50.00 | $125.00 | not published | 0 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $66.00 | $165.00 | $33.08 – $138.82 | 13 |
| Acute hepatitis panel CPT 80074 | $103.20 | $258.00 | $5.88 – $93.35 | 15 |
| Acute venous thrombus image CPT 78456 | not published | not published | $272.41 – $6,214.62 | 14 |
| Acyclovir 400 mg tablet HCPCS J8499 | $3,010.68 | $7,526.70 | $3.86 – $4.41 | 2 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $2.31 | $5.76 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $19.60 | $49.00 | $8.63 – $33.07 | 15 |
| Acylcarnitines qual CPT 82016 | not published | not published | $8.63 – $32.32 | 14 |
| Adalimumab injection HCPCS J0135 | not published | not published | $2,717.77 – $8,493.69 | 3 |
| Adapt behavior tx phys/qhp CPT 97155 | not published | not published | $34.33 – $852.02 | 14 |
| Adapter b 8 channel 10cm HCPCS C1883 | $33,014.00 | $82,535.00 | not published | 0 |
| Adaptive behavior tx by tech CPT 97153 | not published | not published | $34.33 – $487.67 | 14 |
| Adding walker to prev cast CPT 29440 | not published | not published | $133.68 – $780.03 | 14 |
| Additional switch, ext power HCPCS L6611 | not published | not published | $481.04 – $2,138.00 | 12 |
| Add le poly knee custom kafo HCPCS L2387 | $116.00 | $290.00 | $195.50 – $1,008.28 | 13 |
| Add ue prost a/e acrylic HCPCS L7404 | not published | not published | $649.38 – $2,886.16 | 12 |
| Add ue prost a/e ultlite mat HCPCS L7401 | not published | not published | $400.87 – $1,781.67 | 12 |
| Add ue prost b/e acrylic HCPCS L7403 | not published | not published | $430.23 – $1,912.14 | 12 |
| Add ue prost be/wd, ultlite HCPCS L7400 | not published | not published | $358.08 – $1,591.47 | 12 |
| Add ue prost s/d acrylic HCPCS L7405 | not published | not published | $849.29 – $3,774.61 | 12 |
| Add ue prost s/d ultlite mat HCPCS L7402 | not published | not published | $432.91 – $1,924.09 | 12 |
| Add up-ex prosthes lock mech HCPCS L6698 | not published | not published | $789.29 – $3,508.01 | 12 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $30.54 | $76.35 | not published | 0 |
| Adenovirus ag ia CPT 87301 | $30.40 | $76.00 | $5.12 – $23.48 | 15 |
| Adenovirus antibody,serum - quest CPT 86603 | $32.40 | $81.00 | $7.40 – $25.23 | 15 |
| Adenovirus assay w/optic CPT 87809 | not published | not published | $5.12 – $42.65 | 14 |
| Adenovirus vaccine type 4 CPT 90476 | not published | not published | $572.77 – $1,657.45 | 2 |
| Adhesiolysis tube ovary 58740 CPT 58740 | not published | not published | $2,500.00 – $4,965.71 | 2 |
| Adh-sendout CPT 84588 | $78.40 | $196.00 | $8.93 – $66.52 | 15 |
| Adj gastric band via subq port CPT 43999 | $2,156.40 | $5,391.00 | $1,037.34 – $4,353.73 | 15 |
| Adjmt/revj ext fixj sys anes CPT 20693 | not published | not published | $1,708.81 – $34,831.50 | 14 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | not published | not published | $1,390.20 – $9,904.20 | 14 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $31.10 | $77.75 | not published | 0 |
| Admin ecg contrast agent CPT 93352 | not published | not published | $329.43 – $355.78 | 5 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $162.40 | $406.00 | $82.35 – $393.17 | 15 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $692.00 | $1,730.00 | $82.35 – $345.63 | 15 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $816.40 | $2,041.00 | $215.09 – $1,585.54 | 15 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $594.00 | $1,485.00 | $31.36 – $1,585.54 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $162.40 | $406.00 | $31.36 – $345.63 | 15 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $162.40 | $406.00 | $31.36 – $345.63 | 15 |
| Administration immunization 1 vaccine CPT 90471 | $55.60 | $139.00 | $27.29 – $345.63 | 15 |
| Administration immunization each additional component CPT 90461 | not published | not published | $27.29 – $29.48 | 5 |
| Administration immunization each additional vaccine CPT 90472 | $35.60 | $89.00 | $27.29 – $29.48 | 5 |
| Administration immunization first component each vaccine CPT 90460 | not published | not published | $27.29 – $29.48 | 5 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $46.00 | $115.00 | $27.29 – $345.63 | 15 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $46.00 | $115.00 | $27.29 – $29.48 | 5 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $283.20 | $708.00 | $27.29 – $29.48 | 5 |
| Administration vaccine hepatitis b HCPCS G0010 | $38.80 | $97.00 | $53.56 – $224.76 | 13 |
| Administration vaccine influenza virus HCPCS G0008 | $24.80 | $62.00 | $27.29 – $224.76 | 15 |
| Administration vaccine pneumococcal HCPCS G0009 | $38.80 | $97.00 | $27.29 – $224.76 | 15 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $283.20 | $708.00 | $27.29 – $29.48 | 5 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | not published | not published | $41.35 – $3,428.99 | 14 |
| Adrenal cortex & medulla img CPT 78075 | not published | not published | $684.51 – $6,214.62 | 14 |
| Adrenalectomy expl w/exc retro tumor 60545 CPT 60545 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Adrenalin epinephrine inject HCPCS J0171 | $17.10 | $42.73 | not published | 0 |
| Advance care planning each additional 30 min 99498 CPT 99498 | not published | not published | $73.56 – $104.24 | 6 |
| Adv prim care mgmt lvl 1 HCPCS G0556 | not published | not published | $42.85 – $179.84 | 11 |
| Adv prim care mgmt lvl 2 HCPCS G0557 | not published | not published | $42.85 – $179.84 | 11 |
| Adv prim care mgmt lvl 3 HCPCS G0558 | not published | not published | $116.19 – $487.67 | 11 |
| Aep hearing status deter i&r CPT 92651 | not published | not published | $58.00 – $1,036.49 | 13 |
| Aep neurodiagnostic i&r CPT 92653 | not published | not published | $58.00 – $1,296.68 | 13 |
| Aep thrshld est mlt freq i&r CPT 92652 | not published | not published | $58.00 – $1,296.68 | 13 |
| Afamelanotide implant, 1 mg HCPCS J7352 | not published | not published | $2,884.55 – $13,303.52 | 11 |
| Afamitresgene autoleucel HCPCS Q2057 | not published | not published | $755,207.60 – $1,510,415.20 | 9 |
| _afb id by dna probe rflx ast CPT 87149 | $50.40 | $126.00 | $5.12 – $39.30 | 15 |
| #afb mycobacteria suscep. #1 CPT 87190 | $14.40 | $36.00 | $5.12 – $14.33 | 15 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $292.00 | $730.00 | $113.05 – $226.11 | 13 |
| Aff2 gen aly detc abnl allel CPT 81171 | not published | not published | $30.75 – $268.52 | 14 |
| Aff2 gen alys charac alleles CPT 81172 | not published | not published | $84.33 – $538.67 | 14 |
| Aflibercept injection HCPCS J0178 | not published | not published | $717.25 – $4,137.14 | 14 |
| Afluria vacc, 3 yrs & >, im HCPCS Q2035 | not published | not published | $16.65 – $20.75 | 6 |
| Afo molded ankle gauntlet HCPCS L1904 | $275.60 | $689.00 | $452.68 – $2,334.63 | 13 |
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.