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 |
|---|---|---|---|---|
| Diagnostic anoscopy CPT 46601 | not published | not published | $127.62 – $2,144.37 | 14 |
| Diagnostic anoscopy & biopsy CPT 46607 | not published | not published | $689.17 – $5,744.14 | 14 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $344.40 | $861.00 | $127.62 – $638.68 | 15 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $87.60 | $219.00 | $122.34 – $139.81 | 2 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $68.40 | $171.00 | $95.39 – $109.01 | 2 |
| Diagnostic laryngoscopy 31505 CPT 31505 | not published | not published | $78.87 – $958.15 | 14 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $469.60 | $1,174.00 | $78.87 – $958.15 | 15 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $384.40 | $961.00 | $35.95 – $220.58 | 15 |
| Diagnostic Mammogram (one breast) CPT 77065 | $299.60 | $749.00 | $35.95 – $178.86 | 15 |
| Diagnostic radio unlisted proc CPT 76499 | $37.20 | $93.00 | $40.64 – $417.74 | 15 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $2,101.20 | $5,253.00 | not published | 0 |
| Dialysis one evaluation CPT 90945 | $540.80 | $1,352.00 | $477.23 – $1,865.50 | 15 |
| Dialysis repeated eval CPT 90947 | $1,583.60 | $3,959.00 | not published | 0 |
| Diathermy eg microwave CPT 97024 | not published | not published | $4.29 – $34.54 | 14 |
| Diatrizoate meglumine 18 % urethral solution HCPCS Q9958 | $0.40 | $1.00 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $50.00 | $125.00 | not published | 0 |
| Dicyclomine injection HCPCS J0500 | $86.42 | $216.05 | not published | 0 |
| Difelikefalin, esrd on dialy HCPCS J0879 | not published | not published | $0.18 – $275.57 | 8 |
| Diffusing capacity CPT 94729 | $232.40 | $581.00 | $36.95 – $39.90 | 5 |
| Digital analysis of eeg CPT 95957 | $396.40 | $991.00 | $27.35 – $29.53 | 5 |
| Digit nerve surgery add-on CPT 64778 | not published | not published | $976.42 – $1,054.54 | 5 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $34.82 | $87.05 | not published | 0 |
| Digoxin immune fab 40 mg intravenous solution HCPCS J1162 | not published | not published | $4,208.84 – $21,268.23 | 14 |
| Digoxin total therapeutic drug level CPT 80162 | $32.40 | $81.00 | $7.45 – $26.03 | 15 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $141.42 | $353.55 | not published | 0 |
| Dilate biliary duct/ampulla CPT 47542 | $1,073.60 | $2,684.00 | $1,788.22 – $1,931.28 | 5 |
| Dilate esophagus CPT 43453 | not published | not published | $477.34 – $9,211.19 | 14 |
| Dilate esophagus 1/mult pass CPT 43450 | not published | not published | $477.34 – $4,353.73 | 14 |
| Dilate ic vasospasm ea add vsl diff territory CPT 61642 | $624.00 | $1,560.00 | $358.26 – $8,616.02 | 7 |
| Dilate ic vasospasm ea add vsl same territory CPT 61641 | $286.80 | $717.00 | $179.12 – $8,616.02 | 7 |
| Dilate ic vasospasm init CPT 61640 | $817.60 | $2,044.00 | $510.08 – $8,616.02 | 7 |
| Dilate tear duct opening CPT 68801 | not published | not published | $223.72 – $2,144.37 | 14 |
| Dilate urethra stricture CPT 53600 | not published | not published | $51.14 – $1,199.32 | 14 |
| Dilate urethra stricture CPT 53601 | not published | not published | $51.14 – $638.68 | 14 |
| Dilate urethra stricture CPT 53605 | not published | not published | $269.75 – $16,920.72 | 14 |
| Dilate urethra stricture CPT 53621 | not published | not published | $269.75 – $1,199.32 | 14 |
| Dilation/female urethra/initial 53660 CPT 53660 | not published | not published | $51.14 – $673.34 | 14 |
| Dilation of anal sphincter CPT 45905 | $1,995.20 | $4,988.00 | $1,045.71 – $5,744.14 | 15 |
| Dilation of cervical canal 57800 CPT 57800 | not published | not published | $1,612.89 – $15,538.94 | 14 |
| Dilation of rectal stricture 45910 CPT 45910 | not published | not published | $1,045.71 – $5,744.14 | 14 |
| Dilation of salivary duct CPT 42660 | not published | not published | $616.84 – $2,588.91 | 14 |
| Dilation of urethra CPT 53661 | not published | not published | $51.14 – $638.68 | 14 |
| Dilation of urethra CPT 53665 | not published | not published | $269.75 – $10,034.34 | 14 |
| Dilation of vagina CPT 57400 | not published | not published | $1,728.07 – $15,538.94 | 14 |
| Dilation salivary duct 42650 CPT 42650 | not published | not published | $1,774.58 – $7,447.96 | 14 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | not published | not published | $269.75 – $3,347.17 | 14 |
| Dilator fascial 10fx20cm HCPCS C2627 | $555.20 | $1,388.00 | not published | 0 |
| Dilat xst trc ndurlgc px CPT 50436 | $1,510.80 | $3,777.00 | $1,071.48 – $16,920.72 | 15 |
| Dilat xst trc new access rcs CPT 50437 | $2,520.40 | $6,301.00 | $1,071.48 – $16,920.72 | 15 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $3.05 | $7.62 | not published | 0 |
| Dimecaprol injection HCPCS J0470 | not published | not published | $60.50 – $276.92 | 2 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | not published | not published | $255.16 – $2,957.18 | 14 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $37.46 | $93.65 | not published | 0 |
| Dir nsl mucous membrane test CPT 95065 | not published | not published | $30.21 – $179.28 | 14 |
| Disability dlco CPT 94727 | $289.20 | $723.00 | $36.95 – $1,036.49 | 15 |
| Disaccharidases CPT 82657 | $46.00 | $115.00 | $8.63 – $43.45 | 15 |
| Disarticulation sho sec clsr CPT 23921 | not published | not published | $1,238.45 – $9,904.20 | 14 |
| Disarticulation shoulder CPT 23920 | not published | not published | $14,683.87 – $61,628.63 | 10 |
| Discectomy ant dcmprn cord thoracic 1 ntrspc 63077 CPT 63077 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Discectomy ant dcmprn cord thoracic ea ntrsp 63078 CPT 63078 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Discography cerv/thor spine CPT 72285 | $5,070.40 | $12,676.00 | $416.21 – $9,373.54 | 15 |
| Disconnect insert locking wr HCPCS L6616 | $48.80 | $122.00 | $79.87 – $411.93 | 13 |
| Disconnect locking wrist uni HCPCS L6615 | $133.20 | $333.00 | $219.19 – $1,130.41 | 13 |
| Dise eval slp do brth flx dx CPT 42975 | not published | not published | $827.61 – $8,543.90 | 11 |
| Dissect brain w/scope CPT 62161 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Dis site tele svcs rhc/fqhc HCPCS G2025 | not published | not published | $109.74 – $455.04 | 2 |
| Dist revas ligation hemo CPT 36838 | not published | not published | $2,600.99 – $26,710.80 | 14 |
| Div aberrant vsl w/reanast CPT 33803 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Diverticulectomy/hypophar/esoph 43130 CPT 43130 | not published | not published | $2,894.25 – $28,416.55 | 14 |
| Division of fallopian tube 58605 CPT 58605 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| #d/lmeth-l-methamphetamine CPT 80374 | $41.60 | $104.00 | not published | 0 |
| Dlyd plmt xtn prosth ea addl CPT 34711 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Dmd dup/delet analysis CPT 81161 | $228.00 | $570.00 | $84.33 – $546.84 | 15 |
| Dmpk gene charac alleles CPT 81239 | $367.20 | $918.00 | $84.33 – $538.67 | 15 |
| Dmpk gene detc abnor allele CPT 81234 | $143.60 | $359.00 | $30.75 – $268.52 | 15 |
| Dna antibody native/double stranded CPT 86225 | $34.00 | $85.00 | $7.40 – $26.93 | 15 |
| Dna gardnerella CPT 87510 | $50.40 | $126.00 | $5.12 – $39.30 | 15 |
| Dna probe chlamydia CPT 87490 | $50.40 | $126.00 | $5.12 – $44.59 | 15 |
| Dna probe gc CPT 87590 | $54.00 | $135.00 | $5.12 – $52.68 | 15 |
| Dna trichomonas CPT 87660 | $40.00 | $100.00 | $5.12 – $39.30 | 15 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $44.40 | $111.00 | not published | 0 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | not published | not published | $2.22 – $55.13 | 6 |
| Docetaxel (docivyx), 1 mg HCPCS J9172 | not published | not published | $49.59 – $236.08 | 13 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $4.85 | $12.10 | not published | 0 |
| Doppler echo complete CPT 93320 | $560.40 | $1,401.00 | $329.43 – $355.78 | 5 |
| Doppler intravascular pressure flow initial vessel CPT 93571 | $2,158.80 | $5,397.00 | $1,296.35 – $1,400.06 | 5 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $455.60 | $1,139.00 | $118.97 – $1,036.49 | 15 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $340.00 | $850.00 | $78.52 – $638.68 | 15 |
| Doripenem 50 mg/ml inj 10 ml HCPCS J1267 | not published | not published | $3.00 – $64.17 | 7 |
| Dornase alfa non-comp unit HCPCS J7639 | $53.62 | $134.04 | $131.84 – $131.84 | 1 |
| Dorsi & plantar flex ass/res HCPCS L2220 | $56.80 | $142.00 | $93.16 – $480.46 | 13 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | not published | not published | $242.14 – $7,001.18 | 13 |
| Double transfer toe-hand CPT 26554 | not published | not published | $8,299.08 – $34,831.50 | 10 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $264.42 | $661.05 | not published | 0 |
| Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension HCPCS Q2050 | not published | not published | $70.42 – $1,272.76 | 14 |
| Doxycycline hyclate 100 mg intravenous powder for solution HCPCS J1271 | $0.68 | $1.68 | not published | 0 |
| Dpyd gene common variants CPT 81232 | $210.40 | $526.00 | $171.31 – $342.63 | 13 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | not published | not published | $78.87 – $3,399.19 | 14 |
| Drainage ext aud canal abscess 69020 CPT 69020 | not published | not published | $78.87 – $3,399.19 | 14 |
| Drainage external ear complex 69005 CPT 69005 | not published | not published | $652.16 – $7,928.07 | 14 |
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.