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 |
|---|---|---|---|---|
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $50.00 | $125.00 | $0.13 – $0.20 | 3 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $78.60 | $196.50 | not published | 0 |
| Hydromorphone injection HCPCS J1170 | $50.00 | $125.00 | not published | 0 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.01 – $0.02 | 3 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $45.84 | $114.60 | not published | 0 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $44.00 | $110.00 | $8.93 – $35.08 | 15 |
| Hymenotomy CPT 56442 | not published | not published | $324.94 – $15,538.94 | 14 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $17.77 – $82.58 | 12 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $2,476.42 – $28,416.55 | 14 |
| Hyperbaric oxygen therapy CPT 99183 | not published | not published | not published | 0 |
| #hypersens-actinomyces ab CPT 86602 | $15.60 | $39.00 | $7.40 – $19.95 | 15 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $345.64 – $3,343.22 | 14 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $129.92 – $1,851.45 | 14 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $345.64 – $2,652.31 | 14 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $345.64 – $2,652.31 | 14 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $345.64 – $2,652.31 | 14 |
| Hypnotherapy CPT 90880 | not published | not published | $116.19 – $487.67 | 12 |
| Hypothermia ill neonate CPT 99184 | $416.40 | $1,041.00 | $2,500.00 – $2,500.00 | 1 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $18.43 – $73.48 | 12 |
| Hysterectomy/bladder repair CPT 51925 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Hysterectomy/revise vagina 58275 CPT 58275 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Hysterectomy/revise vagina 58280 CPT 58280 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Hysteroplasty 58540 CPT 58540 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Hysterorrhaphy of ruptured uterus 59350 CPT 59350 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Hysterosalpingography s&i CPT 74740 | $610.40 | $1,526.00 | $85.70 – $1,145.33 | 15 |
| Hysteroscopy ablation CPT 58563 | not published | not published | $1,612.89 – $24,012.92 | 14 |
| Hysteroscopy biopsy CPT 58558 | not published | not published | $1,612.89 – $15,538.94 | 14 |
| Hysteroscopy dx sep proc CPT 58555 | not published | not published | $1,612.89 – $15,538.94 | 14 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $1,612.89 – $24,012.92 | 14 |
| Hysteroscopy remove fb CPT 58562 | not published | not published | $1,612.89 – $15,538.94 | 14 |
| Hysteroscopy remove myoma CPT 58561 | not published | not published | $2,938.41 – $24,012.92 | 14 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $1,612.89 – $24,012.92 | 14 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $2,631.36 – $24,012.92 | 14 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $79.20 | $198.00 | $77.90 – $310.31 | 6 |
| I-123 iobenguane diag HCPCS A9582 | $7,262.80 | $18,157.00 | $2,271.15 – $12,205.42 | 11 |
| I-123 ioflupane diag HCPCS A9584 | not published | not published | $1,359.99 – $8,824.22 | 11 |
| I-123 sod iodide diag per 100 uci HCPCS A9516 | $205.20 | $513.00 | not published | 0 |
| I125 iothalamate, dx HCPCS A9554 | not published | not published | $636.65 – $3,007.83 | 10 |
| I125 serum albumin, dx HCPCS A9532 | not published | not published | $459.68 – $2,171.75 | 10 |
| I-131 iobenguane sulf diag mibg HCPCS A9508 | not published | not published | $933.95 – $4,412.44 | 10 |
| I131 iodide cap, rx HCPCS A9517 | $33.20 | $83.00 | $23.59 – $347.38 | 15 |
| I131 iodide sol, rx HCPCS A9530 | not published | not published | $20.35 – $347.38 | 14 |
| Iaadi respiratory synctial virus CPT 87280 | $31.20 | $78.00 | $5.12 – $26.30 | 15 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | not published | not published | $19.51 – $68.78 | 14 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | $34.00 | $85.00 | $7.40 – $35.46 | 15 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $21.50 – $88.75 | 13 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $113.26 – $142.84 | 7 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $286.81 – $4,799.18 | 13 |
| Ibutilide fumarate 0.1 mg/ml intravenous solution HCPCS J1742 | not published | not published | $113.26 – $1,293.58 | 14 |
| Icatibant injection HCPCS J1744 | not published | not published | $189.08 – $897.48 | 4 |
| Icd cobalt xt dr MRI is1 df1 HCPCS C1721 | $25,334.80 | $63,337.00 | not published | 0 |
| Icd crtd cobalt hf MRI is1 df1 HCPCS C1882 | $30,186.80 | $75,467.00 | not published | 0 |
| Icd crtp serena MRI HCPCS C2621 | $11,588.00 | $28,970.00 | not published | 0 |
| Icd reliance df4 ib 64cm HCPCS C1895 | $5,964.00 | $14,910.00 | not published | 0 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $223.72 – $1,296.68 | 14 |
| Icut allergy test-delayed CPT 95028 | not published | not published | $30.21 – $179.28 | 14 |
| Icut allergy test drug/bug CPT 95024 | not published | not published | $30.21 – $283.18 | 14 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $30.21 – $138.82 | 14 |
| I&d abscess posterior spine l/s/ls-22015 CPT 22015 | not published | not published | $8,299.08 – $34,831.50 | 10 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $652.16 – $15,914.98 | 14 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $51.05 – $55.13 | 5 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $1,531.31 – $7,928.07 | 14 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $548,585.46 – $1,097,170.92 | 10 |
| Identify sperm tissue CPT 89264 | not published | not published | $59.60 – $250.15 | 12 |
| Idet 1 or more levels CPT 22527 | $1,474.40 | $3,686.00 | $1,751.24 – $3,567.91 | 7 |
| Idet single level CPT 22526 | $1,888.80 | $4,722.00 | $2,133.15 – $3,567.91 | 7 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | not published | not published | $1,227.92 – $15,706.36 | 14 |
| Idh1 common variants CPT 81120 | $139.60 | $349.00 | $84.33 – $378.77 | 15 |
| Idh2 common variants CPT 81121 | $213.20 | $533.00 | $84.33 – $579.75 | 15 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $1,594.99 – $13,323.79 | 14 |
| I&d lacrimal gland CPT 68400 | not published | not published | $951.83 – $4,785.26 | 14 |
| I&d lacrimal sac CPT 68420 | not published | not published | $1,175.19 – $11,412.47 | 14 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | not published | not published | $1,238.45 – $13,943.31 | 14 |
| Idursulfase injection HCPCS J1743 | not published | not published | $547.06 – $2,513.86 | 12 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $1,728.07 – $13,943.31 | 14 |
| I&d vag hemtma obst/postpart CPT 57022 | not published | not published | $1,346.48 – $13,943.31 | 14 |
| Ifnl3 gene CPT 81283 | not published | not published | $30.75 – $143.81 | 14 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $84.33 – $406.33 | 13 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $30.75 – $134.36 | 14 |
| Igh gene rearrange amp meth CPT 81261 | $355.20 | $888.00 | $84.33 – $388.06 | 15 |
| Igh@ var region somatic mutation analy CPT 81263 | $527.60 | $1,319.00 | $84.33 – $577.26 | 15 |
| Igk rearrangeabn clonal pop CPT 81264 | $295.20 | $738.00 | $84.33 – $338.55 | 15 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $92.40 | $231.00 | $28.69 – $30.98 | 5 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $657.60 | $1,644.00 | $28.69 – $1,720.62 | 15 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $248.40 | $621.00 | $28.69 – $817.83 | 15 |
| Iiv3 vacc no prsv 0.25 ml im CPT 90655 | not published | not published | $19.59 – $19.59 | 1 |
| Ikbkap gene CPT 81260 | $69.20 | $173.00 | $30.75 – $77.05 | 15 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Iliac bone graft microvasc CPT 20956 | not published | not published | $8,299.08 – $34,831.50 | 10 |
| Iliac/fem angio cath insert HCPCS G0278 | not published | not published | $2,922.55 – $3,156.36 | 5 |
| Iliac revasc add-on 37222 CPT 37222 | not published | not published | $7,787.45 – $8,410.44 | 5 |
| Iloprost non-comp unit dose HCPCS Q4074 | not published | not published | $171.96 – $223.22 | 2 |
| Imbrication/diaphragm/transthor/transabd 39545 CPT 39545 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $57.01 – $256.83 | 11 |
| Img rta detcj/mntr ds staff CPT 92227 | not published | not published | $67.47 – $283.18 | 12 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | not published | not published | $42.72 – $179.28 | 12 |
| Img rta detc/mntr ds poc aly CPT 92229 | not published | not published | $67.47 – $283.18 | 11 |
| Immob elbow child sm HCPCS L3762 | $127.60 | $319.00 | $98.33 – $507.12 | 13 |
| Immobilizer lwr extrem nylon 20in reinforc 21-35in HCPCS L2999 | $29.20 | $73.00 | not published | 0 |
| Immobilizer shldr cntor adlt HCPCS L3670 | $175.60 | $439.00 | $110.73 – $571.06 | 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.