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 |
|---|---|---|---|---|
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,895.60 | $4,739.00 | $316.75 – $1,705.83 | 15 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,703.20 | $4,258.00 | $180.77 – $1,145.33 | 15 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $359.20 | $898.00 | $40.64 – $501.84 | 15 |
| Lower jaw bone graft CPT 21215 | not published | not published | $2,803.36 – $28,416.55 | 14 |
| Low frequency non-thermal Ultrasound CPT 97610 | not published | not published | $25.91 – $836.09 | 12 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $21.42 – $110.31 | 9 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $4,239.64 – $51,025.66 | 14 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $4,239.64 – $51,025.66 | 14 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $4,239.64 – $51,025.66 | 14 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $4,239.64 – $51,025.66 | 14 |
| Lso corset front HCPCS L0972 | not published | not published | $114.96 – $510.97 | 12 |
| Lso flex no ri stays pre ots HCPCS L0628 | $14.40 | $36.00 | $23.74 – $202.93 | 13 |
| Lso full corset HCPCS L0976 | not published | not published | $218.68 – $971.93 | 12 |
| Lso r post pnl sj-t9 pre cst HCPCS L0630 | $99.20 | $248.00 | $162.74 – $839.33 | 13 |
| Lso sag-coronal panel custom HCPCS L0638 | not published | not published | $1,537.88 – $6,835.13 | 12 |
| Lso sag-co shell pnl pre ots HCPCS L0651 | not published | not published | $398.32 – $2,790.45 | 12 |
| Lso sag ctr rigi pos pre ots HCPCS L0643 | not published | not published | $54.31 – $391.74 | 12 |
| Lso sagit rigid panel prefab HCPCS L0635 | not published | not published | $1,232.14 – $5,476.27 | 12 |
| Lso sagittal rigid panel cus HCPCS L0636 | not published | not published | $1,606.52 – $7,140.15 | 12 |
| Lso sc r pos/lat pnl pre cst HCPCS L0633 | $175.20 | $438.00 | $288.16 – $1,486.14 | 13 |
| Lso sc r pos/lat pnl pre ots HCPCS L0649 | not published | not published | $96.16 – $693.67 | 12 |
| Lso s/c shell/panel custom HCPCS L0640 | $640.00 | $1,600.00 | $1,051.52 – $5,423.07 | 13 |
| Lso s/c shell/panel prefab HCPCS L0639 | not published | not published | $1,310.58 – $5,824.86 | 12 |
| L/s ratio fetal lung CPT 83661 | $47.60 | $119.00 | $8.63 – $43.10 | 15 |
| Lumbar bolster pad HCPCS L1030 | not published | not published | $73.02 – $324.52 | 12 |
| Lumbar derotation pad HCPCS L1240 | $48.80 | $122.00 | $79.89 – $412.02 | 13 |
| Lumbar diskogram s&i CPT 72295 | $2,689.20 | $6,723.00 | $416.21 – $9,373.54 | 15 |
| Lumbar or lumbar rib pad HCPCS L1040 | not published | not published | $107.79 – $479.07 | 12 |
| Lumbar sling HCPCS L1090 | not published | not published | $111.02 – $493.47 | 12 |
| Lumbar Spinal Fusion (single level) CPT 22612 | not published | not published | $7,277.63 – $101,386.03 | 14 |
| Lumizyme injection HCPCS J0221 | not published | not published | $203.36 – $21,879.71 | 14 |
| Lung function test (mbc/mvv) CPT 94200 | $73.20 | $183.00 | $36.95 – $283.18 | 15 |
| Lung Function Test (Spirometry) CPT 94010 | $240.40 | $601.00 | $36.95 – $1,036.49 | 15 |
| Lung perfusion imaging CPT 78580 | $802.00 | $2,005.00 | $457.23 – $1,919.01 | 15 |
| Lung transplant double CPT 32853 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Lung transplant single CPT 32851 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Lung transplant with bypass CPT 32852 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Lung transplant with bypass CPT 32854 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Lung volume reduction 32491 CPT 32491 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | not published | not published | $207.86 – $3,428.99 | 13 |
| Luspatercept-aamt 25 mg subcutaneous solution HCPCS J0896 | not published | not published | $41.90 – $178.07 | 12 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $636.80 | $1,592.00 | $313.55 – $1,306.96 | 13 |
| Lutetium lu 177 vipivotide HCPCS A9607 | not published | not published | $254.40 – $30,528.69 | 13 |
| Lvad shower bag heartmate HCPCS Q0501 | $1,285.20 | $3,213.00 | $514.17 – $2,651.74 | 13 |
| Lw ntsty Ultrasound stimj bone healg CPT 20979 | not published | not published | $33.08 – $138.82 | 14 |
| Lwr ext dynamic prosth pylon HCPCS L5985 | $173.20 | $433.00 | $284.32 – $1,466.37 | 13 |
| Lyme dis dna dir probe CPT 87475 | not published | not published | $5.12 – $39.30 | 14 |
| Lymphadenect/stage/pelv/paraaortic 38562 CPT 38562 | not published | not published | $9,348.07 – $39,234.15 | 10 |
| Lymphatics/lymph node imaging CPT 78195 | $1,140.40 | $2,851.00 | $621.01 – $2,606.40 | 15 |
| Lymphocyte culture mixed CPT 86821 | not published | not published | $3.05 – $71.66 | 14 |
| Lymphocyte transformation mitogen CPT 86353 | $124.40 | $311.00 | $21.50 – $96.10 | 15 |
| Lymphocytotoxicity assay CPT 86805 | not published | not published | $18.60 – $371.44 | 14 |
| Lymphocytotoxicity assay CPT 86806 | not published | not published | $3.05 – $93.28 | 14 |
| Lymph vessel x-ray arm/leg CPT 75801 | not published | not published | $598.07 – $3,011.21 | 14 |
| Lymph vessel x-ray arms/legs CPT 75803 | not published | not published | $598.07 – $7,556.28 | 14 |
| Lymph vessel x-ray trunk CPT 75805 | $6,492.00 | $16,230.00 | $598.07 – $15,156.63 | 15 |
| Lymph vessel x-ray trunk CPT 75807 | not published | not published | $1,296.35 – $15,156.63 | 14 |
| Lysis intranasal synechia 30560 CPT 30560 | not published | not published | $616.84 – $2,588.91 | 14 |
| Lysis of labial adhesions CPT 56441 | $5,492.00 | $13,730.00 | $1,728.07 – $15,538.94 | 15 |
| Lysis penil circumic lesion CPT 54162 | not published | not published | $1,393.78 – $10,034.34 | 14 |
| Lyumjev for insulin pump use HCPCS J1813 | not published | not published | $24.92 – $72.60 | 2 |
| Macro exam dissect molec study ea CPT 88387 | not published | not published | $15.70 – $16.96 | 5 |
| Macroscopic exam arthropod CPT 87168 | $11.20 | $28.00 | $4.18 – $8.37 | 15 |
| Macroscopic exam parasite CPT 87169 | $11.60 | $29.00 | $4.22 – $8.45 | 15 |
| Magnesium CPT 83735 | $22.40 | $56.00 | $3.47 – $13.13 | 15 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $30.80 | $77.00 | not published | 0 |
| Magnetic image bone marrow CPT 77084 | $1,871.60 | $4,679.00 | $180.77 – $1,145.33 | 15 |
| Makena, 10 mg HCPCS J1726 | not published | not published | $19.35 – $80.28 | 4 |
| Malaria antibody CPT 86750 | not published | not published | $7.40 – $25.85 | 14 |
| Male sling procedure CPT 53440 | not published | not published | $3,796.07 – $63,331.64 | 14 |
| Management of liver hemorrhage 47361 CPT 47361 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Manipulate finger w/anesth CPT 26340 | not published | not published | $700.79 – $7,718.72 | 14 |
| Manipulate wrist w/anesthes CPT 25259 | not published | not published | $700.79 – $7,718.72 | 14 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $139.60 | $349.00 | $23.50 – $638.68 | 15 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $174.40 | $436.00 | $14.92 – $638.68 | 15 |
| Manipulation of hip joint CPT 27275 | not published | not published | $700.79 – $7,718.72 | 14 |
| Manipulation of spine CPT 22505 | not published | not published | $700.79 – $7,718.72 | 14 |
| Manipulat palm cord post inj CPT 26341 | not published | not published | $282.12 – $1,184.07 | 14 |
| Man's shoe oxford brace HCPCS L3225 | not published | not published | $75.57 – $335.86 | 12 |
| Manual diff wbc count b-coat CPT 85009 | $10.40 | $26.00 | $4.01 – $9.94 | 15 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | not published | not published | $226.73 – $244.87 | 5 |
| Mapping io sentinel lymph node CPT 38900 | not published | not published | $215.00 – $232.20 | 5 |
| Map tachycard site(s) CPT 93609 | $5,851.20 | $14,628.00 | $11,601.67 – $12,529.81 | 5 |
| Margetuximab-cmkb 25 mg/ml intravenous solution HCPCS J9353 | not published | not published | $52.21 – $3,428.99 | 13 |
| Marker biop eviva buckle ss HCPCS A4648 | $3,326.80 | $8,317.00 | not published | 0 |
| Marker lymphatic sentimag magtrace 10 vial HCPCS A9697 | not published | not published | $1,228.92 – $2,617.31 | 10 |
| Marsupialization liver lesion 47300 CPT 47300 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Mask full face lg af531 HCPCS A7030 | not published | not published | $123.70 – $149.30 | 2 |
| Mastectomy form HCPCS L8020 | not published | not published | $286.71 – $1,274.31 | 12 |
| Mastectomy partial CPT 19301 | not published | not published | $2,298.80 – $18,794.97 | 14 |
| Mast mod rad CPT 19307 | not published | not published | $4,834.74 – $31,874.32 | 14 |
| Mastoidectomy CPT 69501 | not published | not published | $3,243.71 – $28,416.55 | 14 |
| Mastoidectomy complete 69502 CPT 69502 | not published | not published | $3,243.71 – $28,416.55 | 14 |
| Mastoids complete CPT 70130 | $275.60 | $689.00 | $40.64 – $501.84 | 15 |
| Mastoid surgery revision CPT 69603 | not published | not published | $3,243.71 – $28,416.55 | 14 |
| Mastopexy CPT 19316 | not published | not published | $2,298.80 – $31,874.32 | 14 |
| Mast radical CPT 19305 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Mast rad urban type CPT 19306 | not published | not published | $2,500.00 – $2,500.00 | 1 |
| Mast simple complete CPT 19303 | not published | not published | $2,298.80 – $31,874.32 | 14 |
| Matrion 1 sq cm HCPCS Q4201 | not published | not published | $142.33 – $597.36 | 10 |
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.