Good Samaritan Hospital
San Jose, CA
Posts prices for 35 of the 66 common shoppable procedures we track. Price file retrieved 2026-09-03.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| CT head/brain without contrast (70450) | $19,447.54 | $19,447.54 | 126.5× |
| MRI brain without contrast (70551) | $20,680.10 | $20,680.10 | 58.9× |
| MRI brain with contrast (70552) | $27,326.81 | $27,326.81 | 53.3× |
| MRI brain without and with contrast (70553) range across 4 matching MRF lines |
$27,326.81–$39,916.07 | $27,326.81–$39,916.07 | varies |
| MRI lumbar spine without contrast (72148) | $22,182.83 | $22,182.83 | 63.2× |
| CT pelvis with contrast (72193) | $20,570.52 | $20,570.52 | 79.7× |
| MRI lower-extremity joint without contrast (73721) range across 5 matching MRF lines |
$18,082.61–$27,122.83 | $18,082.61–$27,122.83 | varies |
| CT abdomen and pelvis with contrast (74177) | $44,564.21 | $44,564.21 | 86.8× |
| Ultrasound, abdomen complete (76700) range across 2 matching MRF lines |
$3,629.33–$7,061.18 | $3,629.33–$7,061.18 | varies |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $6,669.50 | $6,669.50 | 43.4× |
| Ultrasound, transvaginal (76830) | $5,167.86 | $5,167.86 | 33.6× |
| Mammography, one breast (diagnostic) (77065) range across 8 matching MRF lines |
$702–$1,930.22 | $702–$1,930.22 | varies |
| Mammography, both breasts (diagnostic) (77066) range across 5 matching MRF lines |
$1,127.32–$2,516.12 | $1,127.32–$2,516.12 | varies |
| Mammography, screening (bilateral) (77067) range across 4 matching MRF lines |
$1,508.15–$2,620.28 | $1,508.15–$2,620.28 | varies |
| Basic metabolic panel (80048) | $2,184.50 | $2,184.50 | 258.2× |
| Comprehensive metabolic panel (80053) | $3,215.13 | $3,215.13 | 304.5× |
| Lipid panel (80061) range across 2 matching MRF lines |
$19.13–$1,408.88 | $19.13–$1,408.88 | varies |
| Renal function panel (80069) | $2,602.06 | $2,602.06 | 299.8× |
| Hepatic function panel (80076) | $2,030.44 | $2,030.44 | 248.5× |
| Urinalysis, non-automated, without microscopy (81002) | $274.13 | $274.13 | 78.8× |
| PSA, total (84153) range across 2 matching MRF lines |
$3.19–$27.63 | $3.19–$27.63 | varies |
| Thyroid stimulating hormone (TSH) (84443) range across 3 matching MRF lines |
$13.81–$1,900.81 | $13.81–$1,900.81 | varies |
| CBC, automated (85027) | $1,039.13 | $1,039.13 | 160.6× |
| Prothrombin time (PT) (85610) range across 3 matching MRF lines |
$6.38–$928.63 | $6.38–$928.63 | varies |
| Partial thromboplastin time (PTT) (85730) range across 6 matching MRF lines |
$5.31–$1,067.81 | $5.31–$1,067.81 | varies |
| Psychotherapy, 30 minutes (90832) | $1,292.24 | $1,292.24 | 4.9× |
| Psychotherapy, 45 minutes (90834) | $1,736 | $1,736 | 6.6× |
| Psychotherapy, 60 minutes (90837) | $2,069.10 | $2,069.10 | 7.9× |
| Family psychotherapy, without patient (50 min) (90846) | $1,736 | $1,736 | 6.6× |
| Family psychotherapy, with patient (50 min) (90847) | $1,736 | $1,736 | 6.6× |
| Group psychotherapy (90853) | $1,448.48 | $1,448.48 | 9.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 9 matching MRF lines |
$449.19–$744.31 | $449.19–$744.31 | varies |
| Office visit, new patient (low complexity, ~30 min) (99203) range across 4 matching MRF lines |
$1,286–$2,235.10 | $1,286–$2,235.10 | varies |
| Office visit, new patient (moderate complexity, ~45 min) (99204) range across 4 matching MRF lines |
$1,584–$2,957.71 | $1,584–$2,957.71 | varies |
| Office visit, new patient (high complexity, ~60 min) (99205) range across 4 matching MRF lines |
$1,882–$3,886.47 | $1,882–$3,886.47 | varies |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
More prices at this hospital
- Imaging: 371 codes with posted prices and Medicare benchmarks
- Lab & pathology: 809 codes with posted prices and Medicare benchmarks
- Visits & medical services: 223 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 30 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 44 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (JSON, 677.5 MB) ↓ — captured 2026-09-03
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.