Supplies, drugs & other prices at Good Samaritan Hospital
San Jose, CA · every code in this section with a posted price and a Medicare benchmark.
44 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| 2d tee w or w/o fol w/con,in (C8925) range across 2 matching MRF lines |
$18,767.25–$27,018.67 | $18,767.25–$27,018.67 | varies |
| 2d tte w or w/o fol w/con,fu (C8924) | $8,686.51 | $8,686.51 | 16.9× |
| Adm tocilizu covid-19 1st (M0249) | $596.25 | $596.25 | 0.9× |
| Admin hepatitis b vaccine (G0010) | $394.32 | $394.32 | 5.7× |
| Admin influenza virus vac (G0008) | $394.32 | $394.32 | 5.7× |
| Admin pneumococcal vaccine (G0009) | $394.32 | $394.32 | 5.7× |
| Catheterize for urine spec (P9612) | $1,723.38 | $1,723.38 | 184.5× |
| Covid-19 lab test non-cdc (U0002) range across 4 matching MRF lines |
$61.63–$121.13 | $61.63–$121.13 | varies |
| Diab manage trn per indiv (G0108) range across 2 matching MRF lines |
$434–$1,261.86 | $434–$1,261.86 | varies |
| Diab manage trn ind/group (G0109) range across 3 matching MRF lines |
$119.35–$943.95 | $119.35–$943.95 | varies |
| Direct refer hospital observ (G0379) | $1,227.14 | $1,227.14 | 1.4× |
| Drug test def 1-7 classes (G0480) | $231.63 | $231.63 | 2.0× |
| Drug test def 15-21 classes (G0482) | $1,578.88 | $1,578.88 | 7.9× |
| Drug test def 22+ classes (G0483) | $1,159.19 | $1,159.19 | 4.7× |
| Drug test def 8-14 classes (G0481) | $643.88 | $643.88 | 4.1× |
| Elec stim other than wound (G0283) range across 6 matching MRF lines |
$209.41–$618.45 | $209.41–$618.45 | varies |
| Fern test (Q0114) | $646 | $646 | 66.3× |
| Group mnt 2 or more 30 mins (G0271) | $124.78 | $124.78 | 7.3× |
| Hbot, full body chamber, 30m (G0277) | $2,159.82 | $2,159.82 | 10.7× |
| Hep c screen high risk/other (G0472) | $61.63 | $61.63 | 1.3× |
| Histotripsy mal hepatocellular tiss w/img gdn (0686T) | $97,909.99 | $97,909.99 | 3.9× |
| Hiv combination assay (G0475) | $12.75 | $12.75 | 0.5× |
| Lev 1 hosp type b ed visit (G0380) | $450.24 | $450.24 | 4.1× |
| Lev 2 hosp type b ed visit (G0381) | $2,376.64 | $2,376.64 | 17.4× |
| Lev 3 hosp type b ed visit (G0382) | $3,393.60 | $3,393.60 | 13.4× |
| Lev 4 hosp type b ed visit (G0383) | $6,624.80 | $6,624.80 | 17.0× |
| Lev 5 hosp type b ed visit (G0384) | $10,168.48 | $10,168.48 | 16.8× |
| Mnt subs tx for change dx (G0270) | $224.60 | $224.60 | 7.1× |
| Mra w/cont, lwr ext (C8912) range across 3 matching MRF lines |
$10,680.74–$20,898.19 | $10,680.74–$20,898.19 | varies |
| Mra w/o fol w/cont, abd (C8902) | $25,382.49 | $25,382.49 | 49.5× |
| Mra w/o fol w/cont, chest (C8911) | $30,837.87 | $30,837.87 | 60.1× |
| Mra w/o fol w/cont, lwr ext (C8914) | $14,766.85 | $14,766.85 | 28.8× |
| Mra w/o fol w/cont, pelvis (C8920) | $1,280.30 | $1,280.30 | 2.5× |
| Mra, w/o&w/dye, upper extr (C8936) | $10,680.74 | $10,680.74 | 20.8× |
| Mri w/cont, breast, bi (C8906) | $31,115.63 | $31,115.63 | 60.6× |
| Mri w/cont, breast, uni (C8903) range across 4 matching MRF lines |
$13,133.93–$27,356.11 | $13,133.93–$27,356.11 | varies |
| Mri w/o fol w/cont, breast, (C8908) | $37,243.71 | $37,243.71 | 72.6× |
| Mri w/o fol w/cont, brst, un (C8905) range across 2 matching MRF lines |
$32,592.32–$32,743.13 | $32,592.32–$32,743.13 | varies |
| Quan CT tiss charac i&r w/cncrnt CT exam (0722T) | $2,513.95 | $2,513.95 | 2.7× |
| Tee w or w/o fol w/cont,cong (C8926) | $34,371.72 | $34,371.72 | 29.8× |
| Tte w or w/o fol w/cont, com (C8921) | $28,802.41 | $28,802.41 | 25.0× |
| Tte w or w/o fol w/cont, f/u (C8922) | $18,630.54 | $18,630.54 | 16.2× |
| Tte w or wo fol wcon,doppler (C8929) range across 2 matching MRF lines |
$12,299.56–$16,540.83 | $12,299.56–$16,540.83 | varies |
| Unsched dialysis esrd pt hos (G0257) | $13,960.70 | $13,960.70 | 13.8× |
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.