Good Samaritan Regional Hlth Center
Mount Vernon, IL
Posts prices for 42 of the 66 common shoppable procedures we track. Price file retrieved 2026-10-01.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Upper GI endoscopy (EGD), diagnostic (43235) | $1,151.70 | $2,094 | 1.2× |
| CT head/brain without contrast (70450) | $1,887.60 | $3,432 | 16.8× |
| MRI brain without contrast (70551) range across 2 matching MRF lines |
$2,783–$3,374.25 | $5,060–$6,135 | varies |
| MRI brain with contrast (70552) | $3,551.90 | $6,458 | 9.5× |
| MRI brain without and with contrast (70553) | $3,729 | $6,780 | 10.0× |
| X-ray lower spine, 4+ views (72110) | $846.45 | $1,539 | 7.6× |
| MRI lumbar spine without contrast (72148) range across 2 matching MRF lines |
$2,291.85–$2,898.50 | $4,167–$5,270 | varies |
| CT pelvis with contrast (72193) | $2,161.50 | $3,930 | 11.5× |
| MRI lower-extremity joint without contrast (73721) | $3,015.10 | $5,482 | 11.8× |
| CT abdomen and pelvis with contrast (74177) | $4,334 | $7,880 | 11.6× |
| Ultrasound, abdomen complete (76700) | $1,271.60 | $2,312 | 11.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | $1,332.65 | $2,423 | 11.9× |
| Ultrasound, transvaginal (76830) | $856.90 | $1,558 | 7.6× |
| Mammography, one breast (diagnostic) (77065) | $289.85 | $527 | 3.4× |
| Mammography, both breasts (diagnostic) (77066) | $580.25 | $1,055 | 5.2× |
| Mammography, screening (bilateral) (77067) range across 2 matching MRF lines |
$174.35–$348.15 | $317–$633 | varies |
| Basic metabolic panel (80048) | $107.25 | $195 | 12.7× |
| Comprehensive metabolic panel (80053) | $148.50 | $270 | 14.1× |
| Obstetric panel (80055) | $57.20 | $104 | 1.2× |
| Lipid panel (80061) range across 2 matching MRF lines |
$128.70–$143.55 | $234–$261 | varies |
| Renal function panel (80069) | $139.15 | $253 | 16.0× |
| Hepatic function panel (80076) | $159.50 | $290 | 19.5× |
| Urinalysis, non-automated, with microscopy (81000) | $46.75 | $85 | 11.6× |
| Urinalysis, non-automated, without microscopy (81002) | $34.10 | $62 | 9.8× |
| PSA, total (84153) range across 3 matching MRF lines |
$27.50–$246.40 | $50–$448 | varies |
| Thyroid stimulating hormone (TSH) (84443) | $147.40 | $268 | 8.8× |
| CBC with automated differential (85025) | $81.40 | $148 | 10.5× |
| CBC, automated (85027) | $81.40 | $148 | 12.6× |
| Prothrombin time (PT) (85610) range across 8 matching MRF lines |
$15.40–$45.10 | $28–$82 | varies |
| Partial thromboplastin time (PTT) (85730) range across 4 matching MRF lines |
$34.65–$96.80 | $63–$176 | varies |
| Psychotherapy, 30 minutes (90832) range across 3 matching MRF lines |
$200.75–$265.10 | $365–$482 | varies |
| Psychotherapy, 45 minutes (90834) | $265.10 | $482 | 1.4× |
| Psychotherapy, 60 minutes (90837) | $366.30 | $666 | 1.9× |
| Family psychotherapy, without patient (50 min) (90846) | $290.40 | $528 | 1.5× |
| Family psychotherapy, with patient (50 min) (90847) | $300.85 | $547 | 1.6× |
| Group psychotherapy (90853) range across 4 matching MRF lines |
$137.50–$283.80 | $250–$516 | varies |
| Left heart catheterization (93452) | $5,848.70 | $10,634 | 1.7× |
| Sleep study (attended polysomnography) (95810) | $3,960.55 | $7,201 | 4.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) range across 2 matching MRF lines |
$107.25–$112.75 | $195–$205 | varies |
| Office visit, new patient (low complexity, ~30 min) (99203) | $148.50 | $270 | 1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) | $205.15 | $373 | 1.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) | $226.60 | $412 | 1.6× |
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: 351 codes with posted prices and Medicare benchmarks
- Lab & pathology: 883 codes with posted prices and Medicare benchmarks
- Visits & medical services: 225 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 546 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 67 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (JSON, 14.8 MB) ↓ — captured 2026-10-01
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.