Supplies, drugs & other prices at Good Samaritan Regional Medical Center

Corvallis, OR · every code in this section with a posted price and a Medicare benchmark.

61 codes. Prices are the hospital's own posted facility charges.

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ProcedurePosted cashPosted gross× Medicare
2d tee w or w/o fol w/con,in (C8925) $2,168 $2,710 2.5×
2d tte w or w/o fol w/con,fu (C8924) $1,072 $1,340 2.8×
Adm of soc dtr assess 5-15 m (G0136)
range across 2 matching MRF lines
$25.60–$37.60 $32–$47 varies
Admin hepatitis b vaccine (G0010) $72 $90 1.4×
Admin pneumococcal vaccine (G0009) $64 $80 1.2×
Alcohol/subs interv 15-30mn (G0396) $128 $160 3.1×
Alcohol/subs interv >30 min (G0397) $232 $290 1.2×
Ascvd rsk mng clin stf pr mo (G0538) $20.80 $26 0.2×
Catheterize for urine spec (P9612) $58.40 $73 6.3×
Chemo extend iv infus w/pump (G0498) $880 $1,100 2.4×
Comm hlth intg svs sdoh 60mn (G0019) $112 $140 1.0×
Diab manage trn per indiv (G0108) $104 $130 1.9×
Diab manage trn ind/group (G0109) $42.40 $53 2.6×
Direct refer hospital observ (G0379) $1,056 $1,320 1.6×
Ekg tracing for initial prev (G0404) $52 $65 1.6×
Elec stim other than wound (G0283)
range across 2 matching MRF lines
$16.80–$65.60 $21–$82 varies
Followup eval of foot pt lop (G0246) $160 $200 1.1×
Group behave couns 2-10 (G0473) $56 $70 1.3×
Group mnt 2 or more 30 mins (G0271) $18.40 $23 1.1×
Hbot, full body chamber, 30m (G0277)
range across 2 matching MRF lines
$448–$472 $560–$590 varies
Hdr electronic brachytherapy ntrstl/intrcav (0395T) $1,984 $2,480 2.6×
Hep c screen high risk/other (G0472) $80 $100 1.7×
Hepb screen high risk indiv (G0499) $152 $190 5.4×
Hiv combination assay (G0475) $96 $120 4.0×
Home sleep test/type 3 porta (G0399) $768 $960 3.2×
Ig paraprotein qual imprcip&ms bld/ur w/isotype (0077U) $448 $560 10.3×
Initial foot exam pt lops (G0245) $208 $260 1.4×
Jak2 Gene Analysis Trgt Seq Alys Exons 12-15 (0027U) $440 $550 3.6×
Liver Dis 10 Assays Serum Algorithm W/Nash (0003M) $976 $1,220 1.9×
Low intensity eswt corpus cavernosum low energy (0864T) $320 $400 1.2×
Mnt subs tx for change dx (G0270) $50.40 $63 1.6×
Mra w/o fol w/cont, chest (C8911) $2,672 $3,340 6.9×
Nav srv peer sup 60 min pr m (G0140) $112 $140 1.0×
Neuro csf prion prtn qual (0035U)
range across 2 matching MRF lines
$488–$649.60 $610–$812 varies
Obtaining screen pap smear (Q0091) $58.40 $73 1.8×
Onc merkel cell carc detcj antb serum reprtd +/- (0059U) $344.80 $431 1.1×
Onc Merkel Cll Carc Srm Quan (0058U)
range across 2 matching MRF lines
$355.20–$664 $444–$830 varies
Oth resp proc, group (G0239) $76.80 $96 1.8×
Oth resp proc, indiv (G0238) $76.80 $96 2.4×
Pemivibart infusion (M0224) $544 $680 1.1×
Perc d-e cor revasc chro sin (C9607) $19,848 $24,810 1.0×
Perc d-e cor revasc t cabg s (C9604) $14,136 $17,670 1.1×
Perc d-e cor stent ather s (C9602) $17,200 $21,500 0.8×
Perc drug-el cor stent sing (C9600) $24,000 $30,000 1.9×
Pin service 60m per month (G0023) $104 $130 0.9×
Pne flu hepb cov home admin (M0201) $29.60 $37 0.7×
Prolonged iv inf, req pump (C8957) $430.40 $538 1.8×
Prostate biopsy, any mthd (G0416) $488 $610 1.2×
Psa screening (G0103) $88 $110 4.6×
Rem multi day cplx uroflowmetry dev sply w/reprt (0812T)
range across 2 matching MRF lines
$48.80–$62.40 $61–$78 varies
Rem multi day cplx uroflowmetry setup&pt educaj (0811T)
range across 2 matching MRF lines
$27.20–$168 $34–$210 varies
Risk ascvd tst once pr 12 mo (G0537) $25.60 $32 0.6×
Routine footcare pt w lops (G0247) $184 $230 0.8×
Rx Metab Advrs Trgt Seq Alys (0029U) $1,728 $2,160 2.3×
Therapeutic procd strg endur (G0237) $68.80 $86 2.1×
Trauma respons w/hosp criti (G0390)
range across 4 matching MRF lines
$1,568–$4,152 $1,960–$5,190 varies
Trgt gen seq alys sld orgn neo DNA 324 genes (0037U)
range across 2 matching MRF lines
$4,736–$8,440 $5,920–$10,550 varies
Trluml Perip Athrc Iliac Art (0238T) $20,056 $25,070 1.0×
Tte w or w/o contr, cont ecg (C8930) $2,080 $2,600 2.4×
Tte w or wo fol wcon,doppler (C8929) $1,712 $2,140 2.0×
Unsched dialysis esrd pt hos (G0257) $1,352 $1,690 1.8×

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.