Intermountain Health Good Samaritan Hospital
Lafayette, CO
Posts prices for 33 of the 66 common shoppable procedures we track. Price file retrieved 2026-06-28.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Transforaminal epidural injection, lumbar/sacral (64483) | — | $2,735.60 | — |
| After-cataract laser surgery (YAG capsulotomy) (66821) | — | $1,645.80 | — |
| CT head/brain without contrast (70450) | — | $2,358.05 | — |
| MRI brain without contrast (70551) | — | $3,207.80 | — |
| MRI brain with contrast (70552) | — | $3,391.85 | — |
| MRI brain without and with contrast (70553) | — | $4,452.80 | — |
| X-ray lower spine, 4+ views (72110) | — | $577.70 | — |
| MRI lumbar spine without contrast (72148) | — | $3,190.95 | — |
| CT pelvis with contrast (72193) | — | $2,535.35 | — |
| MRI lower-extremity joint without contrast (73721) | — | $2,783.65 | — |
| CT abdomen and pelvis with contrast (74177) | — | $8,431.40 | — |
| Ultrasound, abdomen complete (76700) | — | $1,513.75 | — |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) | — | $1,482.85 | — |
| Ultrasound, transvaginal (76830) | — | $1,482.85 | — |
| Mammography, one breast (diagnostic) (77065) | — | $481.95 | — |
| Mammography, both breasts (diagnostic) (77066) | — | $616.35 | — |
| Mammography, screening (bilateral) (77067) | — | $509.55 | — |
| Basic metabolic panel (80048) | — | $255.85 | — |
| Comprehensive metabolic panel (80053) | — | $319.35 | — |
| Obstetric panel (80055) range across 2 matching MRF lines |
— | $1,253.14–$1,445.80 | — |
| Lipid panel (80061) range across 2 matching MRF lines |
— | $350.96–$404.90 | — |
| Renal function panel (80069) | — | $262.50 | — |
| Hepatic function panel (80076) | — | $247.05 | — |
| Urinalysis, non-automated, without microscopy (81002) range across 2 matching MRF lines |
— | $17.55–$63.55 | — |
| PSA, total (84153) range across 3 matching MRF lines |
— | $198.02–$482.02 | — |
| Thyroid stimulating hormone (TSH) (84443) range across 2 matching MRF lines |
— | $132.98–$297.70 | — |
| CBC with automated differential (85025) | — | $153.70 | — |
| CBC, automated (85027) | — | $151.30 | — |
| Prothrombin time (PT) (85610) range across 3 matching MRF lines |
— | $81.10–$108.59 | — |
| Partial thromboplastin time (PTT) (85730) range across 2 matching MRF lines |
— | $106.50–$135.23 | — |
| Left heart catheterization (93452) | — | $8,524.85 | — |
| Sleep study (attended polysomnography) (95810) | — | $9,506.90 | — |
| Physical therapy, therapeutic exercise (per 15 min) (97110) | — | $203.45 | — |
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: 405 codes with posted prices and Medicare benchmarks
- Lab & pathology: 1030 codes with posted prices and Medicare benchmarks
- Visits & medical services: 304 codes with posted prices and Medicare benchmarks
- Procedures & surgery: 692 codes with posted prices and Medicare benchmarks
- Supplies, drugs & other: 40 codes with posted prices and Medicare benchmarks
Get the raw price file
Download the machine-readable file (ZIP, 5.8 MB) ↓ — captured 2026-06-28
File links point at the hospital's own hosting and sometimes rotate — if the download fails, use the hospital's transparency page.