CostGrade

All published prices at Good Samaritan Medical Center

104 procedures, each showing what the hospital billed, what that care was actually paid for, and how the charge compares with the national middle for the same coded work.

A
Procedure Patients Charged Actually paid vs national
Comprehensive Observation Services

APC 8011 · Hospital outpatient visit

417 $10,763 $2,906 -45%
Sepsis (severe)

MS-DRG 871 · Inpatient stay

296 $31,788 $16,041 -51%
Heart Failure (severe)

MS-DRG 291 · Inpatient stay

225 $21,722 $11,000 -50%
Pneumonia (severe)

MS-DRG 193 · Inpatient stay

155 $15,744 $10,773 -66%
Respiratory Infection (severe)

MS-DRG 177 · Inpatient stay

147 $21,921 $13,464 -60%
Level 1 Laparoscopy and Related Services

APC 5361 · Hospital outpatient visit

120 $17,790 $6,156 -49%
Level 2 Excision/ Biopsy/ Incision and Drainage

APC 5072 · Hospital outpatient visit

119 $4,965 $1,232 -51%
Heart Attack (severe)

MS-DRG 280 · Inpatient stay

116 $21,712 $13,198 -65%
Level 1 Nerve Procedures

APC 5431 · Hospital outpatient visit

102 $5,411 $1,923 -52%
Digestive Disorder (without major complications)

MS-DRG 392 · Inpatient stay

101 $13,110 $6,750 -59%
Fainting

MS-DRG 312 · Inpatient stay

89 $14,443 $7,465 -61%
Level 3 Musculoskeletal Procedures

APC 5113 · Hospital outpatient visit

88 $11,303 $3,168 -45%
Urinary Tract Infection (without major complications)

MS-DRG 690 · Inpatient stay

80 $11,779 $7,020 -60%
Urinary Tract Infection (severe)

MS-DRG 689 · Inpatient stay

77 $15,506 $9,754 -62%
Level 4 Urology and Related Services

APC 5374 · Hospital outpatient visit

74 $10,930 $3,744 -47%
Level 5 Musculoskeletal Procedures

APC 5115 · Hospital outpatient visit

70 $41,983 $13,693 -33%
Fluid and Electrolyte Disorder (without major complications)

MS-DRG 641 · Inpatient stay

68 $14,177 $7,278 -54%
COPD (severe)

MS-DRG 190 · Inpatient stay

67 $14,169 $9,348 -66%
Level 1 Endovascular Procedures

APC 5191 · Hospital outpatient visit

65 $10,539 $3,466 -58%
Fluid and Electrolyte Disorder (severe)

MS-DRG 640 · Inpatient stay

64 $19,000 $10,901 -61%
Irregular Heartbeat (with complications)

MS-DRG 309 · Inpatient stay

61 $12,649 $6,623 -59%
Kidney Failure (severe)

MS-DRG 682 · Inpatient stay

60 $19,101 $11,817 -64%
Back Problems (without major complications)

MS-DRG 552 · Inpatient stay

59 $14,598 $8,086 -63%
Level 2 Musculoskeletal Procedures

APC 5112 · Hospital outpatient visit

58 $5,784 $1,557 -48%
Level 4 Musculoskeletal Procedures

APC 5114 · Hospital outpatient visit

56 $18,962 $6,366 -52%
Level 2 Upper GI Procedures

APC 5302 · Hospital outpatient visit

52 $4,875 $2,012 -59%
Respiratory Failure

MS-DRG 189 · Inpatient stay

50 $17,254 $10,463 -64%
Pneumonia (with complications)

MS-DRG 194 · Inpatient stay

50 $11,955 $7,051 -62%
Level 3 Vascular Procedures

APC 5183 · Hospital outpatient visit

49 $16,296 $3,312 -15%
Skin Infection (without major complications)

MS-DRG 603 · Inpatient stay

48 $10,220 $7,414 -67%
Chest Pain

MS-DRG 313 · Inpatient stay

47 $13,056 $6,163 -61%
Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh without

MS-DRG 563 · Inpatient stay

47 $11,513 $7,613 -69%
Hip or Knee Replacement (without major complications)

MS-DRG 470 · Inpatient stay

46 $46,654 $15,823 -42%
Kidney Failure (with complications)

MS-DRG 683 · Inpatient stay

43 $13,578 $7,664 -59%
Level 5 Urology and Related Services

APC 5375 · Hospital outpatient visit

41 $11,356 $5,557 -59%
Stroke (severe)

MS-DRG 064 · Inpatient stay

40 $22,562 $15,451 -70%
Gastrointestinal Bleeding (severe)

MS-DRG 377 · Inpatient stay

40 $27,189 $13,904 -62%
Gastrointestinal Bleeding (with complications)

MS-DRG 378 · Inpatient stay

39 $16,970 $8,402 -59%
Stroke (with complications)

MS-DRG 065 · Inpatient stay

38 $17,436 $8,394 -62%
Diabetes (with complications)

MS-DRG 638 · Inpatient stay

36 $11,698 $7,474 -66%
Transient Ischemia without Thrombolytic

MS-DRG 069 · Inpatient stay

35 $14,255 $6,850 -65%
Respiratory Infection (with complications)

MS-DRG 178 · Inpatient stay

35 $14,126 $8,267 -62%
Digestive Disorder (severe)

MS-DRG 391 · Inpatient stay

35 $19,238 $10,902 -63%
Diabetes with Major Complications

MS-DRG 637 · Inpatient stay

35 $17,571 $11,014 -69%
Irregular Heartbeat (severe)

MS-DRG 308 · Inpatient stay

33 $17,780 $10,231 -62%
Red Blood Cell Disorders without Major Complications

MS-DRG 812 · Inpatient stay

33 $16,375 $7,734 -56%
Seizures without Major Complications

MS-DRG 101 · Inpatient stay

31 $13,467 $7,578 -67%
Heart Catheter Procedure (severe)

MS-DRG 321 · Inpatient stay

31 $94,042 $24,449 -35%
Kidney or Urinary Disorder (severe)

MS-DRG 698 · Inpatient stay

30 $16,116 $13,170 -72%
Organic Disturbances and Intellectual Disability

MS-DRG 884 · Inpatient stay

29 $35,678 $12,990 -29%
Level 3 Endovascular Procedures

APC 5193 · Hospital outpatient visit

29 $64,028 $11,799 -5%
Heart Attack (with complications)

MS-DRG 281 · Inpatient stay

28 $17,426 $7,817 -60%
Dysequilibrium

MS-DRG 149 · Inpatient stay

27 $13,189 $6,458 -66%
Heart Catheter Procedure (without major complications)

MS-DRG 322 · Inpatient stay

26 $79,543 $15,527 -22%
Level 1 Abdominal/peritoneal/biliary and Related Procedures

APC 5341 · Hospital outpatient visit

26 $17,905 $3,605 -23%
Red Blood Cell Disorders with Major Complications

MS-DRG 811 · Inpatient stay

25 $25,375 $11,849 -55%
Degenerative Nervous System Disorders without Major Complications

MS-DRG 057 · Inpatient stay

23 $15,234 $9,772 -68%
Kidney or Urinary Disorder (with complications)

MS-DRG 699 · Inpatient stay

23 $14,671 $8,387 -61%
Bronchitis and Asthma with Complications/mcc

MS-DRG 202 · Inpatient stay

23 $10,634 $8,406 -73%
COPD (with complications)

MS-DRG 191 · Inpatient stay

22 $11,991 $7,112 -64%
Heart Attack (uncomplicated)

MS-DRG 282 · Inpatient stay

21 $16,039 $6,204 -58%
Hypertension without Major Complications

MS-DRG 305 · Inpatient stay

21 $12,198 $6,530 -64%
Skin Infection (severe)

MS-DRG 602 · Inpatient stay

21 $21,904 $12,301 -57%
Infection Needing Surgery (severe)

MS-DRG 853 · Inpatient stay

20 $99,735 $42,332 -44%
Signs and Symptoms without Major Complications

MS-DRG 948 · Inpatient stay

20 $12,120 $6,968 -63%
Level 3 Urology and Related Services

APC 5373 · Hospital outpatient visit

20 $6,626 $2,100 -49%
Gastrointestinal Obstruction with Complications

MS-DRG 389 · Inpatient stay

19 $12,392 $6,596 -60%
Hip or Thigh Bone Surgery (with complications)

MS-DRG 481 · Inpatient stay

19 $39,803 $17,012 -52%
Circulatory Disorders Except Heart Attack, with Cardiac Catheterization without Major

MS-DRG 287 · Inpatient stay

18 $28,398 $9,033 -48%
Hip Replacement with Principal Diagnosis of Hip Fracture without Major Complications

MS-DRG 522 · Inpatient stay

18 $42,320 $17,621 -51%
Sepsis

MS-DRG 870 · Inpatient stay

18 $112,176 $55,167 -58%
Sepsis (without major complications)

MS-DRG 872 · Inpatient stay

18 $16,791 $8,991 -57%
Poisoning and Toxic Effects of Drugs with Major Complications

MS-DRG 917 · Inpatient stay

18 $19,585 $13,063 -71%
Uterine and Adnexa Procedures for Non-malignancy without Complications/mcc

MS-DRG 743 · Inpatient stay

18 $15,040 $11,077 -77%
Level 3 Excision/ Biopsy/ Incision and Drainage

APC 5073 · Hospital outpatient visit

18 $7,723 $2,747 -56%
Level 2 Endovascular Procedures

APC 5192 · Hospital outpatient visit

18 $18,257 $6,138 -47%
Circulatory Disorders Except Heart Attack, with Cardiac Catheterization with Major

MS-DRG 286 · Inpatient stay

16 $39,071 $16,560 -56%
Other Circulatory System Diagnoses with Major Complications

MS-DRG 314 · Inpatient stay

16 $31,280 $14,798 -60%
Level 3 Lower GI Procedures

APC 5313 · Hospital outpatient visit

16 $8,771 $3,015 -47%
Respiratory System Diagnosis with Ventilator Support <=96 Hours

MS-DRG 208 · Inpatient stay

15 $48,655 $22,517 -57%
Major Small and Large Bowel Procedures with Complications

MS-DRG 330 · Inpatient stay

15 $38,837 $18,387 -61%
Gastrointestinal Obstruction with Major Complications

MS-DRG 388 · Inpatient stay

15 $17,295 $11,602 -70%
Other Digestive System Diagnoses with Complications

MS-DRG 394 · Inpatient stay

15 $12,546 $7,969 -68%
Other Disorders of Nervous System with Complications

MS-DRG 092 · Inpatient stay

15 $16,056 $8,455 -64%
Back Problems (severe)

MS-DRG 551 · Inpatient stay

15 $22,645 $13,311 -67%
Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy with Major Complications

MS-DRG 896 · Inpatient stay

15 $26,979 $14,820 -59%
Peripheral Vascular Disorders with Complications

MS-DRG 300 · Inpatient stay

14 $13,423 $9,154 -69%
Irregular Heartbeat (uncomplicated)

MS-DRG 310 · Inpatient stay

14 $10,365 $4,809 -59%
Alcohol, Drug Abuse or Dependence without Rehabilitation Therapy without Major

MS-DRG 897 · Inpatient stay

14 $13,647 $7,173 -58%
Trauma to the Skin, Subcutaneous Tissue and Breast without Major Complications

MS-DRG 605 · Inpatient stay

14 $15,577 $7,793 -62%
Other Vascular Procedures with Major Complications

MS-DRG 252 · Inpatient stay

13 $68,070 $28,792 -53%
Major Small and Large Bowel Procedures without Complications/mcc

MS-DRG 331 · Inpatient stay

13 $32,189 $14,000 -57%
Bone Diseases and Arthropathies without Major Complications

MS-DRG 554 · Inpatient stay

13 $12,947 $7,087 -60%
Other Disorders of Nervous System with Major Complications

MS-DRG 091 · Inpatient stay

12 $22,265 $14,011 -69%
Cirrhosis and Alcoholic Hepatitis with Complications

MS-DRG 433 · Inpatient stay

12 $13,002 $8,804 -72%
Level 1 Breast/lymphatic Surgery and Related Procedures

APC 5091 · Hospital outpatient visit

12 $12,522 $4,094 -48%
Level 2 Vascular Procedures

APC 5182 · Hospital outpatient visit

12 $8,184 $1,720 -5%
Pulmonary Embolism with Major Complications or Acute Cor Pulmonale

MS-DRG 175 · Inpatient stay

11 $25,184 $10,187 -54%
Fractures of Hip and Pelvis without Major Complications

MS-DRG 536 · Inpatient stay

11 $12,365 $6,801 -62%
Other Digestive System Diagnoses with Major Complications

MS-DRG 393 · Inpatient stay

11 $37,080 $13,982 -42%

These figures are averages across this hospital's Medicare patients in the most recent federal data year. They are not a quote and not your bill. For your own case, ask the hospital for a written good-faith estimate and check its published machine-readable price file.