Does Good Samaritan Hospital publish its standard charges and chargemaster?

Yes. Good Samaritan Hospital publishes a machine-readable file with 1,288 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of B. Browse the negotiated rates by procedure and payer on this page.

How much does Good Samaritan Hospital charge for procedures?

Good Samaritan Hospital (Vincennes, IN) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · IN · CCN 150042

Good Samaritan Hospital

Vincennes, IN, 47591

99 bedsAcute Care Hospitals9

Compliance grade

86/100

Rates published

1,288

last crawl 2026-05-23

Procedures tracked

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All IN hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://www.medstarhealth.org/-/media/project/mho/medstar/billing-and-insurance/2026/520591607_medstar_good_samaritan_standardcharges.csv · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychiatric diagnostic evaluation	CPT	90791	0	$773.72	$758.25	—	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$967.24	$947.9	—	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$322.42	$315.97	—	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$386.88	$379.14	—	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$580.29	$568.68	—	—	—	—
Crisis psychotherapy 60 minutes	CPT	90839	0	$580.29	$568.68	—	—	—	—
emergency
ED visit level 1	CPT	99281	0	$158.5	$155.33	—	—	—	—
ED visit level 2	CPT	99282	0	$158.5	$155.33	—	—	—	—
ED visit level 3	CPT	99283	0	$317.01	$310.67	—	—	—	—
ED visit level 4	CPT	99284	0	$634.02	$621.34	—	—	—	—
ED visit level 5	CPT	99285	0	$1,109.53	$1,087.34	—	—	—	—
imaging
CT head without contrast	CPT	70450	0	$111.4	$109.17	—	—	—	—
CT head with contrast	CPT	70460	0	$159.15	$155.97	—	—	—	—
CT head with and without contrast	CPT	70470	0	$190.98	$187.16	—	—	—	—
CT neck with contrast	CPT	70491	0	$249.33	$244.34	—	—	—	—
MRI brain without contrast	CPT	70551	0	$732.57	$717.92	—	—	—	—
MRI brain with contrast	CPT	70552	0	$1,082.2	$1,060.56	—	—	—	—
MRI brain with and without contrast	CPT	70553	0	$1,232.05	$1,207.41	—	—	—	—
Chest X-ray single view	CPT	71045	0	$111.46	$109.23	—	—	—	—
Chest X-ray 2 views	CPT	71046	0	$185.77	$182.05	—	—	—	—
Chest X-ray 3 views	CPT	71047	0	$260.07	$254.87	—	—	—	—
CT chest without contrast	CPT	71250	0	$190.98	$187.16	—	—	—	—
CT chest with contrast	CPT	71260	0	$249.33	$244.34	—	—	—	—
CT chest with and without contrast	CPT	71270	0	$307.68	$301.53	—	—	—	—
MRI chest without contrast	CPT	71550	0	$1,598.33	$1,566.36	—	—	—	—
MRI chest with contrast	CPT	71551	0	$1,748.18	$1,713.22	—	—	—	—
MRI chest with and without contrast	CPT	71552	0	$2,181.06	$2,137.44	—	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$260.07	$254.87	—	—	—	—
CT cervical spine without contrast	CPT	72125	0	$196.28	$192.35	—	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$190.98	$187.16	—	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$190.98	$187.16	—	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$699.27	$685.28	—	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$699.27	$685.28	—	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$699.27	$685.28	—	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$1,082.2	$1,060.56	—	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$1,232.05	$1,207.41	—	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$1,232.05	$1,207.41	—	—	—	—
CT pelvis without contrast	CPT	72192	0	$137.93	$135.17	—	—	—	—
CT pelvis with contrast	CPT	72193	0	$249.33	$244.34	—	—	—	—
Shoulder X-ray	CPT	73030	0	$371.53	$364.1	—	—	—	—
Humerus X-ray	CPT	73060	0	$222.92	$218.46	—	—	—	—
Hand X-ray 3 views	CPT	73130	0	$445.84	$436.92	—	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$1,565.03	$1,533.73	—	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$3,396.46	$3,328.53	—	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$445.84	$436.92	—	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$445.84	$436.92	—	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$1,565.03	$1,533.73	—	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$3,396.46	$3,328.53	—	—	—	—
CT abdomen without contrast	CPT	74150	0	$132.62	$129.97	—	—	—	—
CT abdomen with contrast	CPT	74160	0	$249.33	$244.34	—	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$286.46	$280.73	—	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$169.76	$166.36	—	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$328.9	$322.32	—	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$376.65	$369.12	—	—	—	—
MRI abdomen without contrast	CPT	74181	0	$1,215.4	$1,191.09	—	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$1,848.07	$1,811.11	—	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$854.53	$837.44	—	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$668.76	$655.38	—	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$817.37	$801.02	—	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$780.22	$764.62	—	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$965.99	$946.67	—	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$891.68	$873.85	—	—	—	—
Transvaginal ultrasound	CPT	76830	0	$928.83	$910.25	—	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$780.22	$764.62	—	—	—	—
Scrotal ultrasound	CPT	76870	0	$371.53	$364.1	—	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$965.99	$946.67	—	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$1,263.21	$1,237.95	—	—	—	—
Screening mammography bilateral	CPT	77067	0	$1,040.29	$1,019.48	—	—	—	—
EKG tracing only	CPT	93005	0	$56.78	$55.64	—	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$283.92	$278.24	—	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$212.94	$208.68	—	—	—	—
Stress echocardiogram	CPT	93350	0	$283.92	$278.24	—	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$32.96	$32.3	—	—	—	—
Electrolyte panel	CPT	80051	0	$23.97	$23.49	—	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$44.95	$44.05	—	—	—	—
Lipid panel	CPT	80061	0	$56.94	$55.8	—	—	—	—
Renal function panel	CPT	80069	0	$35.96	$35.24	—	—	—	—
Hepatic function panel	CPT	80076	0	$32.96	$32.3	—	—	—	—
Urinalysis automated	CPT	81003	0	$11.99	$11.75	—	—	—	—
Glucose quantitative	CPT	82947	0	$11.99	$11.75	—	—	—	—
Hemoglobin A1c	CPT	83036	0	$59.93	$58.73	—	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$44.95	$44.05	—	—	—	—
Complete blood count with automated differential	CPT	85025	0	$29.97	$29.37	—	—	—	—
Complete blood count without differential	CPT	85027	0	$23.97	$23.49	—	—	—	—
Urine culture bacterial	CPT	87086	0	$59.93	$58.73	—	—	—	—
Urine culture identification	CPT	87088	0	$29.97	$29.37	—	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$179.8	$176.2	—	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$193.4	$189.53	—	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$257.94	$252.78	—	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$322.44	$315.99	—	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$386.88	$379.14	—	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$129	$126.42	—	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$193.4	$189.53	—	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$257.94	$252.78	—	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$322.44	$315.99	—	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$386.88	$379.14	—	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

Related data on other Healthparse brands

Explore this hospital across cost reports, quality ratings, and non-profit filings.

HCRIS.io

Medicare cost reports, margins, utilization

Stetho.io

SNF, HHA, hospice, dialysis cost reports + ownership

990Health

IRS Form 990 financials, executive compensation

CareLens

CMS quality ratings, inspections, staffing