Los Angeles → Pih Health Good Samaritan Hospital

Pih Health Good Samaritan Hospital

goodsamsanjose.com · Los Angeles

C Price transparency: 15 of 58 common services carry a self-pay price
15
services with a self-pay price
58
services with any published price
58
services we look for

Every price this hospital publishes

click a procedure to compare across the metro
Procedure Self-pay List price Insurers pay
Abdominal ultrasound Ultrasound abdomen complete $3,629–$7,061 varies $7,061 $72–$7,061
Chest X-ray Chest X-ray, 2 views $2,705 $2,705 $18–$5,074
CT scan of the abdomen and pelvis CT abdomen/pelvis with contrast $44,564 $44,564 $203–$44,564
CT scan of the chest CT chest without contrast $22,592 $22,592 $79–$22,592
CT scan of the head CT head without contrast $19,448 $19,448 $63–$19,448
CT scan of the pelvis CT pelvis with contrast $20,571 $20,571 $168–$20,571
Echocardiogram (heart ultrasound) Echocardiogram complete $4,553–$16,541 varies $4,553 $177–$16,541
EKG (heart rhythm test) Electrocardiogram (ECG) billed by the doctor $15–$204
MRI of the brain MRI brain without contrast $20,680 $20,680 $121–$20,680
MRI of the brain, with and without contrast MRI brain with/without contrast $27,327–$39,916 varies $32,724 $203–$39,916
MRI of the knee MRI knee without contrast $18,083–$27,123 varies $25,339 $133–$27,123
MRI of the lower back MRI lumbar spine without contrast $22,183 $22,183 $117–$22,183
Pregnancy ultrasound Ultrasound pregnancy $6,670 $6,670 $81–$6,670
Screening mammogram Screening mammogram, bilateral $1,508–$2,620 varies $2,326 $84–$5,074
Sleep study Sleep study (polysomnography) not published $275–$6,239
Transvaginal ultrasound Ultrasound transvaginal $5,168 $5,168 $71–$5,168
X-ray of the lower back X-ray lower spine not published $35–$5,074
X-ray of the shoulder X-ray shoulder $2,648–$3,983 varies $2,648 $23–$5,074
A1c diabetes blood test Hemoglobin A1c $18–$745 varies $18 $3–$745
Basic metabolic panel (blood test) Basic metabolic panel $2,184 $2,184 $8–$2,184
Blood clotting time (PT/INR) Prothrombin time $6–$929 varies $38 $1–$929
Blood clotting time (PTT) Partial thromboplastin time $5–$1,068 varies $53 $1–$1,068
Cholesterol panel Lipid panel $19–$1,409 varies $1,409 $3–$1,409
Complete blood count (CBC) CBC with differential not published $8–$81
Comprehensive metabolic panel (blood test) Comprehensive metabolic panel $3,215 $3,215 $11–$3,215
Liver function blood test Hepatic function panel $2,030 $2,030 $8–$2,030
PSA prostate blood test PSA (prostate screen) $3–$28 varies $28 $0–$191
Thyroid (TSH) blood test TSH (thyroid) $14–$1,901 varies $1,901 $2–$1,901
Urine test with microscope Urinalysis with microscopy $1,073 $1,073 $3–$1,073
Cataract surgery with lens implant Cataract surgery w/ lens implant not published $172–$22,079
Colonoscopy Colonoscopy diagnostic not published $29–$14,449
Colonoscopy with biopsy Colonoscopy w/ biopsy not published $14–$14,449
Colonoscopy with polyp removal Colonoscopy w/ polyp removal not published $14–$14,449
C-section delivery Cesarean section without CC/MCC not published $750–$18,680
Draining an abscess Incision & drainage of abscess not published $22–$7,317
Emergency room visit, moderate Emergency department visit, moderate $7,104 $7,104 $64–$7,104
Epidural steroid injection, lower back Epidural injection lumbar w/ imaging not published $18–$7,317
Follow-up office visit Established patient office visit, 20-29 min $1,052–$1,824 varies $1,052 $28–$1,824
Gallbladder removal Gallbladder removal laparoscopic not published $179–$22,079
Hernia repair Inguinal hernia repair not published $50–$18,309
Hip or knee replacement Major joint replacement (hip/knee), no MCC not published $750–$54,166
Joint injection Joint injection (major joint) not published $20–$7,317
Knee arthroscopy (meniscus) Knee arthroscopy w/ meniscectomy not published $93–$18,309
Laser treatment after cataract surgery YAG laser capsulotomy not published $43–$14,449
Nerve root injection, lower back Transforaminal epidural, lumbar not published $10–$7,317
New patient office visit New patient office visit, 30-44 min $1,286–$2,235 varies $1,756 $82–$2,235
Physical therapy session Physical therapy, therapeutic exercise $449–$744 varies $738 $13–$744
Prostate biopsy Prostate biopsy not published $29–$14,449
Removal of a breast lump Excision of breast lesion not published $57–$17,393
Shoulder arthroscopy Shoulder arthroscopy w/ decompression not published $86–$17,393
Stitches for a simple cut Simple wound repair not published $17–$7,317
Therapy session, 60 minutes Psychotherapy, 60 minutes $2,069 $2,069 $98–$2,069
Tonsil and adenoid removal (under 12) Tonsillectomy w/ adenoidectomy, under 12 not published $52–$17,393
Upper endoscopy Upper GI endoscopy diagnostic not published $22–$7,848
Upper endoscopy with biopsy Upper GI endoscopy w/ biopsy not published $22–$14,449
Vaginal delivery, full maternity care Vaginal delivery, global obstetric care not published $50–$9,703
Vaginal delivery (hospital stay) Vaginal delivery without CC/MCC not published $750–$17,518
Vasectomy Vasectomy not published $36–$14,449

Read from the file Pih Health Good Samaritan Hospital publishes, last read 6 August 2026. We scanned 432676 rows to find these 58 procedures. 346 payer rows carried a percentage rather than a dollar amount and are not included in the negotiated ranges — a percentage of a charge is not a price until the charge is known.