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Good Samaritan Hospital

San Jose, CA · 474 beds · 26 procedures priced

Sourced from this hospital's machine-readable file, posted Tue Jun 02 2026 00:00:00 GMT+0000 (Coordinated Universal Time) · data quality 93/100 · source file ↗

Category

Procedure ▲	Negotiated i	Cash i	Gross i
Basic Metabolic Panel	$8$7$126	$6	$8
Chest X-ray (2 Views)	$111$111$167	$130	$186
Complete Abdominal Ultrasound	$134$41$201	$255	$364
Complete Blood Count (CBC) with Differential	$8$7$126	$8	$12
Comprehensive Metabolic Panel	$11$9$126	$15	$21
CT Abdomen and Pelvis with Contrast	$447$126$670	$531	$758
CT Chest without Contrast	$134$126$201	$240	$343
CT Head without Contrast	$134$41$201	$255	$365
Diagnostic Colonoscopy	$1,144$126$1.8k	$7,000	$10,000
Group Therapy Session	$128$3$195	$40	$57
Hemoglobin A1c (Diabetes Test)	$10$9$126	$14	$19
HIV Antibody Test	$9$8$126	$77	$110
Inguinal Hernia Repair (Open)	$4,822$126$12k	$10,500	$15,000
Initial Psychiatric Diagnostic Evaluation	$227$126$341	$259	$370
Initial Psychiatric Evaluation with Medication Management	$227$103$341	$290	$414
IUD Insertion	$172$126$882	$434	$620
IUD Removal	$390$49$882	$434	$620
Laparoscopic Gallbladder Removal	$5,247$126$12k	$22,778	$32,539
Lipid Panel (Cholesterol Test)	$13$12$126	$19	$27
Office Visit, Established Patient (Level 3)	$58$24$126	$357	$510
Office Visit, New Patient (Level 3)	$72$57$126	$386	$552
PSA Prostate Cancer Screening	$18$16$126	$51	$74
Skin Biopsy (Tangential)	$520$95$882	$156	$223
TSH Thyroid Function Test	$17$15$126	$24	$34
Urinalysis with Microscopy	$3$3$126	$158	$226
Vitamin D Blood Test	$30$21$126	$41	$59

Median facility price per procedure. Negotiated shows the median across payers with the full range. Figures as reported in the hospital's file — not a quote.