MultiCare Good Samaritan Hospital — price list
← Hospital overviewVerified from MultiCare Good Samaritan Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
16 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| Acetaminophen 160 mg/5 ml soln Inpatient | 0250 RC | $1.67 | $0.67 | $1.22 – $1.22 | — | |
| Apixaban 2.5 mg tabs Inpatient | 0250 RC | $6.38 | $2.56 | $4.66 – $4.66 | — | |
| Bisoprolol fumarate 5 mg tabs Inpatient | 0250 RC | $1.65 | $0.66 | $1.20 – $1.20 | — | |
| Budesonide 0.25 mg/2ml susp Inpatient | 0250 RC | $19.57 | $7.83 | $14.29 – $14.29 | — | |
| Calcitriol 0.25 mcg caps Inpatient | 0250 RC | $2.84 | $1.14 | $2.07 – $2.07 | — | |
| Cephalexin 125 mg/5ml susr Inpatient | 0250 RC | $7.52 | $3.01 | $5.49 – $5.49 | — | |
| Dapagliflozin 5 mg tabs Inpatient | 0250 RC | $43.85 | $17.54 | $32.01 – $32.01 | — | |
| Donepezil 5 mg tabs Inpatient | 0250 RC | $1.78 | $0.72 | $1.30 – $1.30 | — | |
| Ethambutol 400 mg tabs Inpatient | 0250 RC | $5.63 | $2.26 | $4.11 – $4.11 | — | |
| Fludrocortisone 0.1 mg tabs Inpatient | 0250 RC | $3.78 | $1.52 | $2.76 – $2.76 | — | |
| Levothyroxine 150 mcg tabs Inpatient | 0250 RC | $4.91 | $1.97 | $3.58 – $3.58 | — | |
| Methimazole 10 mg tabs Inpatient | 0250 RC | $1.68 | $0.68 | $1.23 – $1.23 | — | |
| Metoprolol 5 mg/5 ml soln Inpatient | 0250 RC | $37.98 | $15.20 | $27.73 – $27.73 | — | |
| Rocuronium 10 mg/ml soln Inpatient | 0250 RC | $200 | $80.00 | $146 – $146 | — | |
| Senna 8.6 mg tabs Inpatient | 0250 RC | $1.63 | $0.66 | $1.19 – $1.19 | — | |
| Vancomycin 50 mg/ml 50 mg/ml solr Inpatient | 0250 RC | $3.50 | $1.40 | $2.56 – $2.56 | — |