Good Samaritan Regional Hlth Center

1 Good Samaritan Way, Mount Vernon, IL 62864 · (618) 899-2201

Acute Care HospitalsVoluntary non-profit - PrivateCMS rating 4/5Mount Vernon, IL metro Website ↗

Price file

Prices published

File dated 2026-04-01

2,050 price rows for 59 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 3 lines · metro median $17

$85

cash

$8 to $2,632

43 negotiated rates

$131

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 3 lines · metro median $209

$1,199

cash

$298 to $2,632

45 negotiated rates

$1,844

list

CT scan of the head, no contrast

CPT 70450 · lowest of 3 lines · metro median $181

$1,129

cash

$112 to $2,632

45 negotiated rates

$1,737

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 3 lines · metro median $267

$1,391

cash

$188 to $2,632

45 negotiated rates

$2,140

list

Cataract surgery with lens implant

CPT 66984

—

cash

$4,759 to $4,759

1 negotiated rates

—

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$4,774 to $16,785

8 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 9 lines · metro median $45

$45

cash

$22 to $2,632

123 negotiated rates

$82

list

Colonoscopy (diagnostic)

CPT 45378

—

cash

$997 to $3,629

4 negotiated rates

—

list

Colonoscopy with biopsy

CPT 45380

—

cash

$1,282 to $3,629

4 negotiated rates

—

list

Colonoscopy with polyp removal

CPT 45385

—

cash

$1,282 to $3,629

4 negotiated rates

—

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 5 lines · metro median $6

$49

cash

$8 to $2,632

83 negotiated rates

$75

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 3 lines · metro median $23

$140

cash

$11 to $2,632

43 negotiated rates

$215

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 3 lines · metro median $70

$385

cash

$115 to $2,632

42 negotiated rates

$593

list

Established patient office visit (about 40 minutes)

CPT 99215 · metro median $114

$212

cash

—

$386

list

Family psychotherapy with the patient

CPT 90847 · metro median $83

$301

cash

—

$547

list

Family psychotherapy without the patient

CPT 90846 · metro median $85

$290

cash

—

$528

list

Gallbladder removal (laparoscopic)

CPT 47562

—

cash

$6,479 to $6,802

3 negotiated rates

—

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 9 lines · metro median $47

$57

cash

$16 to $2,632

123 negotiated rates

$104

list

Group psychotherapy

CPT 90853 · lowest of 4 lines · metro median $42

$138

cash

—

$250

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$15,597 to $34,970

8 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$6,558 to $14,472

7 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$10,184 to $22,230

7 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505

—

cash

$3,837 to $4,029

3 negotiated rates

—

list

Knee arthroscopy with meniscus repair

CPT 29881

—

cash

$3,506 to $3,682

3 negotiated rates

—

list

Left heart catheterization

CPT 93452 · metro median $246

$5,849

cash

$3,474 to $3,648

3 negotiated rates

$10,634

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 6 lines · metro median $11

$33

cash

$10 to $2,632

83 negotiated rates

$51

list

Liver function panel

CPT 80076 · lowest of 3 lines · metro median $16

$107

cash

$8 to $2,632

43 negotiated rates

$164

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 3 lines · metro median $702

$2,226

cash

$374 to $3,082

45 negotiated rates

$3,424

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 4 lines · metro median $431

$1,529

cash

$256 to $3,000

15 negotiated rates

$2,352

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 4 lines · metro median $434

$1,608

cash

$256 to $2,632

45 negotiated rates

$2,474

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 3 lines · metro median $566

$1,331

cash

$256 to $2,632

45 negotiated rates

$2,047

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$15,546 to $43,904

8 negotiated rates

—

list

New patient office visit (about 30 minutes)

CPT 99203 · metro median $87

$149

cash

—

$270

list

New patient office visit (about 45 minutes)

CPT 99204 · metro median $129

$205

cash

—

$373

list

New patient office visit (about 60 minutes)

CPT 99205 · metro median $158

$227

cash

—

$412

list

PSA test (prostate)

CPT 84153 · lowest of 7 lines · metro median $18

$28

cash

$17 to $2,632

83 negotiated rates

$50

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 8 lines · metro median $12

$23

cash

$6 to $2,632

83 negotiated rates

$36

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 4 lines · metro median $23

$77

cash

$23 to $101

11 negotiated rates

$119

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 3 lines · metro median $100

$573

cash

$112 to $2,632

45 negotiated rates

$881

list

Prostate biopsy

CPT 55700 · metro median $233

$1,727

cash

—

$3,140

list

Prostate removal (laparoscopic)

CPT 55866

—

cash

$11,391 to $11,961

3 negotiated rates

—

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 12 lines · metro median $9

$15

cash

$4 to $2,632

83 negotiated rates

$28

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 3 lines · metro median $56

$201

cash

—

$365

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 2 lines · metro median $66

$265

cash

—

$482

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 2 lines · metro median $104

$366

cash

—

$666

list

Removal of a breast lump (biopsy by excision)

CPT 19120

—

cash

$4,196 to $4,406

3 negotiated rates

—

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 5 lines · metro median $50

$174

cash

$61 to $2,632

46 negotiated rates

$317

list

Sleep study (overnight, attended)

CPT 95810 · metro median $788

$3,961

cash

$920 to $966

3 negotiated rates

$7,201

list

Spinal fusion (not neck), no complications

MS-DRG 460

—

cash

$31,396 to $67,843

3 negotiated rates

—

list

Spinal injection, lower back, with imaging guidance

CPT 62323

—

cash

$756 to $794

3 negotiated rates

—

list

TSH test (thyroid)

CPT 84443 · lowest of 3 lines · metro median $13

$30

cash

$9 to $2,632

43 negotiated rates

$46

list

Tonsils and adenoids removal (under age 12)

CPT 42820

—

cash

$6,344 to $6,661

3 negotiated rates

—

list

Transvaginal ultrasound

CPT 76830 · lowest of 3 lines · metro median $100

$424

cash

$86 to $2,632

45 negotiated rates

$653

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 3 lines · metro median $49

$809

cash

$106 to $2,632

45 negotiated rates

$1,244

list

Upper endoscopy (EGD)

CPT 43235 · metro median $317

$1,152

cash

$972 to $3,629

4 negotiated rates

$2,094

list

Upper endoscopy with biopsy

CPT 43239

—

cash

$972 to $1,021

3 negotiated rates

—

list

Urinalysis with microscope

CPT 81001 · lowest of 3 lines · metro median $8

$11

cash

$3 to $2,632

43 negotiated rates

$17

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$2,971 to $11,818

8 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 3 lines · metro median $55

$296

cash

$46 to $2,632

45 negotiated rates

$456

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/stmarys-goodsamaritanhospital
Good Samaritan Hospital · parsed · tall v2.0.0 · file dated 2025-01-01 · 15.9 MB · 1675 price rows read · read Nov 2026
https://hospitalpricedisclosure.com/download.aspx?pi=Cwl2CJAwPiTJ13gcmmCzdA*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health Good Samaritan Hospital - Mt. Vernon · discovered · json v3.0.0 · file dated 2026-04-01 · 14.1 MB · 375 price rows read · read Oct 2026
https://hospitalpricedisclosure.com/download.aspx?pi=oExWW6GEphI226iT5wl0wQ*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health Cardinal Glennon Children's Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 76.6 MB · read Oct 2026
https://hospitalpricedisclosure.com/download.aspx?pi=dMTdTRnP5Lut4neQ4vbLFA*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health St. Joseph Hospital - St. Charles · unmatched · json v3.0.0 · file dated 2026-04-01 · 85.8 MB · read Oct 2026
https://hospitalpricedisclosure.com/download.aspx?pi=I9EbX*__*v9zUT24F6pmGjdHg*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health St. Joseph Hospital- Wentzville · unmatched · json v3.0.0 · file dated 2026-04-01 · 73.6 MB · read Oct 2026
https://hospitalpricedisclosure.com/download.aspx?pi=cCiJ3uXo623a69s9G*__*VgNw*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health Ripon Community Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 29.4 MB · read Oct 2026
https://hospitalpricedisclosure.com/download.aspx?pi=qrjjGipjrFx4NGWFLmvnSg*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health Waupun Memorial Hospital · unmatched · json v3.0.0 · file dated 2026-04-01 · 30.1 MB · read Oct 2026
https://hospitalpricedisclosure.com/download.aspx?pi=Z5XkiXJtDaa7TXO9crU8FQ*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health St. Clare Hospital - Fenton · discovered
https://hospitalpricedisclosure.com/download.aspx?pi=O5oUAG4tejFgDnF2IIIqVQ*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health St. Joseph Hospital - Lake Saint Louis · discovered
https://hospitalpricedisclosure.com/download.aspx?pi=uwouo8M1Pxif8Aqw5LntXw*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
SSM Health Monroe Hospital · discovered