Medstar Good Samaritan Hospital
5601 Loch Raven Boulevard, Baltimore, MD 21239 · Acute care hospital · Emergency room
These are Medstar Good Samaritan Hospital's own posted figures from its standard-charges file dated April 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.
143 of the services we track have a posted price here. Tap a service to compare it with nearby hospitals. How to read these numbers.
Emergency room
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Emergency room visit, level 1 (minor) CPT 99281 | $155.33 | $158.50 | $155.33 – $158.50 |
| Emergency room visit, level 2 CPT 99282 | $155.33 | $158.50 | $155.33 – $158.50 |
| Emergency room visit, level 3 (moderate) CPT 99283 | $310.67 | $317.01 | $310.67 – $317.01 |
| Emergency room visit, level 4 CPT 99284 | $621.34 | $634.02 | $621.34 – $634.02 |
| Emergency room visit, level 5 (most severe) CPT 99285 | $1,087.34 | $1,109.53 | $1,087.34 – $1,109.53 |
Office visits
Imaging
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| 3D screening mammogram (tomosynthesis), add-on CPT 77063 | $254.87 | $260.07 | $254.87 – $260.07 |
| Abdominal X-ray, 1 view CPT 74018 | $182.05 | $185.77 | $182.05 – $185.77 |
| Ankle X-ray, 3 or more views CPT 73610 | $218.46 | $222.92 | $218.46 – $222.92 |
| Bone density scan (DEXA), hips and spine CPT 77080 | $327.69 | $334.38 | $327.69 – $334.38 |
| Breast ultrasound, one breast, complete CPT 76641 | $728.21 | $743.07 | $728.21 – $743.07 |
| Breast ultrasound, one breast, limited CPT 76642 | $546.15 | $557.30 | $546.15 – $557.30 |
| Chest X-ray, 1 view CPT 71045 | $109.23 | $111.46 | $109.23 – $111.46 |
| Chest X-ray, 2 views CPT 71046 | $182.05 | $185.77 | $182.05 – $185.77 |
| CT angiogram of the chest (checks for lung clots) CPT 71275 | $306.73 | $312.99 | $306.73 – $312.99 |
| CT angiogram of the head CPT 70496 | $301.53 | $307.68 | $301.53 – $307.68 |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $322.32 | $328.90 | $322.32 – $328.90 |
| CT scan of the abdomen and pelvis, without and with contrast CPT 74178 | $369.12 | $376.65 | $369.12 – $376.65 |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $166.36 | $169.76 | $166.36 – $169.76 |
| CT scan of the abdomen, without contrast CPT 74150 | $129.97 | $132.62 | $129.97 – $132.62 |
| CT scan of the chest, with contrast CPT 71260 | $244.34 | $249.33 | $244.34 – $249.33 |
| CT scan of the chest, without contrast CPT 71250 | $187.16 | $190.98 | $187.16 – $190.98 |
| CT scan of the head, without contrast CPT 70450 | $109.17 | $111.40 | $109.17 – $111.40 |
| CT scan of the neck (cervical spine), without contrast CPT 72125 | $192.35 | $196.28 | $192.35 – $196.28 |
| CT scan of the pelvis, with contrast CPT 72193 | $244.34 | $249.33 | $244.34 – $249.33 |
| CT scan of the sinuses or face, without contrast CPT 70486 | $140.37 | $143.23 | $140.37 – $143.23 |
| Diagnostic mammogram, both breasts CPT 77066 | $1,237.95 | $1,263.21 | $1,237.95 – $1,263.21 |
| Diagnostic mammogram, one breast CPT 77065 | $946.67 | $965.99 | $946.67 – $965.99 |
| Foot X-ray, 3 or more views CPT 73630 | $218.46 | $222.92 | $218.46 – $222.92 |
| Hand X-ray, 3 or more views CPT 73130 | $218.46 | $222.92 | $218.46 – $222.92 |
| Knee X-ray, 3 views CPT 73562 | $254.87 | $260.07 | $254.87 – $260.07 |
| Leg or arm vein ultrasound, both sides CPT 93970 | $1,674.87 | $1,709.05 | $1,674.87 – $1,709.05 |
| Leg or arm vein ultrasound, one side CPT 93971 | $1,019.48 | $1,040.29 | $1,019.48 – $1,040.29 |
| Lower back X-ray, 2 or 3 views CPT 72100 | $254.87 | $260.07 | $254.87 – $260.07 |
| MRI of both breasts, without and with contrast CPT 77049 | $1,321.62 | $1,348.59 | $1,321.62 – $1,348.59 |
| MRI of the abdomen, without and with contrast CPT 74183 | $1,811.11 | $1,848.07 | $1,811.11 – $1,848.07 |
| MRI of the brain, without and with contrast CPT 70553 | $1,207.41 | $1,232.05 | $1,207.41 – $1,232.05 |
| MRI of the brain, without contrast CPT 70551 | $717.92 | $732.57 | $717.92 – $732.57 |
| MRI of the knee or other leg joint, without contrast CPT 73721 | $766.87 | $782.52 | $766.87 – $782.52 |
| MRI of the lower back (lumbar spine), without contrast CPT 72148 | $685.28 | $699.27 | $685.28 – $699.27 |
| MRI of the mid back (thoracic spine), without contrast CPT 72146 | $685.28 | $699.27 | $685.28 – $699.27 |
| MRI of the neck (cervical spine), without contrast CPT 72141 | $685.28 | $699.27 | $685.28 – $699.27 |
| MRI of the pelvis, without and with contrast CPT 72197 | $1,794.79 | $1,831.42 | $1,794.79 – $1,831.42 |
| MRI of the shoulder or other arm joint, without contrast CPT 73221 | $766.87 | $782.52 | $766.87 – $782.52 |
| Neck X-ray, 2 or 3 views CPT 72040 | $218.46 | $222.92 | $218.46 – $222.92 |
| Pelvic ultrasound, complete (not pregnancy) CPT 76856 | $764.62 | $780.22 | $764.62 – $780.22 |
| Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805 | $946.67 | $965.99 | $946.67 – $965.99 |
| Pregnancy ultrasound, under 14 weeks, single baby CPT 76801 | $764.62 | $780.22 | $764.62 – $780.22 |
| Screening mammogram, both breasts CPT 77067 | $1,019.48 | $1,040.29 | $1,019.48 – $1,040.29 |
| Shoulder X-ray, 2 or more views CPT 73030 | $182.05 | $185.77 | $182.05 – $185.77 |
| Transvaginal pregnancy ultrasound CPT 76817 | $618.98 | $631.61 | $618.98 – $631.61 |
| Transvaginal ultrasound CPT 76830 | $910.25 | $928.83 | $910.25 – $928.83 |
| Ultrasound of the abdomen, complete CPT 76700 | $837.44 | $854.53 | $837.44 – $854.53 |
| Ultrasound of the neck or thyroid CPT 76536 | $910.25 | $928.83 | $910.25 – $928.83 |
| Wrist X-ray, 3 or more views CPT 73110 | $254.87 | $260.07 | $254.87 – $260.07 |
| X-ray of the lower back, 4 or more views CPT 72110 | $327.69 | $334.38 | $327.69 – $334.38 |
Lab tests
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 | $32.30 | $32.96 | $32.30 – $32.96 |
| Blood culture CPT 87040 | $117.47 | $119.87 | $117.47 – $119.87 |
| Blood draw (venipuncture) CPT 36415 | $23.49 | $23.97 | $23.49 – $23.97 |
| BNP test (heart failure) CPT 83880 | $88.10 | $89.90 | $88.10 – $89.90 |
| C-reactive protein (CRP) test CPT 86140 | $44.05 | $44.95 | $44.05 – $44.95 |
| Chlamydia test (DNA/NAAT) CPT 87491 | $132.15 | $134.85 | $132.15 – $134.85 |
| Complete blood count (CBC) with differential CPT 85025 | $29.37 | $29.97 | $29.37 – $29.97 |
| Complete blood count (CBC), automated CPT 85027 | $23.49 | $23.97 | $23.49 – $23.97 |
| Comprehensive metabolic panel (blood test) CPT 80053 | $44.05 | $44.95 | $44.05 – $44.95 |
| COVID-19 PCR test CPT 87635 | $352.42 | $359.61 | $352.42 – $359.61 |
| D-dimer test (blood clots) CPT 85379 | $44.05 | $44.95 | $44.05 – $44.95 |
| Drug screen, instrument chemistry CPT 80307 | $164.46 | $167.82 | $164.46 – $167.82 |
| Ferritin (iron stores) test CPT 82728 | $44.05 | $44.95 | $44.05 – $44.95 |
| Free T4 (thyroid) test CPT 84439 | $44.05 | $44.95 | $44.05 – $44.95 |
| Glucose (blood sugar) test CPT 82947 | $11.75 | $11.99 | $11.75 – $11.99 |
| Gonorrhea test (DNA/NAAT) CPT 87591 | $132.15 | $134.85 | $132.15 – $134.85 |
| Hemoglobin A1c test CPT 83036 | $58.73 | $59.93 | $58.73 – $59.93 |
| Hepatitis C antibody test CPT 86803 | $73.42 | $74.92 | $73.42 – $74.92 |
| HIV-1/HIV-2 antigen and antibody test CPT 87389 | $73.42 | $74.92 | $73.42 – $74.92 |
| Iron test CPT 83540 | $17.62 | $17.98 | $17.62 – $17.98 |
| Kidney function panel CPT 80069 | $35.24 | $35.96 | $35.24 – $35.96 |
| Lipase test (pancreas) CPT 83690 | $23.49 | $23.97 | $23.49 – $23.97 |
| Lipid panel, cholesterol and triglycerides CPT 80061 | $55.80 | $56.94 | $55.80 – $56.94 |
| Liver function panel CPT 80076 | $32.30 | $32.96 | $32.30 – $32.96 |
| Magnesium test CPT 83735 | $17.62 | $17.98 | $17.62 – $17.98 |
| Obstetric blood test panel CPT 80055 | $229.07 | $233.74 | $229.07 – $233.74 |
| Partial thromboplastin time (PTT), clotting test CPT 85730 | $23.49 | $23.97 | $23.49 – $23.97 |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $70.48 | $71.92 | $70.48 – $71.92 |
| Prothrombin time (PT/INR), clotting test CPT 85610 | $23.49 | $23.97 | $23.49 – $23.97 |
| PSA (prostate specific antigen), free CPT 84154 | $73.42 | $74.92 | $73.42 – $74.92 |
| PSA (prostate specific antigen), total CPT 84153 | $58.73 | $59.93 | $58.73 – $59.93 |
| Rapid strep test CPT 87880 | $73.42 | $74.92 | $73.42 – $74.92 |
| Sed rate (ESR) test CPT 85652 | $14.68 | $14.98 | $14.68 – $14.98 |
| TB skin test CPT 86580 | $8.81 | $8.99 | $8.81 – $8.99 |
| Thyroid stimulating hormone (TSH) CPT 84443 | $44.05 | $44.95 | $44.05 – $44.95 |
| Tissue exam by a pathologist (biopsy specimen) CPT 88305 | $176.20 | $179.80 | $176.20 – $179.80 |
| Troponin test (heart damage) CPT 84484 | $73.42 | $74.92 | $73.42 – $74.92 |
| Urinalysis, automated, with microscope CPT 81001 | $26.43 | $26.97 | $26.43 – $26.97 |
| Urinalysis, automated, without microscope CPT 81003 | $11.75 | $11.99 | $11.75 – $11.99 |
| Urine culture, colony count CPT 87086 | $58.73 | $59.93 | $58.73 – $59.93 |
| Urine pregnancy test CPT 81025 | $29.37 | $29.97 | $29.37 – $29.97 |
| Vitamin B12 test CPT 82607 | $44.05 | $44.95 | $44.05 – $44.95 |
| Vitamin D test CPT 82306 | $44.05 | $44.95 | $44.05 – $44.95 |
Heart
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Carotid artery ultrasound, both sides CPT 93880 | $1,674.87 | $1,709.05 | $1,674.87 – $1,709.05 |
| ECG tracing only (no interpretation) CPT 93005 | $55.64 | $56.78 | $55.64 – $56.78 |
| Echocardiogram (heart ultrasound), complete with Doppler CPT 93306 | $278.24 | $283.92 | $278.24 – $283.92 |
| Nuclear stress test (heart perfusion imaging) CPT 78452 | $2,389.43 | $2,438.19 | $2,389.43 – $2,438.19 |
Surgery
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Breast biopsy with ultrasound guidance CPT 19083 | $2,243.33 | $2,289.11 | $2,243.33 – $2,289.11 |
Sleep
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Home sleep apnea test CPT 95806 | $385.16 | $393.02 | $385.16 – $393.02 |
| Sleep study with CPAP titration CPT 95811 | $1,900.10 | $1,938.88 | $1,900.10 – $1,938.88 |
| Sleep study, overnight in a sleep lab CPT 95810 | $1,797.39 | $1,834.07 | $1,797.39 – $1,834.07 |
Lungs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Spirometry (breathing test) CPT 94010 | $211.42 | $215.73 | $211.42 – $215.73 |
Therapy
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Manual therapy, 15 minutes CPT 97140 | $91.56 | $93.43 | $91.56 – $93.43 |
| Physical therapy evaluation, low complexity CPT 97161 | $1,098.79 | $1,121.21 | $1,098.79 – $1,121.21 |
| Physical therapy evaluation, moderate complexity CPT 97162 | $1,098.79 | $1,121.21 | $1,098.79 – $1,121.21 |
| Physical therapy, therapeutic exercise, 15 minutes CPT 97110 | $95.62 | $97.57 | $95.62 – $97.57 |
| Therapeutic activities, 15 minutes CPT 97530 | $167.34 | $170.75 | $167.34 – $170.75 |
Mental health
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Family psychotherapy, with the patient, 50 minutes CPT 90847 | $252.78 | $257.94 | $252.78 – $257.94 |
| Family psychotherapy, without the patient, 50 minutes CPT 90846 | $252.78 | $257.94 | $252.78 – $257.94 |
| Group psychotherapy CPT 90853 | $126.37 | $128.95 | $126.37 – $128.95 |
| Psychiatric diagnostic evaluation CPT 90791 | $758.25 | $773.72 | $758.25 – $773.72 |
| Psychotherapy, 30 minutes CPT 90832 | $315.97 | $322.42 | $315.97 – $322.42 |
| Psychotherapy, 45 minutes CPT 90834 | $379.14 | $386.88 | $379.14 – $386.88 |
| Psychotherapy, 60 minutes CPT 90837 | $568.68 | $580.29 | $568.68 – $580.29 |
Infusions and injections
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Injection under the skin or into a muscle CPT 96372 | $126.37 | $128.95 | $126.37 – $128.95 |
| IV hydration, each additional hour CPT 96361 | $189.53 | $193.40 | $189.53 – $193.40 |
| IV hydration, first hour CPT 96360 | $505.51 | $515.83 | $505.51 – $515.83 |
| IV push injection of a drug, first CPT 96374 | $631.86 | $644.76 | $631.86 – $644.76 |
| IV push injection, each additional drug CPT 96375 | $252.78 | $257.94 | $252.78 – $257.94 |
Drugs
| Service | Cash price | Gross charge | Insurer rates (min – max) |
|---|---|---|---|
| Ceftriaxone (Rocephin) injection, per 250 mg HCPCS J0696 | $3.47 | $3.54 | $3.47 – $3.54 |
| Dexamethasone injection, per 1 mg HCPCS J1100 | $1.99 | $2.03 | $1.99 – $2.03 |
| Fentanyl injection, per 0.1 mg HCPCS J3010 | $15.60 | $15.92 | $15.60 – $15.92 |
| Ketorolac (Toradol) injection, per 15 mg HCPCS J1885 | $5.88 | $6.00 | $5.88 – $6.00 |
| Midazolam (Versed) injection, per 1 mg HCPCS J2250 | $2.24 | $2.29 | $2.24 – $2.29 |
| Morphine injection, up to 10 mg HCPCS J2270 | $17.59 | $17.95 | $17.59 – $17.95 |
| Ondansetron (Zofran) injection, per 1 mg HCPCS J2405 | $2.46 | $2.51 | $2.46 – $2.51 |
| Saline IV solution, 1000 ml HCPCS J7030 | $18.20 | $18.57 | $18.20 – $18.57 |
Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.