Hospitals · Intermountain Health Good Samaritan Medical Center
Intermountain Health Good Samaritan Medical Center: procedure prices
200 Exempla Cir, Lafayette, CO 80026 · part of Intermountain Health (Colorado - ex-SCL). Median prices below are computed from the hospital's own price transparency file.
| Procedure | Gross charge | Cash price | Commercial median | Range | # rates |
|---|---|---|---|---|---|
| Cardiac stress test | $2,275 | — | $955 | $132–$2,275 | 99 |
| EKG (electrocardiogram) | — | — | $52 | $48–$52 | 9 |
| Echocardiogram | $7,300 | — | $3,122 | $435–$7,300 | 90 |
| Nerve conduction / EMG study | $1,283 | — | $593 | $190–$1,412 | 186 |
| Sleep study (overnight in lab) | $9,507 | — | $3,993 | $635–$9,507 | 200 |
| Colonoscopy | — | — | $4,533 | $907–$8,381 | 138 |
| Upper endoscopy (EGD) | — | — | $4,533 | $933–$6,503 | 92 |
| Abdomen and pelvis CT (with contrast) | $8,431 | — | $3,364 | $355–$8,431 | 104 |
| Abdominal ultrasound | $1,514 | — | $638 | $106–$1,514 | 93 |
| Bone density scan (DEXA) | $1,285 | — | $550 | $103–$1,285 | 90 |
| Brain MRI (with and without contrast) | $4,453 | — | $1,777 | $355–$4,453 | 104 |
| Brain MRI (without contrast) | $3,208 | — | $1,394 | $240–$3,208 | 104 |
| CT angiogram (chest) | $3,791 | — | $1,512 | $177–$3,791 | 104 |
| Chest X-ray | $563 | — | $241 | $80–$563 | 90 |
| Head CT scan (without contrast) | $2,358 | — | $1,350 | $106–$2,358 | 101 |
| Knee MRI | $2,784 | — | $1,210 | $240–$2,784 | 104 |
| Lower back MRI (lumbar spine) | $3,191 | — | $1,387 | $240–$3,191 | 104 |
| PET/CT scan | $10,408 | — | $5,802 | $1,451–$10,681 | 168 |
| Pregnancy ultrasound | $1,483 | — | $625 | $106–$1,483 | 93 |
| Screening mammogram | $510 | — | $292 | $94–$510 | 93 |
| Blood sugar test (hemoglobin A1c) | $230 | — | $107 | $6–$255 | 181 |
| Cholesterol test (lipid panel) | $378 | — | $171 | $9–$405 | 181 |
| Complete blood count (CBC) | $154 | — | $61 | $5–$154 | 106 |
| Comprehensive metabolic panel | $319 | — | $127 | $7–$319 | 106 |
| PSA test | $348 | — | $147 | $12–$482 | 256 |
| Thyroid test (TSH) | $215 | — | $77 | $11–$298 | 181 |
| Vitamin D test | $595 | — | $281 | $19–$666 | 181 |
| C-section delivery | — | — | $5,838 | $4,129–$11,080 | 9 |
| Childbirth (vaginal delivery) | — | — | $5,838 | $4,129–$11,080 | 9 |
| ACL reconstruction | — | — | $7,200 | $4,411–$13,659 | 43 |
| Appendectomy | — | — | $7,200 | $3,889–$13,659 | 46 |
| Carpal tunnel release | — | — | $5,838 | $1,943–$8,381 | 46 |
| Cataract surgery | — | — | $7,496 | $2,269–$9,185 | 46 |
| Gallbladder removal surgery | — | — | $9,185 | $5,805–$13,659 | 46 |
| Hernia repair surgery (inguinal) | — | — | $6,592 | $3,511–$11,080 | 46 |
| Hip replacement | — | — | $11,463 | $7,739–$30,015 | 39 |
| Tonsillectomy | — | — | $7,200 | $3,227–$11,577 | 138 |
| Total knee replacement | — | — | $11,463 | $7,739–$35,132 | 39 |
| Vasectomy | — | — | $5,838 | $2,038–$8,381 | 46 |
| Joint injection (cortisone shot) | $1,459 | — | $856 | $267–$5,838 | 196 |
| Physical therapy session | $313 | — | $153 | $29–$422 | 162 |
| Emergency room visit | $5,610 | — | $3,254 | $275–$10,353 | 330 |
SOURCE: Intermountain Health Good Samaritan Medical Center standard-charges file dated 2026-03-22 · retrieved 2026-08-15 · 431982139_good-samaritan-medical-center_standardchar · CMS v3.0.0