Goshen Hospital
Goshen Hospital in Goshen, IN publishes cash prices for 56 common procedures listed here, from its own machine-readable price file updated Aug 14, 2026. Click a procedure to compare it with other hospitals nearby.
200 High Park Ave, , Goshen, IN 46526 Collected Sep 22, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct abd/pelvis w cont | $2,797.20 | $3,996.00 | 30% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 Ct abd & pelv w/contrast | $2,797.20 | $3,996.00 | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct abd/pelvis w cont | $2,797.20 | $3,996.00 | 30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 Ct abd & pelv w/contrast | $2,797.20 | $3,996.00 | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 Ct head w/o cont | $1,238.30 | $1,769.00 | 30% |
| CT scan of the head or brain, no contrast dye CPT 70450 Ct head/brain w/o dye | $1,238.30 | $1,769.00 | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct head w/o cont | $1,238.30 | $1,769.00 | 30% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 Ct head/brain w/o dye | $1,238.30 | $1,769.00 | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 Ct pelvis w/dye | $1,565.90 | $2,237.00 | 30% |
| CT scan of the pelvis, with contrast dye CPT 72193 Ct pelvis w cont | $1,565.90 | $2,237.00 | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct pelvis w/dye | $1,565.90 | $2,237.00 | 30% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 Ct pelvis w cont | $1,565.90 | $2,237.00 | 30% |
| Diagnostic mammogram, both breasts both sides CPT 77066 Dx mammo incl cad bi | $385.00 | $550.00 | 30% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 Dx mammo incl cad bi | $385.00 | $550.00 | 30% |
| Diagnostic mammogram, one breast CPT 77065 Dx mammo incl cad uni | $334.60 | $478.00 | 30% |
| Diagnostic mammogram, one breast inpatient CPT 77065 Dx mammo incl cad uni | $334.60 | $478.00 | 30% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 Mri jnt of lwr extre w/o dye | $1,442.00 | $2,060.00 | 30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 Mri jnt of lwr extre w/o dye | $1,442.00 | $2,060.00 | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 Mri joint lwr extr w/o&w/dye | $1,442.00 | $2,060.00 | 30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 Mri joint lwr extr w/o&w/dye | $1,442.00 | $2,060.00 | 30% |
| MRI of the brain, no contrast dye CPT 70551 Mri brain stem w/o dye | $961.10 | $1,373.00 | 30% |
| MRI of the brain, no contrast dye CPT 70551 Mr iac w/o contrast | $961.10 | $1,373.00 | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 Mr iac w/o contrast | $961.10 | $1,373.00 | 30% |
| MRI of the brain, no contrast dye inpatient CPT 70551 Mri brain stem w/o dye | $961.10 | $1,373.00 | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 Mr iac w/wo contrast | $961.10 | $1,373.00 | 30% |
| MRI of the brain, with and without contrast dye CPT 70553 Mri brain stem w/o & w/dye | $961.10 | $1,373.00 | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Mr iac w/wo contrast | $961.10 | $1,373.00 | 30% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 Mri brain stem w/o & w/dye | $961.10 | $1,373.00 | 30% |
| MRI of the lower back, no contrast dye CPT 72148 Mri lumbar spine w/o dye | $961.10 | $1,373.00 | 30% |
| MRI of the lower back, no contrast dye CPT 72148 Mri spine lumbar w/o cont | $961.10 | $1,373.00 | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Mri lumbar spine w/o dye | $961.10 | $1,373.00 | 30% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 Mri spine lumbar w/o cont | $961.10 | $1,373.00 | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Us preg uter>1st tri single | $611.10 | $873.00 | 30% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 Ob us >= 14 wks sngl fetus | $611.10 | $873.00 | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Us preg uter>1st tri single | $611.10 | $873.00 | 30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 Ob us >= 14 wks sngl fetus | $611.10 | $873.00 | 30% |
| Screening mammogram, both breasts both sides CPT 77067 Scr mammo bi incl cad | $275.10 | $393.00 | 30% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 Scr mammo bi incl cad | $275.10 | $393.00 | 30% |
| Sleep study in a lab (polysomnography) CPT 95810 Polysom 6/> yrs 4/> param | $3,655.40 | $5,222.00 | 30% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 Polysom 6/> yrs 4/> param | $3,655.40 | $5,222.00 | 30% |
| Transvaginal pelvic ultrasound CPT 76830 Transvaginal us non-ob | $551.60 | $788.00 | 30% |
| Transvaginal pelvic ultrasound CPT 76830 Us pelvis (nonob) transvaginal | $551.60 | $788.00 | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Us pelvis (nonob) transvaginal | $551.60 | $788.00 | 30% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 Transvaginal us non-ob | $551.60 | $788.00 | 30% |
| Ultrasound of the abdomen, complete CPT 76700 Us exam abdom complete | $926.80 | $1,324.00 | 30% |
| Ultrasound of the abdomen, complete CPT 76700 Us abdomen complete | $926.80 | $1,324.00 | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Us abdomen complete | $926.80 | $1,324.00 | 30% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 Us exam abdom complete | $926.80 | $1,324.00 | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 Spine lumbar min 4v | $477.40 | $682.00 | 30% |
| X-ray of the lower back, 4 or more views CPT 72110 X-ray exam l-2 spine 4/>vws | $477.40 | $682.00 | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 Spine lumbar min 4v | $477.40 | $682.00 | 30% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 X-ray exam l-2 spine 4/>vws | $477.40 | $682.00 | 30% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 Ebmp | $16.80 | $24.00 | 30% |
| Basic metabolic panel (blood test) CPT 80048 Metabolic panel total ca | $16.80 | $24.00 | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Metabolic panel total ca | $16.80 | $24.00 | 30% |
| Basic metabolic panel (blood test) inpatient CPT 80048 Ebmp | $16.80 | $24.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Lipid panel | $89.60 | $128.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 Gfgh - lipid | $89.60 | $128.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Lipid panel | $89.60 | $128.00 | 30% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 Gfgh - lipid | $89.60 | $128.00 | 30% |
| Complete blood count (CBC) with differential CPT 85025 Complete cbc w/auto diff wbc | $50.40 | $72.00 | 30% |
| Complete blood count (CBC) with differential CPT 85025 Ghgh - cbc | $50.40 | $72.00 | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Complete cbc w/auto diff wbc | $50.40 | $72.00 | 30% |
| Complete blood count (CBC) with differential inpatient CPT 85025 Ghgh - cbc | $50.40 | $72.00 | 30% |
| Complete blood count (CBC), no differential CPT 85027 Automated hemogram | $11.90 | $17.00 | 30% |
| Complete blood count (CBC), no differential CPT 85027 Complete cbc automated | $11.90 | $17.00 | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Complete cbc automated | $11.90 | $17.00 | 30% |
| Complete blood count (CBC), no differential inpatient CPT 85027 Automated hemogram | $11.90 | $17.00 | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 Gfgh - cmp | $170.10 | $243.00 | 30% |
| Comprehensive metabolic panel (blood test) CPT 80053 Comprehen metabolic panel | $170.10 | $243.00 | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Comprehen metabolic panel | $170.10 | $243.00 | 30% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 Gfgh - cmp | $170.10 | $243.00 | 30% |
| Kidney function blood test panel CPT 80069 Renal function panel | $17.50 | $25.00 | 30% |
| Kidney function blood test panel inpatient CPT 80069 Renal function panel | $17.50 | $25.00 | 30% |
| Liver function blood test panel CPT 80076 Hepatic function panel | $16.10 | $23.00 | 30% |
| Liver function blood test panel inpatient CPT 80076 Hepatic function panel | $16.10 | $23.00 | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Psa free & total - cpt 84154 | $72.80 | $104.00 | 30% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 Assay of psa free | $72.80 | $104.00 | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Assay of psa free | $72.80 | $104.00 | 30% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 Psa free & total - cpt 84154 | $72.80 | $104.00 | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Assay of psa total | $91.00 | $130.00 | 30% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 Gfgh - psa | $91.00 | $130.00 | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Assay of psa total | $91.00 | $130.00 | 30% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 Gfgh - psa | $91.00 | $130.00 | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Antiphospholipid syndrome | $150.50 | $215.00 | 30% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 Thromboplastin time partial | $150.50 | $215.00 | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Antiphospholipid syndrome | $150.50 | $215.00 | 30% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 Thromboplastin time partial | $150.50 | $215.00 | 30% |
| Prothrombin time (PT/INR) clotting test CPT 85610 Prothrombin time | $8.40 | $12.00 | 30% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 Prothrombin time | $8.40 | $12.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Gfgh - tsh | $93.80 | $134.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 Assay thyroid stim hormone | $93.80 | $134.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Assay thyroid stim hormone | $93.80 | $134.00 | 30% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 Gfgh - tsh | $93.80 | $134.00 | 30% |
| Urinalysis with microscope exam, automated CPT 81001 Q urinalysis | $4.99 | $7.13 | 30% |
| Urinalysis with microscope exam, automated CPT 81001 Urinalysis auto w/scope | $4.99 | $7.13 | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Q urinalysis | $4.99 | $7.13 | 30% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 Urinalysis auto w/scope | $4.99 | $7.13 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Urinalysis auto w/o scope | $11.20 | $16.00 | 30% |
| Urinalysis without microscope exam, automated CPT 81003 Glucose qualitative urine | $11.20 | $16.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Urinalysis auto w/o scope | $11.20 | $16.00 | 30% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 Glucose qualitative urine | $11.20 | $16.00 | 30% |
| Urinalysis without microscope exam, manual CPT 81002 Urinalysis nonauto w/o scope | $39.90 | $57.00 | 30% |
| Urinalysis without microscope exam, manual CPT 81002 Urine dipstick | $39.90 | $57.00 | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urine dipstick | $39.90 | $57.00 | 30% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 Urinalysis nonauto w/o scope | $39.90 | $57.00 | 30% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cesarean delivery, including prenatal and postpartum care inpatient CPT 59510 Cesarean delivery | $14,451.16 | $20,644.52 | 30% |
| Colonoscopy with endoscopic ultrasound CPT 45391 Colonoscopy w/endoscope us | $7,113.86 | $10,162.65 | 30% |
| Colonoscopy with endoscopic ultrasound inpatient CPT 45391 Colonoscopy w/endoscope us | $34,573.80 | $49,391.14 | 30% |
| Colonoscopy with polyp removal CPT 45385 Colonoscopy w/lesion removal | $5,761.37 | $8,230.53 | 30% |
| Colonoscopy with polyp removal inpatient CPT 45385 Colonoscopy w/lesion removal | $5,761.37 | $8,230.53 | 30% |
| Colonoscopy with tissue sample CPT 45380 Colonoscopy and biopsy | $5,709.92 | $8,157.03 | 30% |
| Colonoscopy with tissue sample inpatient CPT 45380 Colonoscopy and biopsy | $32,649.69 | $46,642.41 | 30% |
| Colonoscopy, diagnostic CPT 45378 Diagnostic colonoscopy | $5,011.23 | $7,158.90 | 30% |
| Colonoscopy, diagnostic inpatient CPT 45378 Diagnostic colonoscopy | $34,573.80 | $49,391.14 | 30% |
| Gallbladder removal, laparoscopic CPT 47562 Laparoscopic cholecystectomy | $19,683.36 | $28,119.09 | 30% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 Laparoscopic cholecystectomy | $38,733.81 | $55,334.02 | 30% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 Prp i/hern init reduc >5 yr | $9,129.68 | $13,042.40 | 30% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 Prp i/hern init reduc >5 yr | $28,627.05 | $40,895.79 | 30% |
| Knee arthroscopy with meniscus trim CPT 29881 Knee arthroscopy/surgery | $26,798.74 | $38,283.91 | 30% |
| Knee arthroscopy with meniscus trim inpatient CPT 29881 Knee arthroscopy/surgery | $36,935.33 | $52,764.75 | 30% |
| Left heart catheterization, diagnostic one side CPT 93452 Left hrt cath w/ventrclgrphy | $9,552.90 | $13,647.00 | 30% |
| Left heart catheterization, diagnostic one side CPT 93452 Left heart cath w lv inj | $9,552.90 | $13,647.00 | 30% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Left heart cath w lv inj | $9,552.90 | $13,647.00 | 30% |
| Left heart catheterization, diagnostic inpatient one side CPT 93452 Left hrt cath w/ventrclgrphy | $9,552.90 | $13,647.00 | 30% |
| Lower-back epidural injection, with imaging guidance CPT 62323 Njx interlaminar lmbr/sac | $2,377.77 | $3,396.81 | 30% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 Njx interlaminar lmbr/sac | $2,377.77 | $3,396.81 | 30% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 Inj foramen epidural l/s | $5,619.66 | $8,028.08 | 30% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 Inj foramen epidural l/s | $5,619.66 | $8,028.08 | 30% |
| Prostate removal (prostatectomy), laparoscopic inpatient CPT 55866 Laparo radical prostatectomy | $50,166.75 | $71,666.78 | 30% |
| Removal of a breast lump, open surgery CPT 19120 Exc cyst fibroadenoma breast | $7,621.60 | $10,888.00 | 30% |
| Removal of a breast lump, open surgery CPT 19120 Removal of breast lesion | $7,705.12 | $11,007.32 | 30% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Exc cyst fibroadenoma breast | $7,621.60 | $10,888.00 | 30% |
| Removal of a breast lump, open surgery inpatient CPT 19120 Removal of breast lesion | $32,412.58 | $46,303.69 | 30% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 Shoulder arthroscopy/surgery | $28,642.80 | $40,918.28 | 30% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) inpatient CPT 29826 Shoulder arthroscopy/surgery | $28,642.80 | $40,918.28 | 30% |
| Tonsil and adenoid removal, child under 12 CPT 42820 Remove tonsils and adenoids | $13,538.83 | $19,341.18 | 30% |
| Tonsil and adenoid removal, child under 12 inpatient CPT 42820 Remove tonsils and adenoids | $13,538.83 | $19,341.18 | 30% |
| Total hip replacement CPT 27130 Total hip arthroplasty | $41,847.58 | $59,782.25 | 30% |
| Total hip replacement inpatient CPT 27130 Total hip arthroplasty | $47,417.83 | $67,739.76 | 30% |
| Total knee replacement CPT 27447 Total knee arthroplasty | $42,110.17 | $60,157.38 | 30% |
| Total knee replacement inpatient CPT 27447 Total knee arthroplasty | $49,271.87 | $70,388.39 | 30% |
| Upper endoscopy (EGD) with biopsy CPT 43239 Egd biopsy single/multiple | $6,167.41 | $8,810.59 | 30% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 Egd biopsy single/multiple | $29,778.74 | $42,541.06 | 30% |
| Upper endoscopy (EGD), diagnostic CPT 43235 Egd diagnostic brush wash | $4,751.32 | $6,787.60 | 30% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 Egd diagnostic brush wash | $29,479.13 | $42,113.04 | 30% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care inpatient CPT 59610 Vbac delivery | $11,237.46 | $16,053.51 | 30% |
| Vaginal delivery, including prenatal and postpartum care inpatient CPT 59400 Obstetrical care | $11,238.92 | $16,055.60 | 30% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| New patient office visit, about 30 minutes CPT 99203 Op visit new pt level 3 | $245.00 | $350.00 | 30% |
| New patient office visit, about 30 minutes CPT 99203 Office/outpatient visit new | $245.00 | $350.00 | 30% |
| New patient office visit, about 30 minutes CPT 99203 Ob eval new pt level 3 | $245.00 | $350.00 | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Office/outpatient visit new | $245.00 | $350.00 | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Ob eval new pt level 3 | $245.00 | $350.00 | 30% |
| New patient office visit, about 30 minutes inpatient CPT 99203 Op visit new pt level 3 | $245.00 | $350.00 | 30% |
| New patient office visit, about 45 minutes CPT 99204 Op visit new pt level 4 | $314.30 | $449.00 | 30% |
| New patient office visit, about 45 minutes CPT 99204 Office/outpatient visit new | $314.30 | $449.00 | 30% |
| New patient office visit, about 45 minutes CPT 99204 Ob eval new pt level 4 | $314.30 | $449.00 | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Op visit new pt level 4 | $314.30 | $449.00 | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Ob eval new pt level 4 | $314.30 | $449.00 | 30% |
| New patient office visit, about 45 minutes inpatient CPT 99204 Office/outpatient visit new | $314.30 | $449.00 | 30% |
| New patient office visit, about 60 minutes CPT 99205 Op visit new pt level 5 | $462.70 | $661.00 | 30% |
| New patient office visit, about 60 minutes CPT 99205 Office/outpatient visit new | $463.40 | $662.00 | 30% |
| New patient office visit, about 60 minutes CPT 99205 Ob eval new pt level 5 | $463.40 | $662.00 | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Op visit new pt level 5 | $462.70 | $661.00 | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Ob eval new pt level 5 | $463.40 | $662.00 | 30% |
| New patient office visit, about 60 minutes inpatient CPT 99205 Office/outpatient visit new | $463.40 | $662.00 | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 Therapeutic exercises | $108.50 | $155.00 | 30% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 Therapeutic exercises | $108.50 | $155.00 | 30% |
Source file: https://goshenhealth.com/uploads/PricingDocuments/35-6001540_Goshen-Hospital_standardcharges.csv