Advocate Good Samaritan Hospital
3815 Highland Avenue, Downers Grove, IL · Advocate Health · · NPI 1578670543
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Shoulder X-ray CPT 73030 | $345.00 | $690.00 | $107.66 – $634.00 | 18 |
| Shoulder X-ray (single view, both shoulders) CPT 73020 | $255.00 | $510.00 | $65.44 – $634.00 | 18 |
| Shrinker prosth above knee HCPCS L8460 | not published | not published | $115.99 – $282.06 | 7 |
| Shrinker prosth below knee HCPCS L8440 | not published | not published | $81.59 – $197.43 | 7 |
| Shrinker upper limb HCPCS L8465 | not published | not published | $107.20 – $263.25 | 7 |
| Shunt as-aort to pulm art CPT 33755 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Shunt central w/prostc graft CPT 33764 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Shunt desc aorta to pulm art CPT 33762 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | $345.00 | $690.00 | $160.73 – $634.00 | 18 |
| Shunt subclavian to pulm art CPT 33750 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Shunt supr v/c p-art 1 lung CPT 33766 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Shunt supr v/c p-art bth lng CPT 33767 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $12.22 – $65.81 | 13 |
| Sialography s&i CPT 70390 | $472.50 | $945.00 | $220.00 – $756.00 | 18 |
| Sialolithotomy 42330 CPT 42330 | not published | not published | $3,126.00 – $6,490.83 | 8 |
| Sickling rbc CPT 85660 | $187.50 | $375.00 | $5.51 – $64.00 | 18 |
| Sigmoidoscopy and biopsy CPT 45331 | not published | not published | $1,378.06 – $6,071.00 | 8 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $1,378.06 – $6,181.00 | 8 |
| Sigmoidoscopy for bleeding CPT 45334 | not published | not published | $1,782.19 – $6,181.00 | 8 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $1,378.06 – $6,071.00 | 8 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $1,782.19 – $6,181.00 | 8 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | not published | not published | $1,782.19 – $6,181.00 | 8 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $3,126.00 – $11,914.23 | 8 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Sigmoidoscopy w/tumr remove CPT 45338 | not published | not published | $1,782.19 – $6,181.00 | 8 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $1,378.06 – $6,181.00 | 8 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $1,782.19 – $6,181.00 | 8 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | not published | not published | $1,378.06 – $6,071.00 | 8 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | $280.00 | $560.00 | $89.78 – $448.00 | 18 |
| Sig w/tndsc balloon dilation CPT 45340 | not published | not published | $1,782.19 – $6,181.00 | 8 |
| Sildenafil citrate, 25 mg HCPCS S0090 | not published | not published | $0.54 – $79.91 | 5 |
| Silicon gel insert w/wo lock HCPCS L6692 | not published | not published | $1,119.53 – $2,726.52 | 7 |
| Sim ang w/prs cath rad emb HCPCS C8004 | not published | not published | $17,141.37 – $22,697.54 | 4 |
| Simple cystometrogram 51725 CPT 51725 | not published | not published | $367.61 – $6,291.00 | 8 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | $157.65 | $315.29 | $124.22 – $481.72 | 14 |
| Single energy x-ray study HCPCS G0130 | not published | not published | $160.73 – $212.83 | 7 |
| Single pivot hinge pair HCPCS L6605 | not published | not published | $408.67 – $996.59 | 7 |
| Single transfer toe-hand CPT 26553 | not published | not published | $9,155.00 – $18,102.00 | 4 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,285.00 | $2,570.00 | $269.08 – $2,056.00 | 18 |
| Sinus CT scan (with contrast) CPT 70487 | $890.00 | $1,780.00 | $269.08 – $1,424.00 | 18 |
| Sinus CT scan (without contrast) CPT 70486 | $785.00 | $1,570.00 | $160.73 – $1,256.00 | 18 |
| Sinus/juglr venogram s&i CPT 75860 | $3,295.00 | $6,590.00 | $220.00 – $6,299.55 | 18 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $4,901.93 – $12,362.00 | 8 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Sinus X-ray (complete) CPT 70220 | $242.50 | $485.00 | $123.47 – $634.00 | 18 |
| Sinus X-ray (limited) CPT 70210 | $160.00 | $320.00 | $108.59 – $634.00 | 18 |
| Sio flex pelvisacral custom HCPCS L0622 | not published | not published | $466.96 – $1,706.43 | 7 |
| Sio rig pnl pelv/sac pre ots HCPCS L0623 | not published | not published | $164.36 – $217.63 | 4 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $81,121.66 – $187,633.20 | 10 |
| Sirolimus, oral HCPCS J7520 | not published | not published | $2.21 – $41.41 | 9 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $122.57 – $384.44 | 10 |
| Six volt bat otto bock/eq ea HCPCS L7360 | not published | not published | $463.09 – $1,128.22 | 7 |
| Skeletal muscle relaxant 1/2 CPT 80369 | $287.50 | $575.00 | $200.68 – $460.00 | 14 |
| Skin and muscle repair face CPT 15845 | not published | not published | $5,533.59 – $17,439.00 | 8 |
| Skin barrier with flange HCPCS A4373 | not published | not published | $12.70 – $42.31 | 7 |
| Skin Biopsy CPT 11102 | $212.50 | $425.00 | $167.45 – $6,291.00 | 18 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $2,764.90 – $12,362.00 | 8 |
| Skin full graft add-on 15241 CPT 15241 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $5,533.59 – $17,439.00 | 8 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Skin test unlisted antigen ea CPT 86486 | not published | not published | $22.99 – $49.02 | 13 |
| Skull base/brainstem surgery CPT 61575 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Skull base/brainstem surgery CPT 61576 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Skull X-ray (1 to 3 views) CPT 70250 | $290.00 | $580.00 | $119.90 – $634.00 | 18 |
| Skull X-ray (complete) CPT 70260 | $437.50 | $875.00 | $141.33 – $700.00 | 18 |
| Skyla, 13.5 mg HCPCS J7301 | not published | not published | $1,907.17 – $3,906.81 | 6 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $174.81 – $794.66 | 10 |
| Sleep study attended CPT 95807 | not published | not published | $802.01 – $4,841.00 | 12 |
| Sleep Study (Polysomnography) CPT 95810 | $3,235.00 | $6,470.00 | $1,283.00 – $4,841.00 | 18 |
| Sleep study unattended CPT 95806 | $495.00 | $990.00 | $236.49 – $828.00 | 18 |
| Sleeve fing rolyan med HCPCS L3933 | $235.00 | $470.00 | $150.30 – $449.20 | 18 |
| Sleeve irr assura 1pc disp HCPCS A4397 | not published | not published | $28.92 – $32.91 | 3 |
| Sleeve pneumonectomy CPT 32442 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Sling arm deluxe w/pad xs HCPCS A4565 | not published | not published | $15.60 – $37.62 | 7 |
| Sling pelv split sam med HCPCS L0621 | not published | not published | $91.68 – $550.00 | 7 |
| Sling suprapubic suburetheral HCPCS C1771 | $13,837.20 | $27,674.39 | $1,846.69 – $4,423.20 | 14 |
| Slitting of prepuce CPT 54000 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Slitting of prepuce CPT 54001 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Slp eval for nonspeech dev ea addl 30 mins CPT 92618 | not published | not published | $46.96 – $62.18 | 4 |
| Slp eval non-spch gen comm dev CPT 92605 | not published | not published | $134.80 – $178.49 | 4 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $89.78 – $828.00 | 8 |
| Slp ther svc non-spch gen CPT 92606 | $172.50 | $345.00 | $114.96 – $469.00 | 18 |
| Sm-153 lexidron ther HCPCS A9604 | not published | not published | $6,256.62 – $58,338.29 | 10 |
| Small animal inoculation CPT 87003 | not published | not published | $16.84 – $94.02 | 14 |
| Small Bowel Barium X-ray (Follow-Through) CPT 74250 | $397.50 | $795.00 | $220.00 – $636.00 | 18 |
| Small bowel endoscopy CPT 44360 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy CPT 44364 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy CPT 44366 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy CPT 44369 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy CPT 44376 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy CPT 44378 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy CPT 44382 | not published | not published | $1,417.13 – $6,181.00 | 8 |
| Small bowel endoscopy CPT 44384 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $1,417.13 – $6,181.00 | 8 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.