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 |
|---|---|---|---|---|
| Biopsy tongue anterior two-thirds CPT 41100 | not published | not published | $769.74 – $6,291.00 | 8 |
| Biopsy vaginal mucosa xtnsv CPT 57105 | not published | not published | $4,805.89 – $12,362.00 | 8 |
| Biopsy vestibule of mouth 40808 CPT 40808 | not published | not published | $769.74 – $6,291.00 | 8 |
| Biopsy vrt bdy open lmbr/crv CPT 20251 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Biopsy vrt bdy open thoracic CPT 20250 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Biospy of bladder CPT 53899 | $980.00 | $1,960.00 | $367.61 – $6,291.00 | 18 |
| Biotinidase - quest CPT 82261 | $82.50 | $165.00 | $16.87 – $91.42 | 18 |
| Biovance 1 square cm HCPCS Q4154 | not published | not published | $245.80 – $503.52 | 6 |
| Biovance tri or 3l, sq cm HCPCS Q4283 | not published | not published | $1,600.00 – $3,580.13 | 6 |
| Bis xtracell fluid analysis CPT 93702 | $202.50 | $405.00 | $159.57 – $469.00 | 18 |
| Bivalirudin HCPCS J0583 | $0.79 | $1.58 | $0.33 – $13.40 | 14 |
| Bk/ak locking mechanism HCPCS L5671 | not published | not published | $865.68 – $2,110.70 | 7 |
| Bk back check HCPCS L5686 | not published | not published | $100.75 – $244.44 | 7 |
| Bk flex inner socket ext fra HCPCS L5645 | not published | not published | $1,705.26 – $4,155.60 | 7 |
| Bk fork strap HCPCS L5684 | not published | not published | $83.77 – $202.13 | 7 |
| Bk joint covers pair HCPCS L5678 | not published | not published | $69.11 – $169.24 | 7 |
| Bk knee joints polycentric p HCPCS L5677 | not published | not published | $965.85 – $2,355.15 | 7 |
| Bk knee joints single axis p HCPCS L5676 | not published | not published | $630.66 – $1,537.19 | 7 |
| Bk molded distal cushion HCPCS L5668 | not published | not published | $199.90 – $488.90 | 7 |
| Bk molded supracondylar susp HCPCS L5670 | not published | not published | $472.25 – $1,151.72 | 7 |
| Bk mold socket sach ft endo HCPCS L5301 | not published | not published | $4,689.76 – $11,427.91 | 7 |
| Bk removable medial brim sus HCPCS L5672 | not published | not published | $624.92 – $1,523.09 | 7 |
| Bk thigh lacer glut/ischia m HCPCS L5682 | not published | not published | $1,088.40 – $2,651.31 | 7 |
| Bk thigh lacer non-molded HCPCS L5680 | not published | not published | $529.71 – $1,292.75 | 7 |
| Bk waist belt padded and lin HCPCS L5690 | not published | not published | $218.43 – $531.21 | 7 |
| Bk waist belt webbing HCPCS L5688 | not published | not published | $107.01 – $258.56 | 7 |
| Bladder calculi irrig sol HCPCS Q2004 | not published | not published | $242.42 – $496.59 | 4 |
| Bladder Catheter Insertion (simple) CPT 51702 | $245.00 | $490.00 | $105.00 – $6,291.00 | 18 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $550.00 | $1,100.00 | $367.61 – $6,291.00 | 18 |
| Bladder irrigation tubing HCPCS A4355 | not published | not published | $18.07 – $42.31 | 7 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $660.80 – $6,291.00 | 8 |
| Bld prd mix CPT 86965 | not published | not published | $94.52 – $342.97 | 14 |
| Bld push tfuj 2 yr/< CPT 36440 | not published | not published | $660.80 – $6,291.00 | 8 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | not published | not published | $41.48 – $84.97 | 6 |
| Blepharoplasty lower 15820 CPT 15820 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Blepharp lwr eyelid fat pad CPT 15821 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | not published | not published | $236.65 – $513.62 | 10 |
| Blind cor sinus reducer impl HCPCS C9783 | not published | not published | $17,141.37 – $47,462.00 | 8 |
| Blinded conv. tx mdd clin tr HCPCS G2000 | not published | not published | $802.01 – $1,061.97 | 4 |
| Blind interatrial shunt ide HCPCS C9758 | not published | not published | $26,452.16 – $97,131.00 | 8 |
| Blind myocar trpl bon marrow HCPCS C9782 | not published | not published | $26,452.16 – $97,131.00 | 8 |
| Blind/nonblind trans atrial HCPCS C9792 | not published | not published | $14,737.97 – $47,462.00 | 8 |
| Blink reflex test CPT 95933 | $212.50 | $425.00 | $89.78 – $397.52 | 18 |
| Blm gene CPT 81209 | $140.00 | $280.00 | $39.31 – $224.00 | 18 |
| Bln 1.2 mono emrg 15x1.2 HCPCS C1725 | $10,410.50 | $20,821.00 | $52.35 – $120.00 | 14 |
| Bln 30frx10mmx12cm renal nephromax HCPCS C1726 | $7,586.38 | $15,172.75 | $27.78 – $63.69 | 14 |
| Bln inpact admiral 4x150x130cm HCPCS C2623 | $7,528.79 | $15,057.57 | $1,536.93 – $3,523.04 | 13 |
| Bln press regulation 71-80cm HCPCS C1815 | $30,815.46 | $61,630.92 | $20,584.73 – $49,304.74 | 14 |
| Bln ureth 5ml 28f 2wy ltx st HCPCS A4338 | not published | not published | $24.85 – $61.10 | 7 |
| Block brachial plexus w/cath plmt w/img CPT 64416 | not published | not published | $1,345.68 – $6,071.00 | 8 |
| Block femoral nerve cont infusion cath w/img CPT 64448 | not published | not published | $1,345.68 – $6,071.00 | 8 |
| Block paracervical nrv CPT 64435 | not published | not published | $1,046.75 – $6,071.00 | 8 |
| Block plantar digital nerve CPT 64455 | not published | not published | $446.18 – $6,291.00 | 8 |
| Block tap inj(s) w/wo img bi CPT 64488 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Block tap inj(s) w/wo img uni CPT 64486 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Blood clot lysis time CPT 85175 | not published | not published | $20.37 – $92.26 | 14 |
| Blood clot retraction CPT 85170 | not published | not published | $16.30 – $74.41 | 11 |
| Blood Clotting (PT/INR) Test CPT 85610 | $37.50 | $75.00 | $4.29 – $44.00 | 18 |
| Blood Clotting (PTT) Test CPT 85730 | $47.50 | $95.00 | $6.01 – $76.00 | 18 |
| Blood component/product noc HCPCS P9099 | $242.50 | $485.00 | $70.95 – $388.00 | 18 |
| Blood Count (CBC) Test CPT 85025 | $50.00 | $100.00 | $7.77 – $79.24 | 18 |
| Blood Count (CBC) Test (without differential) CPT 85027 | $50.00 | $100.00 | $6.47 – $60.00 | 18 |
| Blood count spun microhematocrit CPT 85013 | $20.00 | $40.00 | $7.00 – $32.00 | 18 |
| Blood Culture Test CPT 87040 | $82.50 | $165.00 | $10.32 – $132.00 | 18 |
| Blood draw capillary 36416 CPT 36416 | $17.50 | $35.00 | $0.79 – $28.00 | 14 |
| Blood Draw (Venipuncture) CPT 36415 | $22.50 | $45.00 | $3.00 – $36.00 | 17 |
| Blood gases o2 saturation direct measurement CPT 82805 | $122.50 | $245.00 | $78.77 – $358.64 | 18 |
| Blood gases ph venous CPT 82800 | not published | not published | $11.00 – $50.60 | 14 |
| Blood, l/r, irradiated HCPCS P9056 | $515.00 | $1,030.00 | $122.05 – $824.00 | 18 |
| Blood mucoprotein HCPCS P2038 | not published | not published | $4.95 – $28.21 | 13 |
| Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic CPT 82274 | $87.50 | $175.00 | $15.92 – $140.00 | 18 |
| Blood occult feces 1-3 determinations other than neoplasm screening qualitative CPT 82272 | $32.50 | $65.00 | $4.23 – $40.00 | 18 |
| Blood occult feces colorectal neoplasm screening qualitative CPT 82270 | $25.00 | $50.00 | $4.38 – $28.00 | 18 |
| Blood occult peroxidase activity qualitative gastric CPT 82271 | $25.00 | $50.00 | $5.32 – $28.00 | 18 |
| Blood smear interpretation CPT 85060 | not published | not published | $25.26 – $141.03 | 10 |
| Blood smear microscopic w manual differential wbc count CPT 85007 | $30.00 | $60.00 | $3.80 – $48.00 | 18 |
| Blood split unit HCPCS P9011 | $325.00 | $650.00 | $205.61 – $520.00 | 18 |
| Blood thymol turbidity HCPCS P2033 | not published | not published | $4.95 – $9.50 | 8 |
| Blood Transfusion CPT 36430 | $1,005.00 | $2,010.00 | $660.80 – $1,608.00 | 18 |
| Blood typing abo CPT 86900 | $92.50 | $185.00 | $2.99 – $257.99 | 18 |
| Blood typing ag donor ea ag CPT 86902 | $97.50 | $195.00 | $6.35 – $719.96 | 18 |
| Blood typing antigen system CPT 86911 | not published | not published | $23.10 – $95.24 | 10 |
| Blood typing paternity test CPT 86910 | not published | not published | $26.71 – $110.12 | 10 |
| Blood typing patient serum CPT 86904 | $80.00 | $160.00 | $16.34 – $128.00 | 18 |
| Blood typing rbc ag non abo/rh ea CPT 86905 | $220.00 | $440.00 | $3.83 – $719.96 | 18 |
| Blood typing rh (d) CPT 86901 | $92.50 | $185.00 | $2.99 – $136.00 | 18 |
| Blood typing rh phenotype complete reference CPT 86906 | $105.00 | $210.00 | $7.75 – $168.00 | 18 |
| Blood volume CPT 78122 | not published | not published | $758.04 – $1,077.32 | 8 |
| Bls-emergency HCPCS A0429 | not published | not published | $2,040.36 – $2,322.26 | 3 |
| Blue light cysto imag agent HCPCS C9738 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Body jacket mold to patient HCPCS L1300 | not published | not published | $3,010.98 – $7,338.12 | 7 |
| Bone Age X-ray (hand and wrist) CPT 77072 | $270.00 | $540.00 | $65.21 – $634.00 | 18 |
| Bone biopsy open superficial CPT 20240 | not published | not published | $4,326.01 – $12,362.00 | 8 |
| Bone Density Scan (DEXA) CPT 77080 | $395.00 | $790.00 | $133.89 – $634.00 | 18 |
| Bone imaging (3d) CPT 78320 | not published | not published | $1,437.34 – $1,635.92 | 3 |
| Bone imaging multiple areas CPT 78305 | $1,265.00 | $2,530.00 | $607.37 – $3,966.00 | 18 |
| Bone/joint imaging ltd area CPT 78300 | $935.00 | $1,870.00 | $530.00 – $3,966.00 | 18 |
| Bone marrow;aspiration only 38220 CPT 38220 | $1,430.00 | $2,860.00 | $1,126.84 – $6,071.00 | 18 |
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.