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 |
|---|---|---|---|---|
| Cystoscopy and treatment CPT 52214 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52224 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52234 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52235 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52240 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52260 | not published | not published | $3,096.34 – $6,181.00 | 8 |
| Cystoscopy and treatment CPT 52265 | not published | not published | $3,070.00 – $6,071.00 | 8 |
| Cystoscopy and treatment CPT 52276 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52277 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52283 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52285 | not published | not published | $1,008.89 – $6,181.00 | 8 |
| Cystoscopy and treatment CPT 52290 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52300 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52301 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52305 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52310 | $2,125.00 | $4,250.00 | $1,674.50 – $6,181.00 | 18 |
| Cystoscopy and treatment CPT 52315 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52320 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy and treatment CPT 52330 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy (Bladder Scope) CPT 52000 | $1,080.00 | $2,160.00 | $84.00 – $1,728.00 | 18 |
| Cystoscopy chemodenervation CPT 52287 | not published | not published | $3,096.34 – $6,181.00 | 8 |
| Cystoscopy & duct catheter CPT 52010 | not published | not published | $1,008.89 – $6,071.00 | 8 |
| Cystoscopy implant stent CPT 52282 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystoscopy inject material CPT 52327 | not published | not published | $7,683.94 – $18,102.00 | 8 |
| Cystoscopy prostatic imp 1-3 HCPCS C9739 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Cystoscopy removal of clots CPT 52001 | not published | not published | $3,126.00 – $6,902.93 | 8 |
| Cystoscopy & revise urethra CPT 52270 | not published | not published | $3,096.34 – $6,181.00 | 8 |
| Cystoscopy & revise urethra CPT 52275 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Cystoscopy stone removal CPT 52325 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Cystoscopy & ureter catheter CPT 52005 | $2,295.00 | $4,590.00 | $1,808.46 – $4,099.98 | 13 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Cystotomy/cystostomy fulg+/insj radact matrl 51020 CPT 51020 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystotomy excise/incise/repair 51535 CPT 51535 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystouretero & or pyeloscope CPT 52351 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cysto/uretero stricture tx CPT 52344 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystouretero w/biopsy CPT 52354 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Cystouretero w/excise tumor CPT 52355 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Cysto/uretero w/lithotripsy CPT 52356 | not published | not published | $7,683.94 – $18,102.00 | 8 |
| Cystouretero w/lithotripsy CPT 52353 | not published | not published | $7,683.94 – $18,102.00 | 8 |
| Cystouretero w/renal strict CPT 52346 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Cystouretero w/stone remove CPT 52352 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cysto/uretero w/up stricture CPT 52345 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystourethro cut ejacul duct CPT 52402 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $2,295.00 | $4,590.00 | $1,808.46 – $4,099.98 | 13 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | not published | not published | $3,096.34 – $12,362.00 | 8 |
| Cystourethro w/addl implant 52442 CPT 52442 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Cystourethro w/implant CPT 52441 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Cysto with bx(s) with blue light HCPCS C7550 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Cysto w/renal stricture tx CPT 52343 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cysto w/up stricture tx CPT 52342 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cysto w/ureter stricture tx CPT 52341 | not published | not published | $5,213.15 – $12,362.00 | 8 |
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | not published | not published | $1.25 – $2.57 | 6 |
| Cytarabine liposome inj HCPCS J9098 | not published | not published | $694.24 – $2,684.23 | 9 |
| Cytog alys chrml abnr lw-ps CPT 81349 | not published | not published | $1,160.00 – $5,272.41 | 10 |
| Cytogenetics 25-99 CPT 88274 | $190.00 | $380.00 | $42.38 – $304.00 | 18 |
| Cytogenetics 3-5 CPT 88272 | $1,105.00 | $2,210.00 | $40.70 – $1,768.00 | 18 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,160.00 – $5,272.41 | 10 |
| Cytogenom microarray copy nmbr var CPT 81228 | not published | not published | $900.00 – $4,090.84 | 10 |
| Cytog genom-wid alys hem mal CPT 81195 | not published | not published | $1,832.12 – $2,425.98 | 4 |
| Cytomegalovirus ag ia CPT 87332 | not published | not published | $11.98 – $65.81 | 14 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $85.00 | $170.00 | $14.39 – $136.00 | 18 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $95.00 | $190.00 | $16.85 – $152.00 | 18 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $13.42 – $65.81 | 14 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | not published | not published | $2,623.69 – $6,125.03 | 13 |
| Cytomeg dna dir probe CPT 87495 | not published | not published | $30.03 – $136.91 | 11 |
| Cyto/molecular report CPT 88291 | not published | not published | $34.65 – $178.65 | 10 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $25.37 – $117.53 | 14 |
| Cytopath c/v automated CPT 88147 | not published | not published | $49.56 – $229.17 | 14 |
| Cytopath c/v auto redo CPT 88152 | not published | not published | $27.64 – $125.00 | 14 |
| Cytopath c/v auto rescreen CPT 88148 | not published | not published | $16.00 – $80.36 | 14 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $14.65 – $66.97 | 14 |
| Cytopath c/v manual CPT 88150 | not published | not published | $15.12 – $80.36 | 14 |
| Cytopath c/v redo CPT 88153 | not published | not published | $24.03 – $108.63 | 14 |
| Cytopath c/v thin layer redo CPT 88143 | not published | not published | $23.04 – $112.82 | 14 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $22.99 – $305.56 | 14 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $192.50 | $385.00 | $49.47 – $308.00 | 18 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $137.50 | $275.00 | $26.61 – $220.00 | 18 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $110.00 | $220.00 | $20.26 – $176.00 | 18 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $177.50 | $355.00 | $33.43 – $284.00 | 18 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $132.50 | $265.00 | $33.43 – $221.65 | 18 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $147.50 | $295.00 | $7.22 – $236.00 | 14 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $295.00 | $590.00 | $91.63 – $472.00 | 18 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $205.00 | $410.00 | $49.47 – $450.78 | 18 |
| Cytopath smear other source CPT 88160 | $97.50 | $195.00 | $22.99 – $248.43 | 18 |
| Cytopath smear other source CPT 88162 | $140.00 | $280.00 | $49.47 – $409.11 | 18 |
| Cytopath smear oth prep screen & interp CPT 88161 | $95.00 | $190.00 | $22.99 – $257.36 | 18 |
| Cytopath tbs c/v auto redo CPT 88166 | not published | not published | $15.12 – $80.36 | 14 |
| Cytopath tbs c/v manual CPT 88164 | $62.50 | $125.00 | $15.12 – $100.00 | 18 |
| Cytopath tbs c/v redo CPT 88165 | not published | not published | $42.22 – $191.97 | 14 |
| Cytopath tbs c/v select CPT 88167 | not published | not published | $15.12 – $80.36 | 14 |
| Cytotoxic antibody screening CPT 86807 | not published | not published | $78.65 – $357.15 | 14 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $29.68 – $164.54 | 14 |
| Cytp urine 3-5 probes cmptr CPT 88121 | $855.00 | $1,710.00 | $259.01 – $1,666.61 | 18 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | not published | not published | $5.94 – $23.51 | 9 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | not published | not published | $439.24 – $3,248.33 | 13 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | not published | not published | $22.55 – $53.37 | 10 |
| Dalteparin sodium HCPCS J1645 | not published | not published | $26.88 – $65.81 | 9 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $0.26 | $0.51 | $0.03 – $4.47 | 14 |
| Daptomycin (xellia) unrefrig HCPCS J0872 | not published | not published | $0.08 – $1.12 | 10 |
| Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln HCPCS J9144 | not published | not published | $79.27 – $172.38 | 10 |
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.