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 |
|---|---|---|---|---|
| Epoetin beta non esrd HCPCS J0888 | not published | not published | $1.78 – $3.65 | 10 |
| Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr HCPCS J1325 | not published | not published | $27.18 – $79.95 | 9 |
| Epstein barr early antigen antibody CPT 86663 | $72.50 | $145.00 | $13.12 – $116.00 | 18 |
| Epstein barr nuclear antigen antibody CPT 86664 | $85.00 | $170.00 | $15.29 – $136.00 | 18 |
| Epstein barr viral capsid antigen antibody igm CPT 86665 | $112.50 | $225.00 | $18.14 – $180.00 | 18 |
| Eptifibatide 0.75 mg/ml intravenous solution HCPCS J1327 | not published | not published | $5.00 – $108.12 | 9 |
| Eptinezumab-jjmr 100 mg/ml intravenous solution HCPCS J3032 | not published | not published | $28.78 – $63.07 | 10 |
| Ercp biliary & pancreas CPT 74330 | $705.00 | $1,410.00 | $220.00 – $1,128.00 | 14 |
| Ercp bil/panc duct; each stent plcmt 43274 CPT 43274 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Ercp ea duct/ampulla dilate CPT 43277 | not published | not published | $5,750.58 – $12,362.00 | 8 |
| Ercp lesion ablate w/dilate 43278 CPT 43278 | not published | not published | $5,750.58 – $12,362.00 | 8 |
| Ercp lithotripsy calculi CPT 43265 | $6,990.00 | $13,980.00 | $5,508.12 – $12,362.00 | 18 |
| Ercp remove duct calculi 43264 CPT 43264 | $3,420.00 | $6,840.00 | $2,694.96 – $12,362.00 | 18 |
| Ercp remove forgn body duct 43275 CPT 43275 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Ercp sphincter pressure meas CPT 43263 | $4,450.00 | $8,900.00 | $2,867.32 – $12,362.00 | 18 |
| Ercp stent exchange w/dilate CPT 43276 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Ercp w/specimen collection CPT 43260 | $3,420.00 | $6,840.00 | $2,694.96 – $12,362.00 | 18 |
| Ergonovine 0.2 mg/ml inj HCPCS J1330 | not published | not published | $9.74 – $9.74 | 2 |
| Eribulin 1 mg/2 ml (0.5 mg/ml) intravenous solution HCPCS J9179 | not published | not published | $151.65 – $477.56 | 10 |
| Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr HCPCS J1335 | $44.72 | $89.43 | $17.72 – $147.40 | 14 |
| ER Visit (level 1, minor) CPT 99281 | $195.00 | $390.00 | $49.25 – $796.00 | 18 |
| ER Visit (level 2) CPT 99282 | $267.50 | $535.00 | $210.79 – $1,214.00 | 18 |
| ER Visit (level 3) CPT 99283 | $580.00 | $1,160.00 | $418.52 – $2,071.00 | 18 |
| ER Visit (level 4) CPT 99284 | $1,255.00 | $2,510.00 | $643.63 – $3,426.00 | 18 |
| ER Visit (level 5, high severity) CPT 99285 | $2,040.00 | $4,080.00 | $926.71 – $4,020.00 | 18 |
| Erwinaze injection HCPCS J9019 | not published | not published | $798.11 – $1,634.91 | 6 |
| Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr HCPCS J1364 | not published | not published | $41.31 – $235.89 | 9 |
| Escharotomy ea addl incision CPT 16036 | $222.50 | $445.00 | $175.33 – $356.00 | 9 |
| Esd endoscopy or colonoscopy HCPCS C9779 | not published | not published | $5,750.58 – $12,362.00 | 8 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) in sterile water intravenous soln HCPCS J1806 | not published | not published | $0.66 – $1.35 | 6 |
| Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only HCPCS J1805 | $10.79 | $21.57 | $0.38 – $17.26 | 14 |
| Esophageal dilat s&i CPT 74360 | $525.00 | $1,050.00 | $220.00 – $973.70 | 14 |
| Esophageal lengthening add on code 43338 CPT 43338 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esophageal motility CPT 78258 | not published | not published | $607.37 – $1,372.67 | 8 |
| Esophageal recording CPT 93615 | not published | not published | $425.42 – $6,181.00 | 11 |
| Esophageal recording CPT 93616 | not published | not published | $1,834.96 – $6,181.00 | 8 |
| Esophag muc integ w/eso egd HCPCS C9777 | not published | not published | $5,750.58 – $12,362.00 | 8 |
| Esophagomyotomy abdominal 43330 CPT 43330 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esophagomyotomy thoracic 43331 CPT 43331 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esophagoplasty congenital CPT 43313 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esophagosc dilate balloon 30 CPT 43214 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagosc flex trnsn biopsy CPT 43198 | not published | not published | $1,417.13 – $6,181.00 | 8 |
| Esophagoscop mucosal resect CPT 43211 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscop stent placement CPT 43212 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Esophagoscop ultrasound exam CPT 43231 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscopy balloon <30mm CPT 43220 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscopy control bleed CPT 43227 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscopy flex biopsy CPT 43202 | $2,370.00 | $4,740.00 | $1,867.56 – $6,181.00 | 18 |
| Esophagoscopy/flex/diagnostic 43200 CPT 43200 | $1,040.00 | $2,080.00 | $819.52 – $1,876.48 | 13 |
| Esophagoscopy flex dx brush CPT 43197 | not published | not published | $1,417.13 – $6,181.00 | 8 |
| Esophagoscopy flex remove fb CPT 43215 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscopy lesion ablate CPT 43229 | not published | not published | $5,750.58 – $12,362.00 | 8 |
| Esophagoscopy lesion removal CPT 43216 | not published | not published | $2,867.32 – $12,362.00 | 8 |
| Esophagoscopy retro balloon CPT 43213 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscopy rigid balloon CPT 43195 | not published | not published | $3,126.00 – $7,614.56 | 8 |
| Esophagoscopy/rigid/diagnostic 43191 CPT 43191 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscopy rigid trnso 43180 CPT 43180 | not published | not published | $6,296.00 – $12,362.00 | 8 |
| Esophagoscopy snare les remv CPT 43217 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscopy w/us needle bx CPT 43232 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscp guide wire dilat 43196 CPT 43196 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscp rig trnso biopsy CPT 43193 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscp rig trnso inject CPT 43192 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagoscp rig trnso rem fb CPT 43194 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagotomy thrc rmvl fb CPT 43045 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esophagus endoscopy/ligation CPT 43205 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esophagus motility study CPT 91010 | not published | not published | $802.01 – $6,291.00 | 8 |
| Esoph balloon distension tst CPT 91040 | $780.00 | $1,560.00 | $614.64 – $6,291.00 | 18 |
| Esoph egd dilation <30 mm CPT 43249 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esoph endoscopy dilation CPT 43226 | $2,370.00 | $4,740.00 | $1,867.56 – $6,181.00 | 18 |
| Esoph fundoplasty lap 43327 CPT 43327 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esoph fundoplasty thor 43328 CPT 43328 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esophgl motil w/stim/perfus CPT 91013 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esoph imped function test CPT 91037 | not published | not published | $470.68 – $6,291.00 | 8 |
| Esoph imped funct test > 1hr CPT 91038 | not published | not published | $802.01 – $6,291.00 | 8 |
| Esoph optical endomicroscopy CPT 43206 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esoph scope w/sclerosis inj CPT 43204 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esoph scope w/submucous inj CPT 43201 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| Esphg dstl 2/3 w/laps moblj 43287 CPT 43287 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esphg thrsc moblj CPT 43288 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esphg tot w/laps moblj CPT 43286 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esphg tot w/thrcm CPT 43112 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Esrd home pt serv p mo 12-19 CPT 90965 | not published | not published | $2,626.85 – $2,989.77 | 3 |
| Esrd home pt serv p mo 20+ CPT 90966 | not published | not published | $1,375.38 – $1,565.40 | 3 |
| Esrd home pt serv p mo 2-11 CPT 90964 | not published | not published | $2,771.42 – $3,154.32 | 3 |
| Esrd home pt serv p mo <2yrs CPT 90963 | not published | not published | $3,320.74 – $3,779.52 | 3 |
| Esrd serv 1 visit p mo 20+ CPT 90962 | not published | not published | $1,003.65 – $1,142.31 | 3 |
| Esrd serv 1 visit p mo <2yrs CPT 90953 | not published | not published | $2,973.80 – $3,384.66 | 3 |
| Esrd serv 1 vst p mo 12-19 CPT 90959 | not published | not published | $1,709.94 – $1,946.18 | 3 |
| Esrd serv 2-3 vsts p mo <2yr CPT 90952 | not published | not published | $4,460.70 – $5,076.98 | 3 |
| Esrd serv 4 visits p mo <2yr CPT 90951 | not published | not published | $5,881.51 – $6,694.09 | 3 |
| Esrd serv 4 vsts p mo 2-11 CPT 90954 | not published | not published | $4,820.03 – $5,485.95 | 3 |
| Esrd srv 1 visit p mo 2-11 CPT 90956 | not published | not published | $1,850.36 – $2,106.01 | 3 |
| Esrd srv 2-3 vsts p mo 12-19 CPT 90958 | not published | not published | $2,614.46 – $2,975.67 | 3 |
| Esrd srv 2-3 vsts p mo 20+ CPT 90961 | not published | not published | $1,387.77 – $1,579.50 | 3 |
| Esrd srv 2-3 vsts p mo 2-11 CPT 90955 | not published | not published | $2,734.24 – $3,111.99 | 3 |
| Esrd srv 4 visits p mo 20+ CPT 90960 | not published | not published | $1,722.33 – $1,960.28 | 3 |
| Esrd srv 4 vsts p mo 12-19 CPT 90957 | not published | not published | $3,865.93 – $4,400.04 | 3 |
| Esrd svc pr day pt 12-19 CPT 90969 | not published | not published | $90.86 – $103.41 | 3 |
| Esrd svc pr day pt <2 CPT 90967 | not published | not published | $119.78 – $136.32 | 3 |
| Esrd svc pr day pt 20+ CPT 90970 | not published | not published | $49.56 – $56.41 | 3 |
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.