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 |
|---|---|---|---|---|
| Fecal bilirubin test CPT 82252 | not published | not published | $4.56 – $24.65 | 14 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $92.84 – $1,144.10 | 13 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $1,378.06 – $1,824.74 | 4 |
| #fecal-sodium CPT 84302 | $37.50 | $75.00 | $4.86 – $60.00 | 18 |
| Feeding tube reposition CPT 74355 | not published | not published | $501.99 – $930.78 | 4 |
| Fees w/laryngeal sense i&r CPT 92617 | not published | not published | $239.56 – $272.66 | 3 |
| Fees w/laryngeal sense test CPT 92616 | not published | not published | $336.25 – $1,198.74 | 7 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $280.00 | $560.00 | $18.64 – $448.00 | 18 |
| Fem focal defic constant fri HCPCS L5230 | not published | not published | $8,347.11 – $20,336.11 | 7 |
| Femoral endovas graft add-on 34813 CPT 34813 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Femoral lgth sock fx or equa HCPCS L2850 | not published | not published | $105.68 – $258.56 | 7 |
| Fem/popl revasc w/stent CPT 37226 | $15,955.00 | $31,910.00 | $12,572.54 – $47,462.00 | 18 |
| Fem urinary collect pouch HCPCS A4328 | not published | not published | $21.14 – $51.72 | 7 |
| Feno poc CPT 95012 | $92.50 | $185.00 | $59.33 – $1,287.00 | 18 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $60.56 | $121.11 | $1.39 – $8.07 | 14 |
| Fern test HCPCS Q0114 | $32.50 | $65.00 | $9.74 – $52.00 | 18 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | not published | not published | $1.66 – $3.82 | 10 |
| Ferritin CPT 82728 | $80.00 | $160.00 | $13.63 – $128.00 | 18 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | not published | not published | $0.45 – $1.12 | 10 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.45 – $1.12 | 10 |
| Fetal aneuploidy trisom risk CPT 81507 | not published | not published | $795.00 – $3,613.16 | 10 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $460.00 | $920.00 | $160.73 – $736.00 | 18 |
| Fetal chrmoml microdeltj CPT 81422 | not published | not published | $759.05 – $3,449.46 | 10 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | $462.50 | $925.00 | $364.45 – $3,449.46 | 18 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $452.50 | $905.00 | $304.07 – $724.00 | 18 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $459.79 – $6,291.00 | 8 |
| Fetal fibronectin CPT 82731 | $282.50 | $565.00 | $64.41 – $452.00 | 18 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $459.79 – $6,291.00 | 8 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $55.00 | $110.00 | $7.73 – $88.00 | 18 |
| Fetal hemoglobin rosette CPT 85461 | $40.00 | $80.00 | $9.36 – $64.00 | 18 |
| Fetal lung maturity assess lam body dnst CPT 83664 | $92.50 | $185.00 | $19.32 – $148.00 | 18 |
| Fetal monitor/interpret only CPT 59051 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Fetal monitor w/report CPT 59050 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Fetal non stress test CPT 59025 | $450.00 | $900.00 | $304.07 – $720.00 | 18 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $459.79 – $6,291.00 | 8 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $459.79 – $6,291.00 | 8 |
| #_fet/norfentcnfrmur CPT 80354 | $307.50 | $615.00 | $214.64 – $492.00 | 14 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $11.25 – $25.49 | 13 |
| Fibrin degradation d dimer quantitative CPT 85379 | $85.00 | $170.00 | $10.18 – $158.48 | 18 |
| Fibrin degradation products CPT 85362 | not published | not published | $6.89 – $37.62 | 14 |
| Fibrin degrade semiquant CPT 85378 | not published | not published | $9.72 – $44.64 | 14 |
| Fibrin degradj d-dimer CPT 85380 | not published | not published | $10.18 – $56.41 | 14 |
| Fibrinogen activity CPT 85384 | $55.00 | $110.00 | $9.72 – $88.00 | 18 |
| Fibrinogen test CPT 85370 | not published | not published | $12.43 – $61.55 | 14 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | $25.00 | $50.00 | $15.39 – $69.94 | 18 |
| Fibrinolytic antiplasmin CPT 85410 | not published | not published | $7.71 – $42.31 | 14 |
| Fibrinolytic plasmin CPT 85400 | not published | not published | $7.71 – $47.93 | 14 |
| Fibrinolytic plasminogen CPT 85415 | $107.50 | $215.00 | $17.19 – $172.00 | 18 |
| Fibrinolytic plasminogen CPT 85421 | not published | not published | $10.18 – $56.41 | 14 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $100.00 | $200.00 | $6.53 – $160.00 | 18 |
| Fibula bone graft microvasc CPT 20955 | not published | not published | $9,155.00 – $18,102.00 | 4 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.41 – $0.95 | 10 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | not published | not published | $1.43 – $3.81 | 13 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | $1.41 | $2.81 | $0.41 – $2.14 | 18 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Filtered speech hearing test CPT 92571 | not published | not published | $59.33 – $126.93 | 7 |
| Filters elec/combo vad, rep HCPCS Q0500 | not published | not published | $53.42 – $131.63 | 7 |
| Filter spider fx 3mmx320cm HCPCS C1884 | $2,619.00 | $5,238.00 | $1,086.79 – $2,491.20 | 13 |
| Filter vena cava fem denali HCPCS C1880 | $8,709.38 | $17,418.76 | $5,817.87 – $13,935.01 | 14 |
| Fimbrioplasty 58760 CPT 58760 | not published | not published | $8,821.00 – $17,439.00 | 4 |
| Finasteride, 5 mg HCPCS S0138 | not published | not published | $0.32 – $18.81 | 5 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $1,070.00 | $2,140.00 | $843.16 – $6,071.00 | 18 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $535.00 | $1,070.00 | $421.58 – $6,291.00 | 14 |
| Fine needle aspiration biopsy without img gdn; ea addtl 10004 CPT 10004 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $565.00 | $1,130.00 | $445.22 – $6,291.00 | 14 |
| Fine needle asp without image guide 10021 CPT 10021 | $372.50 | $745.00 | $84.00 – $799.64 | 18 |
| Finger joint sz00 swanson w/grommets HCPCS L8630 | not published | not published | $781.78 – $1,903.87 | 7 |
| Finger tendon transfer CPT 26497 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Finger tendon transfer CPT 26498 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Finger X-ray (both hands) CPT 73140 | $345.00 | $690.00 | $87.97 – $634.00 | 18 |
| Fistula repair & colostomy CPT 57307 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Fistula repair transperine 57308 CPT 57308 | not published | not published | $6,296.00 – $12,362.00 | 4 |
| Fit aphakia spectcl monofocl CPT 92352 | not published | not published | $89.78 – $244.44 | 7 |
| Fit aphakia spectcl multifoc CPT 92353 | not published | not published | $89.78 – $286.76 | 7 |
| Fitg c-lens keratoconus 1st CPT 92072 | not published | not published | $346.95 – $394.88 | 3 |
| Fitg spect low vis 1system CPT 92354 | not published | not published | $59.33 – $629.93 | 7 |
| Fitg spect lw vis cmpnd lens CPT 92355 | not published | not published | $59.33 – $352.57 | 7 |
| Fit spectacles bifocal CPT 92341 | not published | not published | $223.04 – $253.85 | 3 |
| Fit spectacles monofocal CPT 92340 | not published | not published | $194.12 – $220.94 | 3 |
| Fit spectacles multifocal CPT 92342 | not published | not published | $239.56 – $272.66 | 3 |
| Fitting of diaphragm/cap 57170 CPT 57170 | not published | not published | $304.07 – $6,291.00 | 8 |
| Fixation of ankle joint CPT 27860 | not published | not published | $3,126.00 – $6,493.91 | 8 |
| Fixation of knee joint CPT 27570 | not published | not published | $2,419.03 – $6,181.00 | 8 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Fix g/colon tube w/device CPT 49460 | $1,240.00 | $2,480.00 | $977.12 – $6,181.00 | 18 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | not published | not published | $4,904.26 – $12,362.00 | 8 |
| Flebogamma injection HCPCS J1572 | not published | not published | $80.85 – $211.54 | 13 |
| Flecainide (tambocor)-sendout CPT 80181 | $77.50 | $155.00 | $18.64 – $124.00 | 18 |
| Fl exam g/colon tube w contrast CPT 49465 | $430.00 | $860.00 | $220.00 – $688.00 | 18 |
| Flex/ext wrist w/wo friction HCPCS L6621 | not published | not published | $4,003.84 – $9,754.39 | 7 |
| Flex foot system HCPCS L5980 | not published | not published | $6,649.51 – $16,199.32 | 7 |
| Flexible keel foot HCPCS L5972 | not published | not published | $692.64 – $1,687.62 | 7 |
| Flexible metal hinge pair HCPCS L6610 | not published | not published | $386.34 – $940.18 | 7 |
| Flexible Sigmoidoscopy CPT 45330 | not published | not published | $1,378.06 – $6,071.00 | 8 |
| Flexion/extension wrist unit HCPCS L6620 | not published | not published | $655.59 – $1,598.31 | 7 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $10,797.81 – $25,111.00 | 8 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $9,155.00 – $18,102.00 | 8 |
| Flex thermoplastic collar mo HCPCS L0130 | not published | not published | $266.67 – $648.74 | 7 |
| Flex-walk sys low ext prosth HCPCS L5981 | not published | not published | $5,972.87 – $14,554.01 | 7 |
| Floor of mouth biopsy 41108 CPT 41108 | not published | not published | $2,449.01 – $6,071.00 | 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.