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 |
|---|---|---|---|---|
| Florbetaben f18 diagnostic HCPCS Q9983 | not published | not published | $1,846.95 – $13,790.40 | 10 |
| Flortaucipir inj 1 millicuri HCPCS A9601 | not published | not published | $714.00 – $12,539.80 | 10 |
| Flotufolastat f18 diag 1 mci HCPCS A9608 | not published | not published | $973.27 – $2,202.64 | 10 |
| Flow cytometry interp 16 or more CPT 88189 | not published | not published | $88.78 – $611.12 | 10 |
| Flow cytometry marker each additional CPT 88185 | $150.00 | $300.00 | $22.38 – $281.40 | 14 |
| Flow cytometry one marker technical component CPT 88184 | $355.00 | $710.00 | $270.71 – $719.96 | 18 |
| Floweramnioflo, 0.1 cc HCPCS Q4177 | not published | not published | $297.00 – $608.40 | 6 |
| Floweramniopatch, per sq cm HCPCS Q4178 | not published | not published | $137.76 – $282.20 | 6 |
| #flow interp 9 - 15 markers CPT 88188 | not published | not published | $66.04 – $479.49 | 10 |
| Floxuridine injection HCPCS J9200 | not published | not published | $305.64 – $13,037.07 | 13 |
| Flt3 gene CPT 81245 | $355.00 | $710.00 | $165.51 – $751.50 | 18 |
| Flt3 gene analysis CPT 81246 | $177.50 | $355.00 | $83.00 – $376.49 | 18 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $70.57 | $141.14 | $4.04 – $112.91 | 14 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | not published | not published | $103.89 – $883.78 | 13 |
| Fluidotherapy charges pt CPT 97022 | $70.00 | $140.00 | $23.37 – $469.00 | 18 |
| Fluid pressure muscle 20950 CPT 20950 | $1,300.00 | $2,600.00 | $1,024.40 – $6,071.00 | 18 |
| Flulaval vacc, 3 yrs & >, im HCPCS Q2036 | not published | not published | $17.14 – $17.14 | 2 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $721.80 – $1,651.81 | 10 |
| Fluocinolone acetonide implt HCPCS J7311 | not published | not published | $492.66 – $115,820.91 | 13 |
| Fluorescein angioscopy i&r CPT 92230 | not published | not published | $313.90 – $1,061.97 | 7 |
| Fluorescein angrph mltiframe CPT 92235 | not published | not published | $470.68 – $775.66 | 7 |
| Fluorescein&icg angiography CPT 92242 | not published | not published | $470.68 – $2,209.45 | 7 |
| Fluorescent antibody titer dna CPT 86256 | $300.00 | $600.00 | $12.05 – $65.34 | 18 |
| Fluorodopa f-18 diag per mci HCPCS A9602 | not published | not published | $723.00 – $1,510.45 | 10 |
| Fluoroestradiol f 18 HCPCS A9591 | not published | not published | $723.07 – $1,496.00 | 6 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $455.00 | $910.00 | $217.74 – $728.00 | 14 |
| Fluoroguide needle placement CPT 77002 | $800.00 | $1,600.00 | $220.00 – $1,280.00 | 14 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $18.91 – $103.41 | 14 |
| Fluoroscopy (Live X-ray Guidance, up to 1 hour) CPT 76000 | $610.00 | $1,220.00 | $126.45 – $976.00 | 18 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | not published | not published | $4.78 – $10.88 | 6 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | not published | not published | $14.72 – $32.91 | 9 |
| Flurpiridaz f18, diag, 1 mci HCPCS A9611 | not published | not published | $768.50 – $1,017.60 | 4 |
| Flutamide 125 mg HCPCS S0175 | not published | not published | $8.26 – $61.10 | 5 |
| Flutemetamol f18 diagnostic HCPCS Q9982 | not published | not published | $2,706.55 – $12,979.20 | 10 |
| Fluvirin vacc, 3 yrs & >, im HCPCS Q2037 | not published | not published | $20.33 – $41.64 | 6 |
| Fluzone vacc, 3 yrs & >, im HCPCS Q2038 | not published | not published | $23.94 – $261.14 | 6 |
| Fmri brain by phys/psych CPT 70555 | $1,500.00 | $3,000.00 | $365.36 – $2,400.00 | 18 |
| Fmri brain by tech CPT 70554 | $1,500.00 | $3,000.00 | $365.36 – $2,400.00 | 18 |
| Fna bx w/ct gdn 1st les CPT 10009 | $1,050.00 | $2,100.00 | $827.40 – $6,071.00 | 18 |
| Fna bx w/ct gdn ea addl CPT 10010 | $525.00 | $1,050.00 | $413.70 – $6,291.00 | 14 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $1,063.48 – $6,071.00 | 8 |
| Fna bx w/mr gdn ea addl CPT 10012 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Foam drg >16<=48 sq in without b HCPCS A6210 | not published | not published | $40.37 – $98.72 | 7 |
| Foam drg <=16 sq in w/border HCPCS A6212 | not published | not published | $19.68 – $26.05 | 4 |
| Foam drg > 48 sq in w/border HCPCS A6214 | not published | not published | $20.87 – $51.72 | 7 |
| Foam drg > 48 sq in without brdr HCPCS A6211 | not published | not published | $59.51 – $145.74 | 7 |
| Foam drsg <=16 sq in without bdr HCPCS A6209 | not published | not published | $15.14 – $37.62 | 7 |
| Foam/fabric leg strap HCPCS A5114 | not published | not published | $15.41 – $37.62 | 7 |
| Foam stability fetal lung CPT 83662 | not published | not published | $18.91 – $103.41 | 14 |
| Folic acid CPT 82746 | $87.50 | $175.00 | $14.70 – $140.00 | 18 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | not published | not published | not published | 0 |
| Follow-up angiography CPT 75898 | $1,575.00 | $3,150.00 | $202.66 – $6,299.55 | 18 |
| Followup eval of foot pt lop HCPCS G0246 | not published | not published | $194.79 – $257.93 | 7 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $3,526.29 – $12,362.00 | 8 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | not published | not published | $8.74 – $61.10 | 13 |
| Fondaparinux sodium HCPCS J1652 | not published | not published | $1.78 – $35.11 | 9 |
| Fo nontorsion joint cf HCPCS L3935 | $217.50 | $435.00 | $145.29 – $465.08 | 18 |
| Foot arch support remov prem HCPCS L3030 | not published | not published | $133.30 – $1,527.80 | 7 |
| Foot arch supp premold metat HCPCS L3050 | not published | not published | $82.23 – $202.13 | 7 |
| Foot drp splt w/exp heel lg HCPCS L4398 | not published | not published | $134.94 – $329.06 | 7 |
| Foot external keel sach foot HCPCS L5970 | not published | not published | $380.23 – $926.08 | 7 |
| Foot insert plastazote or eq HCPCS L3002 | not published | not published | $282.16 – $1,029.49 | 7 |
| Foot insert remov molded spe HCPCS L3001 | not published | not published | $231.09 – $846.16 | 7 |
| Foot insert silicone gel eac HCPCS L3003 | not published | not published | $304.37 – $1,114.12 | 7 |
| Foot lamin/prepreg composite HCPCS L3031 | not published | not published | $213.96 – $1,645.31 | 7 |
| Foot longitudinal arch suppo HCPCS L3010 | not published | not published | $304.37 – $1,114.12 | 7 |
| Foot longitud/metatarsal sup HCPCS L3020 | not published | not published | $346.62 – $1,264.53 | 7 |
| Foot plas heel stabi pre ots HCPCS L3170 | not published | not published | $88.87 – $216.24 | 7 |
| Foot plate molded stirrup at HCPCS L2250 | not published | not published | $583.55 – $1,419.67 | 7 |
| Foot single axis ankle/foot HCPCS L5974 | not published | not published | $405.55 – $987.19 | 7 |
| Foot X-ray CPT 73630 | $355.00 | $710.00 | $100.21 – $634.00 | 18 |
| Foot X-ray (2 views, both feet) CPT 73620 | $280.00 | $560.00 | $91.46 – $634.00 | 18 |
| Forearm/arm cuffs ext/flex a HCPCS L3730 | not published | not published | $1,440.98 – $3,511.58 | 7 |
| Forearm/arm cuffs free motio HCPCS L3720 | not published | not published | $1,086.40 – $2,646.61 | 7 |
| Forearm X-ray (both sides) CPT 73090 | $405.00 | $810.00 | $94.95 – $634.00 | 18 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $5,533.59 – $17,439.00 | 8 |
| Forensic autopsy (necropsy) CPT 88040 | not published | not published | $49.99 – $2,163.96 | 7 |
| Forensic cytopathology CPT 88125 | not published | not published | $30.90 – $106.94 | 14 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $340.00 | $680.00 | $267.92 – $544.00 | 13 |
| Formoterol comp unit HCPCS J7640 | not published | not published | $3.46 – $3.46 | 2 |
| Formoterol fumarate, inh HCPCS J7606 | not published | not published | $4.76 – $28.21 | 9 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | not published | not published | $0.28 – $9.40 | 9 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $22.60 – $165.69 | 13 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | not published | not published | $5.07 – $10.38 | 6 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $28.50 – $145.74 | 14 |
| Fracture assessment via dxa CPT 77086 | not published | not published | $116.03 – $263.25 | 9 |
| _fragile x methylation-sendout CPT 81244 | $222.50 | $445.00 | $44.89 – $356.00 | 18 |
| Fragmenting of kidney stone CPT 50590 | not published | not published | $5,213.15 – $25,111.00 | 8 |
| Frame typ sock above elb/dis HCPCS L6688 | not published | not published | $1,111.00 – $2,707.71 | 7 |
| Frame typ socket bel elbow/w HCPCS L6687 | not published | not published | $1,003.85 – $2,444.48 | 7 |
| Frame typ socket shoulder di HCPCS L6689 | not published | not published | $1,324.11 – $3,224.82 | 7 |
| Frame typ sock interscap-tho HCPCS L6690 | not published | not published | $1,558.94 – $3,798.33 | 7 |
| Free fascial flap microvasc CPT 15758 | not published | not published | $6,296.00 – $12,362.00 | 4 |
| Freeing of bowel adhesion 44005 CPT 44005 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Free jejunum flap microvasc CPT 43496 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Free myo/skin flap microvasc CPT 15756 | not published | not published | $6,296.00 – $12,362.00 | 4 |
| Free omental flap microvasc CPT 49906 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Free/remove chest lining 32320 CPT 32320 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Free skin flap microvasc CPT 15757 | not published | not published | $6,296.00 – $12,362.00 | 4 |
| Frenectomy 41115 CPT 41115 | not published | not published | $2,238.97 – $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.