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 |
|---|---|---|---|---|
| Infectious agent nucleic acid amplified probe trichomonas vaginalis CPT 87661 | $135.00 | $270.00 | $35.09 – $216.00 | 18 |
| Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance CPT 87564 | $185.00 | $370.00 | $111.32 – $296.00 | 18 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets CPT 87507 | $530.00 | $1,060.00 | $416.78 – $1,894.38 | 18 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets CPT 87505 | $197.50 | $395.00 | $128.29 – $583.34 | 18 |
| Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets CPT 87506 | not published | not published | $262.99 – $1,194.96 | 10 |
| Infectious agent nucleic acid quantification bk virus CPT 87799 | $225.00 | $450.00 | $42.84 – $360.00 | 18 |
| Infectious agent nucleic acid quantification hepatitis b CPT 87517 | $242.50 | $485.00 | $42.84 – $388.00 | 18 |
| Infectious agent nucleic acid quantification hepatitis c CPT 87522 | $250.00 | $500.00 | $42.84 – $400.00 | 18 |
| Infectious agent nucleic acid quantification hiv-1 CPT 87536 | $480.00 | $960.00 | $85.10 – $768.00 | 18 |
| Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets CPT 87631 | not published | not published | $142.63 – $648.82 | 10 |
| Infliximab 100 mg intravenous solution HCPCS J1745 | not published | not published | $45.21 – $371.52 | 13 |
| Infliximab-axxq 100 mg intravenous solution HCPCS Q5121 | not published | not published | $30.28 – $73.99 | 10 |
| Infliximab-dyyb 100 mg intravenous solution HCPCS Q5103 | not published | not published | $17.59 – $37.78 | 10 |
| Influenza dna amp prob addl CPT 87503 | not published | not published | $29.22 – $132.44 | 10 |
| Influenza virus vaccine, inact hemagglutinin tiv pf inj CPT 90673 | not published | not published | $142.33 – $188.47 | 6 |
| Influenza virus vaccine, live trivalent intranasal CPT 90660 | not published | not published | $28.02 – $150.43 | 13 |
| Inf lwr xtr fscl pln blk uni w/wo image CPT 64474 | $780.00 | $1,560.00 | $544.44 – $1,248.00 | 14 |
| Infratemporal approach/skull CPT 61591 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Infratemporal approach/skull CPT 61590 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Inf thrc fascial pln blk bi w/wo image CPT 64469 | $780.00 | $1,560.00 | $544.44 – $1,248.00 | 14 |
| Inf thrc fascial pln blk uni w/wo image CPT 64467 | $780.00 | $1,560.00 | $544.44 – $1,248.00 | 14 |
| Infuse radioactive materials CPT 77750 | not published | not published | $322.78 – $2,134.21 | 8 |
| Ingest challenge ini 120 min CPT 95076 | not published | not published | $346.95 – $1,061.97 | 7 |
| Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis CPT 94642 | not published | not published | $276.73 – $407.07 | 7 |
| Init ak ischal plstr direct HCPCS L5505 | not published | not published | $3,631.22 – $8,847.10 | 7 |
| Init bk ptb plaster direct HCPCS L5500 | not published | not published | $2,581.33 – $6,289.82 | 7 |
| Initial care training 30 m HCPCS G0539 | not published | not published | $77.90 – $103.15 | 4 |
| Initial custom socket insert HCPCS L5683 | not published | not published | $2,302.57 – $5,608.18 | 7 |
| Initial foot exam pt lops HCPCS G0245 | not published | not published | $194.79 – $418.38 | 7 |
| Initial hosp neonate 28 d/less than not critically ill 99477 CPT 99477 | not published | not published | $1,879.28 – $2,138.92 | 3 |
| Initial nursing facility care/day 35 minutes CPT 99305 | not published | not published | $648.46 – $738.05 | 3 |
| Initial nursing facility care/day 45 minutes CPT 99306 | not published | not published | not published | 0 |
| Initial nursing facility care/day low severity 99304 CPT 99304 | not published | not published | $466.73 – $531.21 | 3 |
| Initial observation care CPT 99218 | not published | not published | $342.81 – $390.18 | 3 |
| Initial observation care CPT 99219 | not published | not published | $565.85 – $644.03 | 3 |
| Initial observation care CPT 99220 | not published | not published | $797.14 – $907.27 | 3 |
| Init nb em per day non-fac CPT 99461 | not published | not published | $495.63 – $564.10 | 3 |
| Init pm e/m new pat 65+ yrs CPT 99387 | not published | not published | $846.71 – $963.69 | 3 |
| Init/sub psych care m 1st 30 HCPCS G2214 | not published | not published | $139.81 – $185.13 | 4 |
| Inj, abilify asimtufii, 1 mg HCPCS J0402 | not published | not published | $8.75 – $20.01 | 10 |
| Inj, abilify maintena, 1 mg HCPCS J0401 | not published | not published | $8.26 – $23.69 | 13 |
| Inj acetaminoph 10mg/ibu 3mg HCPCS J0138 | not published | not published | $0.32 – $0.48 | 6 |
| Inj, acetaminophen (b braun) HCPCS J0136 | not published | not published | $0.08 – $0.17 | 6 |
| Inj acetaminophen -fresenius HCPCS J0134 | not published | not published | $0.08 – $0.17 | 6 |
| Inj, acetaminophen (hikma) HCPCS J0137 | not published | not published | $0.08 – $0.17 | 6 |
| Inj. acthar gel to 40 units HCPCS J0801 | not published | not published | $5,741.22 – $11,760.81 | 9 |
| Inj, adalimumab, 1 mg HCPCS J0139 | not published | not published | $133.00 – $176.11 | 4 |
| Inj adalimumab-ryvk, 1 mg HCPCS Q5142 | not published | not published | $15.42 – $20.42 | 4 |
| Inj, adstiladrin, per tx dos HCPCS J9029 | not published | not published | $91,975.03 – $214,627.74 | 10 |
| Inj, aducanumab-avwa, 2 mg HCPCS J0172 | not published | not published | $8.67 – $20.21 | 10 |
| Inj, adzynma, 10 iu HCPCS J7171 | not published | not published | $51.60 – $117.22 | 10 |
| Inj, aflibercept-ayyh, 1 mg HCPCS Q5147 | not published | not published | $1,260.17 – $1,668.64 | 4 |
| Inj, aflibercept hd, 1 mg HCPCS J0177 | not published | not published | $463.62 – $1,134.70 | 10 |
| Inj, afstyla, 1 i.u HCPCS J7210 | not published | not published | $2.29 – $4.93 | 10 |
| Inj, alfentanil hcl, 500mcg HCPCS J0216 | not published | not published | $5.14 – $15.28 | 6 |
| Inj allopurinol sodium 1 mg HCPCS J0206 | not published | not published | $6.59 – $18.56 | 10 |
| Inj, alyglo, 500 mg HCPCS J1552 | not published | not published | $190.13 – $251.75 | 4 |
| Inj alymsys 10 mg HCPCS Q5126 | not published | not published | $61.77 – $343.16 | 13 |
| Inj, amisulpride, 1 mg HCPCS J0184 | not published | not published | $14.01 – $30.66 | 10 |
| Inj andexxa, 10 mg HCPCS J7169 | not published | not published | $190.76 – $446.43 | 10 |
| Inj anifrolumab-fnia 1mg HCPCS J0491 | not published | not published | $26.25 – $58.58 | 10 |
| Inj. (ani), up to 40 units HCPCS J0802 | not published | not published | $5,743.63 – $11,765.75 | 9 |
| Inj, aponvie, 1 mg HCPCS C9145 | not published | not published | $2.78 – $6.35 | 10 |
| Inj., aristada initio, 1 mg HCPCS J1943 | not published | not published | $4.72 – $10.61 | 10 |
| Inj, artesunate, 1mg HCPCS J0391 | $119.80 | $239.59 | $75.15 – $191.67 | 18 |
| Inj. asceniv HCPCS J1554 | not published | not published | $719.93 – $1,660.93 | 10 |
| Inj, aspara, rylaze, 0.1 mg HCPCS J9021 | not published | not published | $80.18 – $177.79 | 10 |
| Inj atezolizumb 5mg hya-tqjs HCPCS J9024 | not published | not published | $45.87 – $60.74 | 4 |
| Inj avacincaptad pegol 0.1mg HCPCS J2782 | not published | not published | $153.55 – $373.35 | 10 |
| Inj aval alfa-nqpt 4mg HCPCS J0219 | not published | not published | $117.09 – $262.29 | 13 |
| Inj belantamab mafodot blmf HCPCS J9037 | not published | not published | $77.19 – $158.12 | 6 |
| Inj., benralizumab, 1 mg HCPCS J0517 | not published | not published | $243.79 – $568.58 | 10 |
| Inj beta interferon sq 1 mcg HCPCS Q3028 | not published | not published | $17.60 – $158.39 | 9 |
| Inj, betibeglogene autotemce HCPCS J3393 | not published | not published | $4,278,495.67 – $10,031,840.00 | 8 |
| Inj, bezlotoxumab, 10 mg HCPCS J0565 | not published | not published | $57.75 – $134.83 | 10 |
| Inj bimatoprost itc imp1mcg HCPCS J7351 | not published | not published | $307.93 – $704.32 | 10 |
| Inj, biorphen, 20 micrograms HCPCS J2372 | not published | not published | $0.28 – $0.57 | 6 |
| Inj bortezomib boruzu 0.1 mg HCPCS J9054 | not published | not published | $38.01 – $50.33 | 4 |
| Inj, bortezomib, dr. reddy's HCPCS J9046 | not published | not published | $7.12 – $216.24 | 13 |
| Inj, bortezomib freseniuskab HCPCS J9048 | not published | not published | $8.32 – $93.44 | 10 |
| Inj, bortezomib, hospira HCPCS J9049 | not published | not published | $2.98 – $6.49 | 6 |
| Inj., brexanolone, 1 mg HCPCS J1632 | not published | not published | $117.27 – $240.22 | 6 |
| Inj, brixadi, 7 days or less HCPCS J0577 | not published | not published | $613.10 – $1,443.16 | 10 |
| Inj brixadi, more than 7 day HCPCS J0578 | not published | not published | $2,452.40 – $5,772.63 | 10 |
| Inj, brolucizumab-dbll, 1 mg HCPCS J0179 | not published | not published | $501.98 – $1,119.56 | 10 |
| Inj bulking agent anal canal HCPCS L8605 | not published | not published | $1,253.74 – $3,400.25 | 8 |
| Inj, bupivacaine liposome HCPCS J0666 | not published | not published | $2.26 – $2.99 | 4 |
| Inj, bupivacaine (posimir) HCPCS C9144 | not published | not published | $0.74 – $1.72 | 10 |
| Inj. byooviz, 0.1 mg HCPCS Q5124 | not published | not published | $90.12 – $533.06 | 10 |
| Inj calcitriol per 0.1 mcg HCPCS J0636 | not published | not published | $1.77 – $4.71 | 9 |
| Inj, carmustine (accord) HCPCS J9052 | not published | not published | $376.57 – $877.79 | 10 |
| Inj cefazolin sodium, baxter HCPCS J0689 | not published | not published | $2.10 – $4.29 | 6 |
| Inj cefazolin sodium, hikma HCPCS J0688 | $28.51 | $57.02 | $1.33 – $45.62 | 18 |
| Inj cefazolin (wg crit care) HCPCS J0687 | not published | not published | $1.45 – $3.65 | 10 |
| Inj. cefepime hcl (baxter) HCPCS J0701 | not published | not published | $9.39 – $19.23 | 6 |
| Inj, cefepime hcl (b braun) HCPCS J0703 | not published | not published | $8.46 – $17.34 | 6 |
| Inj, cefiderocol, 10 mg HCPCS J0699 | $6.91 | $13.82 | $3.48 – $11.06 | 18 |
| Inj ceftolozane tazobactam HCPCS J0695 | $406.35 | $812.70 | $13.24 – $650.16 | 18 |
| Inj., cerliponase alfa 1 mg HCPCS J0567 | not published | not published | $217.31 – $445.15 | 6 |
| Inj. cetirizine hcl 0.5mg HCPCS J1201 | not published | not published | $23.78 – $50.56 | 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.