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 |
|---|---|---|---|---|
| Inj marstacim-hncq, 0.5 mg HCPCS J7172 | not published | not published | $73.54 – $97.37 | 4 |
| Inj. meloxicam 1 mg HCPCS J1738 | not published | not published | $6.20 – $12.71 | 6 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $156.64 – $9,726.17 | 13 |
| Inj, melphalan (apotex) 1 mg HCPCS J9249 | not published | not published | $93.93 – $124.37 | 4 |
| Inj, melphalan flufenami 1mg HCPCS J9247 | not published | not published | $969.00 – $969.00 | 2 |
| Inj melphalan (hepzato) 1 mg HCPCS J9248 | not published | not published | $1,142.29 – $2,615.44 | 10 |
| Inj menotropins 75 iu HCPCS S0122 | not published | not published | $301.88 – $495.22 | 5 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | not published | not published | $5.58 – $11.42 | 9 |
| Inj, meropenem (b. braun) HCPCS J2184 | not published | not published | $3.48 – $7.13 | 6 |
| Inj., meropenem, vaborbactam HCPCS J2186 | not published | not published | $3.16 – $7.03 | 10 |
| Inj meropenem (wg crit care) HCPCS J2183 | not published | not published | $2.35 – $5.41 | 10 |
| Inj metaraminol bitartrate HCPCS J0380 | not published | not published | $1.65 – $4.71 | 9 |
| Inj, micafungin (par pharm) HCPCS J2247 | not published | not published | $0.70 – $1.66 | 6 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | not published | not published | $57.32 – $117.42 | 10 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | not published | not published | $360.32 – $806.23 | 10 |
| Inj, motixafortide, 0.25 mg HCPCS J2277 | not published | not published | $36.57 – $85.24 | 10 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | not published | not published | $14.49 – $29.68 | 6 |
| Inj moxifloxacin (fres kabi) HCPCS J2281 | not published | not published | $12.47 – $25.55 | 6 |
| Inj multihance HCPCS A9577 | not published | not published | $3.02 – $14.10 | 9 |
| Inj multihance multipack HCPCS A9578 | not published | not published | $2.99 – $14.10 | 9 |
| Inj. mycophenolate mofetil HCPCS J7519 | not published | not published | $0.89 – $1.83 | 6 |
| Inj naloxone hydrochloride HCPCS J2310 | not published | not published | $15.41 – $31.57 | 9 |
| Inj. naxitamab-gqgk, 1 mg HCPCS J9348 | not published | not published | $994.56 – $2,058.99 | 10 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | $1,080.00 | $2,160.00 | $851.04 – $6,071.00 | 18 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | not published | not published | $3.14 – $7.33 | 10 |
| Inj nivolumab 2 mg hyaluron HCPCS J9289 | not published | not published | $38.77 – $51.33 | 4 |
| Inj, nogapendekin pmln, 1mcg HCPCS J9028 | not published | not published | $136.47 – $180.70 | 4 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | $1,920.00 | $3,840.00 | $1,512.96 – $6,181.00 | 18 |
| Inj, nyposi 1 mcg HCPCS Q5148 | not published | not published | $0.80 – $1.06 | 4 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | not published | not published | $68.50 – $90.70 | 4 |
| Inj, ocriplasmin, 0.125 mg HCPCS J7316 | not published | not published | $2,093.86 – $2,093.86 | 2 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | not published | not published | $68.95 – $249.15 | 9 |
| Inj ogivri 10 mg HCPCS Q5114 | not published | not published | $64.66 – $188.54 | 10 |
| Inj, olaratumab, 10 mg HCPCS J9285 | not published | not published | $97.25 – $199.22 | 6 |
| Inj, oliceridine 0.1 mg HCPCS C9101 | not published | not published | $1.89 – $4.56 | 10 |
| Inj olipudase alfa-rpcp 1mg HCPCS J0218 | not published | not published | $571.04 – $1,290.59 | 10 |
| Inj, omacetaxine mep, 0.01mg HCPCS J9262 | not published | not published | $6.65 – $13.62 | 6 |
| Inj., omadacycline, 1 mg HCPCS J0121 | not published | not published | $5.82 – $13.11 | 10 |
| Inj onase abepar-xioi treat HCPCS J3399 | not published | not published | $3,555,567.62 – $7,958,254.01 | 8 |
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $31.88 – $109.71 | 10 |
| Inj, pafolacianine, 0.1 mg HCPCS A9603 | not published | not published | $270.94 – $270.94 | 2 |
| Inj, palonosetron (posfrea) HCPCS J2468 | not published | not published | $85.31 – $118.32 | 6 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | not published | not published | $12.87 – $26.36 | 6 |
| Inj, panzyga, 500 mg HCPCS J1576 | not published | not published | $107.96 – $235.82 | 10 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $793.62 – $1,625.71 | 10 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | not published | not published | $144.74 – $335.80 | 10 |
| Inj, pedmark, 100 mg HCPCS J0208 | not published | not published | $137.95 – $324.38 | 10 |
| Inj, pegcetacoplan, 1mg HCPCS J2781 | not published | not published | $205.77 – $503.86 | 10 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | not published | not published | $40.58 – $1,172.05 | 10 |
| Inj, pegulicianine, 1 mg HCPCS A9615 | not published | not published | $52.85 – $69.98 | 4 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | not published | not published | $76.48 – $178.97 | 10 |
| Inj pemetrexed (accord) 10mg HCPCS J9296 | not published | not published | $14.12 – $286.76 | 13 |
| Inj, pemetrexed (avyxa) 10mg HCPCS J9292 | not published | not published | $120.76 – $159.91 | 4 |
| Inj pemetrexed (bluepoint) HCPCS J9322 | not published | not published | $19.60 – $286.76 | 5 |
| Inj pemetrexed ditromethamin HCPCS J9323 | not published | not published | $7.74 – $286.76 | 13 |
| Inj pemetrexed, hospira 10mg HCPCS J9294 | not published | not published | $1.24 – $286.76 | 13 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | not published | not published | $1.85 – $286.76 | 9 |
| Inj pemetrexed (teva) 10mg HCPCS J9314 | not published | not published | $5.50 – $286.76 | 13 |
| Inj, pemivibart, 4500 mg HCPCS Q0224 | not published | not published | $9,546.08 – $22,252.23 | 8 |
| Inj, pemrydi rtu, 10 mg HCPCS J9324 | not published | not published | $116.15 – $286.76 | 13 |
| Inj perflexane lip micros,ml HCPCS Q9955 | not published | not published | $26.50 – $79.91 | 5 |
| Inj peritoneal venous shunt CPT 49427 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Inj., perseris, 0.5 mg HCPCS J2798 | not published | not published | $17.60 – $41.27 | 10 |
| Inj plasminogen tvmh 1mg HCPCS J2998 | not published | not published | $46.84 – $118.20 | 10 |
| Inj., plazomicin, 5 mg HCPCS J0291 | not published | not published | $5.18 – $12.13 | 10 |
| Inj pozelimab-bbfg, 1 mg HCPCS J9376 | not published | not published | $171.35 – $351.01 | 6 |
| Inj proc ankle arthr CPT 27648 | $332.50 | $665.00 | $220.00 – $634.00 | 14 |
| Inj proc elbow arthro CPT 24220 | $332.50 | $665.00 | $220.00 – $634.00 | 14 |
| Inj proc for lymphang CPT 38790 | $222.50 | $445.00 | $175.33 – $6,291.00 | 14 |
| Inj proc lumbr disk ea lvl CPT 62290 | $515.00 | $1,030.00 | $405.82 – $6,291.00 | 14 |
| Inj proc myelogram lumbar CPT 62284 | $365.00 | $730.00 | $287.62 – $6,291.00 | 14 |
| Inj proc sialogram CPT 42550 | $262.50 | $525.00 | $206.85 – $6,291.00 | 14 |
| Inj progesterone per 50 mg HCPCS J2675 | not published | not published | $1.20 – $9.40 | 9 |
| Inj prohance multipack HCPCS A9576 | not published | not published | $2.43 – $14.10 | 9 |
| Inj protirelin per 250 mcg HCPCS J2725 | not published | not published | $43.56 – $131.63 | 5 |
| Inj recombin esperoct per iu HCPCS J7204 | not published | not published | $3.28 – $7.33 | 10 |
| Inj, releuko 1 mcg HCPCS Q5125 | not published | not published | $0.59 – $1.39 | 10 |
| Inj retacrit esrd on dialysi HCPCS Q5105 | not published | not published | $1.10 – $2.30 | 10 |
| Inj retro urethrocysto CPT 51610 | $242.50 | $485.00 | $191.09 – $6,291.00 | 14 |
| Inj, rimabotulinumtoxinb HCPCS J0587 | not published | not published | $19.35 – $48.70 | 13 |
| Inj roctavian ml 2x10^13vc g HCPCS J1412 | not published | not published | $17,933.91 – $40,586.40 | 8 |
| Inj., rolapitant, 0.5 mg HCPCS J2797 | not published | not published | $1.80 – $1.80 | 2 |
| Inj romidepsin non-lyo 0.1mg HCPCS J9318 | not published | not published | $41.35 – $114.62 | 10 |
| Inj, rykindo, 0.5 mg HCPCS J2801 | not published | not published | $18.89 – $44.04 | 10 |
| Inj scleros sol mult veins CPT 36471 | $565.00 | $1,130.00 | $348.69 – $6,291.00 | 18 |
| Inj scleros sol sgl vein CPT 36470 | $550.00 | $1,100.00 | $433.40 – $6,291.00 | 18 |
| Inj, sculptra, 0.5mg HCPCS Q2028 | not published | not published | $1.32 – $4.73 | 10 |
| Inj sebelipase alfa 1 mg HCPCS J2840 | not published | not published | $782.55 – $1,820.33 | 10 |
| Inj secretin synthetic human HCPCS J2850 | not published | not published | $63.50 – $159.84 | 13 |
| Inj secukinumab intrav 1mg HCPCS J3247 | not published | not published | $25.87 – $59.35 | 10 |
| Inj, sezaby, 1 mg HCPCS J2561 | not published | not published | $1.66 – $5.41 | 10 |
| Inj, spesolimab-sbzo, 1 mg HCPCS J1747 | not published | not published | $95.31 – $207.60 | 10 |
| Inj(s) sclerosant spider veins limb/trunk CPT 36468 | not published | not published | $603.89 – $6,291.00 | 8 |
| Inj sulf hexa lipid microsph HCPCS Q9950 | not published | not published | $31.42 – $64.36 | 6 |
| Inj, susvimo 0.1 mg HCPCS J2779 | not published | not published | $113.72 – $272.06 | 10 |
| Inj, sutimlimab-jome, 10 mg HCPCS J1302 | not published | not published | $26.26 – $61.18 | 10 |
| Inj. tagraxofusp-erzs 10 mcg HCPCS J9269 | not published | not published | $505.49 – $1,103.67 | 10 |
| Inj, taliglucerace alfa 10 u HCPCS J3060 | not published | not published | $59.54 – $150.65 | 10 |
| Inj teclistamab cqyv 0.5 mg HCPCS J9380 | not published | not published | $48.24 – $173.94 | 13 |
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.