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 |
|---|---|---|---|---|
| Isatuximab-irfc 20 mg/ml intravenous solution HCPCS J9227 | not published | not published | $120.15 – $263.61 | 10 |
| Island pedicle flap graft CPT 15740 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| IV cipaglucosidase alfa-atga HCPCS G0138 | not published | not published | $983.24 – $1,301.94 | 4 |
| Ivc venogram s&i CPT 75825 | $2,975.00 | $5,950.00 | $220.00 – $6,299.55 | 18 |
| IV Fluids (each additional hour) CPT 96361 | $117.50 | $235.00 | $69.74 – $1,270.00 | 18 |
| IV Fluids (first hour) CPT 96360 | $355.00 | $710.00 | $279.74 – $1,270.00 | 18 |
| Ivig non-lyophilized, nos HCPCS J1599 | not published | not published | $303.96 – $303.96 | 2 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $157.50 | $315.00 | $115.65 – $1,270.00 | 14 |
| IV inj ra drug dx study CPT 78808 | $740.00 | $1,480.00 | $583.12 – $3,966.00 | 18 |
| IV Medicine Infusion (additional drug) CPT 96367 | $157.50 | $315.00 | $107.57 – $1,270.00 | 18 |
| IV Medicine Infusion (each additional hour) CPT 96366 | $157.50 | $315.00 | $69.74 – $1,270.00 | 18 |
| IV Medicine Infusion (first hour) CPT 96365 | $395.00 | $790.00 | $311.26 – $1,270.00 | 18 |
| IV njx tst vasc flo flap/grf CPT 15860 | not published | not published | $603.15 – $6,291.00 | 8 |
| IV Push Injection (each additional drug) CPT 96375 | $240.00 | $480.00 | $69.74 – $1,270.00 | 18 |
| IV Push Injection (first drug) CPT 96374 | $320.00 | $640.00 | $252.16 – $1,270.00 | 18 |
| Ivp w/nephrotomography CPT 74415 | not published | not published | $269.08 – $841.46 | 10 |
| Ivp w/wo kub w/wo tomography CPT 74400 | $745.00 | $1,490.00 | $220.00 – $1,192.00 | 18 |
| Ixabepilone 15 mg intravenous solution HCPCS J9207 | not published | not published | $201.07 – $450.08 | 13 |
| Jak2 targeted sequence analysis CPT 81279 | $417.50 | $835.00 | $185.20 – $842.28 | 18 |
| Jaw arthroscopy/surgery CPT 29800 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Jaw arthroscopy/surgery CPT 29804 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Jaw Joint (TMJ) X-ray (both sides, open and closed) CPT 70330 | $232.50 | $465.00 | $133.09 – $634.00 | 18 |
| Jaw (Mandible) X-ray (complete) CPT 70110 | $295.00 | $590.00 | $123.44 – $634.00 | 18 |
| Jejunstmy tube plcmt CPT 44372 | not published | not published | $2,867.32 – $6,181.00 | 8 |
| John cunningham antibody CPT 86711 | $65.00 | $130.00 | $16.89 – $104.00 | 18 |
| J-tube placement CPT 44015 | $347.50 | $695.00 | $273.83 – $6,291.00 | 14 |
| Kafo dbl solid stirrup band/ HCPCS L2020 | not published | not published | $1,925.27 – $4,691.51 | 7 |
| Kafo dbl solid stirrup without j HCPCS L2030 | not published | not published | $1,892.38 – $4,611.60 | 7 |
| Kafo fem fx cast molded to p HCPCS L2128 | not published | not published | $2,801.11 – $6,825.71 | 7 |
| Kafo fem fx cast semi-rigid HCPCS L2134 | not published | not published | $2,013.28 – $4,903.04 | 7 |
| Kafo fem fx cast thermoplas HCPCS L2126 | not published | not published | $2,230.78 – $5,434.25 | 7 |
| Kafo femoral fx cast rigid HCPCS L2136 | not published | not published | $2,203.23 – $5,368.43 | 7 |
| Kafo femoral fx cast soft HCPCS L2132 | not published | not published | $1,700.23 – $4,141.50 | 7 |
| Kafo pla sin up w/wo k/a cus HCPCS L2034 | not published | not published | $3,549.08 – $8,644.96 | 7 |
| Kafo plas sing free knee mol HCPCS L2037 | not published | not published | $2,897.19 – $7,060.75 | 7 |
| Kafo plastic pediatric size HCPCS L2035 | not published | not published | $302.67 – $738.05 | 7 |
| Kafo sing fre stirr thi/calf HCPCS L2000 | not published | not published | $1,954.38 – $4,762.01 | 7 |
| Kafo sng/dbl mechanical act HCPCS L2005 | not published | not published | $7,158.93 – $17,440.37 | 7 |
| Kafo sng solid stirrup without j HCPCS L2010 | not published | not published | $1,524.40 – $3,713.71 | 7 |
| Kafo without joint multi-axis an HCPCS L2038 | not published | not published | $2,335.54 – $5,688.10 | 7 |
| Keratomileusis CPT 65760 | not published | not published | $6,296.00 – $12,362.00 | 4 |
| Keratophakia CPT 65765 | not published | not published | $6,296.00 – $12,362.00 | 4 |
| Keratoprosthesis CPT 65770 | not published | not published | $12,700.00 – $28,599.29 | 8 |
| Kerecis marigen shld sq cm HCPCS A2019 | not published | not published | $1,064.25 – $2,180.10 | 6 |
| Ketamine and metabolite screen - quest CPT 80357 | $357.50 | $715.00 | $249.54 – $572.00 | 14 |
| Ketogenic steroids fract CPT 83582 | not published | not published | $15.47 – $76.24 | 11 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $52.50 | $105.00 | $8.17 – $84.00 | 18 |
| Ketorolac (Toradol) Pain Shot, 15 mg HCPCS J1885 | $59.48 | $118.95 | $0.52 – $85.25 | 18 |
| Kidney endoscopy CPT 50551 | not published | not published | $3,126.00 – $10,174.59 | 8 |
| Kidney endoscopy CPT 50553 | $6,180.00 | $12,360.00 | $4,869.84 – $12,362.00 | 18 |
| Kidney endoscopy CPT 50570 | not published | not published | $3,070.00 – $6,902.93 | 8 |
| Kidney endoscopy CPT 50575 | not published | not published | $7,683.94 – $18,102.00 | 8 |
| Kidney endoscopy & biopsy CPT 50555 | $6,180.00 | $12,360.00 | $3,126.00 – $18,507.68 | 18 |
| Kidney endoscopy & biopsy CPT 50574 | $1,260.00 | $2,520.00 | $992.88 – $6,902.93 | 18 |
| Kidney endoscopy & treatment CPT 50557 | not published | not published | $6,296.00 – $18,507.68 | 8 |
| Kidney endoscopy & treatment CPT 50561 | $6,180.00 | $12,360.00 | $4,869.84 – $12,362.00 | 18 |
| Kidney endoscopy & treatment CPT 50576 | not published | not published | $3,126.00 – $18,507.68 | 8 |
| Kidney endoscopy & treatment CPT 50580 | not published | not published | $3,126.00 – $10,174.59 | 8 |
| Kidney function study CPT 78725 | not published | not published | $358.68 – $804.24 | 8 |
| Kidney imaging (3d) CPT 78710 | not published | not published | $1,338.21 – $1,523.09 | 3 |
| Kidney imaging morphology CPT 78700 | $1,430.00 | $2,860.00 | $607.37 – $3,966.00 | 18 |
| Kidney imag w/bld flow multi CPT 78709 | $1,625.00 | $3,250.00 | $813.60 – $3,966.00 | 18 |
| Kidney img w/bldflw sgl without rx CPT 78707 | not published | not published | $813.60 – $1,523.09 | 8 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $980.00 | $1,960.00 | $160.73 – $1,568.00 | 18 |
| Kidney (Retroperitoneal) Ultrasound (limited) CPT 76775 | $735.00 | $1,470.00 | $147.28 – $1,176.00 | 18 |
| Kit cast tcc 3in w/2reg boots total contact cast HCPCS Q4038 | not published | not published | $74.60 – $173.94 | 7 |
| Kit cath f 8f w/glv + wipe ster HCPCS A4353 | not published | not published | $14.17 – $18.76 | 4 |
| Kit cath ivl 2.5x40mm 135cm shockwave s4 HCPCS C1761 | $10,410.50 | $20,821.00 | $7,266.53 – $16,656.80 | 14 |
| Kit gene analys d816 variant CPT 81273 | $510.00 | $1,020.00 | $124.87 – $816.00 | 18 |
| Kit hfx iq ipg bundle HCPCS C1822 | not published | not published | not published | 0 |
| Kit ipg optimizer smart HCPCS C1824 | $57,590.00 | $115,180.00 | $38,470.12 – $92,144.00 | 14 |
| Kit irrigator stoma cone 7721 HCPCS A4398 | not published | not published | $28.00 – $89.31 | 7 |
| Kit lead specify 5-6-5 HCPCS C1778 | $7,475.63 | $14,951.25 | $2,527.04 – $6,052.80 | 14 |
| Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set HCPCS C1878 | $614.15 | $1,228.30 | $410.25 – $982.64 | 14 |
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | not published | not published | $41.53 – $85.07 | 9 |
| Kit sound processor cochlear osia 2 HCPCS L8691 | not published | not published | $3,014.55 – $11,371.48 | 7 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $2,351.28 | $4,702.56 | $1,570.66 – $3,762.05 | 14 |
| Knee Arthroscopy (Cartilage Smoothing) CPT 29877 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/drainage CPT 29871 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy dx CPT 29870 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee Arthroscopy (Meniscus Trimming) CPT 29881 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29850 | not published | not published | $2,419.03 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29851 | not published | not published | $2,419.03 – $18,102.00 | 8 |
| Knee arthroscopy/surgery CPT 29873 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29874 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29875 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29876 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29879 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29880 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29882 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29883 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29884 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29886 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29887 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Knee arthroscopy/surgery CPT 29888 | not published | not published | $10,797.81 – $25,111.00 | 8 |
| Knee arthroscopy/surgery CPT 29889 | not published | not published | $12,700.00 – $25,752.25 | 8 |
| Knee cap medial or lateral p HCPCS L2800 | not published | not published | $175.93 – $232.95 | 4 |
| Knee control condylar pad HCPCS L2810 | not published | not published | $142.69 – $347.87 | 7 |
| Knee control full kneecap HCPCS L2795 | not published | not published | $143.29 – $347.87 | 7 |
| Knee disart expand wall sock HCPCS L5653 | not published | not published | $1,183.90 – $2,886.36 | 7 |
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.