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 |
|---|---|---|---|---|
| Laryngoscopy w/exc of tumor CPT 31540 | not published | not published | $5,572.86 – $12,362.00 | 8 |
| Laryngoscopy w/fb & op scope CPT 31531 | not published | not published | $3,126.00 – $7,379.23 | 8 |
| Laryngoscopy w/fb removal CPT 31530 | not published | not published | $2,606.55 – $6,181.00 | 8 |
| Laryngoscopy with biopsy CPT 31576 | not published | not published | $2,606.55 – $6,181.00 | 8 |
| Laryngoscopy with biopsy 31510 CPT 31510 | not published | not published | $3,126.00 – $7,379.23 | 8 |
| Laryngoscopy w/w/o tracheoscopy aspiration CPT 31515 | not published | not published | $586.93 – $6,291.00 | 8 |
| Larynscop remve cart + scop CPT 31561 | not published | not published | $6,296.00 – $13,854.95 | 8 |
| Larynscop w/tumr exc + scope CPT 31541 | not published | not published | $5,572.86 – $12,362.00 | 8 |
| Laser surgery eye strands CPT 67031 | not published | not published | $829.21 – $6,071.00 | 8 |
| Laser surgery of cervix 57513 CPT 57513 | not published | not published | $4,805.89 – $12,362.00 | 8 |
| Laser surgery of prostate CPT 52647 | not published | not published | $7,683.94 – $18,102.00 | 8 |
| Laser surgery of prostate CPT 52648 | not published | not published | $7,683.94 – $18,102.00 | 8 |
| Laser surg penis lesion(s) CPT 54057 | not published | not published | $2,764.90 – $6,181.00 | 8 |
| Laser treatment of retina CPT 67039 | not published | not published | $6,080.59 – $18,102.00 | 8 |
| Laser treatment of retina CPT 67040 | not published | not published | $6,080.59 – $18,102.00 | 8 |
| Lateral canthopexy CPT 21282 | not published | not published | $3,126.00 – $6,490.83 | 8 |
| Lateral thoracic extension HCPCS L1210 | not published | not published | $427.43 – $1,043.59 | 7 |
| Lateral trochanteric pad HCPCS L1290 | not published | not published | $135.75 – $329.06 | 7 |
| Latex suspension sleeve each HCPCS L6632 | not published | not published | $113.07 – $277.35 | 7 |
| Lat retinacular release open CPT 27425 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Lavage cannulation maxillary sinus CPT 31000 | not published | not published | $351.00 – $6,291.00 | 8 |
| Lavh >250 gms 58553 CPT 58553 | not published | not published | $12,700.00 – $25,111.00 | 8 |
| Lb with mastopexy 15839 CPT 15839 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $4,015.80 | $8,031.60 | $1,840.21 – $4,407.68 | 14 |
| Lead capillary CPT 83655 | $57.50 | $115.00 | $12.11 – $92.00 | 18 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $584.74 | $1,169.48 | $381.36 – $913.44 | 14 |
| Leads any type vad, rep only HCPCS Q0487 | not published | not published | $597.50 – $1,457.28 | 7 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $5,094.50 | $10,189.00 | $3,336.54 – $7,991.72 | 14 |
| Lefort i-1 piece without graft CPT 21141 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Lefort i-2 piece without graft CPT 21142 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Lefort i-3/> piece with graft CPT 21147 | not published | not published | $9,155.00 – $18,102.00 | 4 |
| Lefort i-3/> piece without graft CPT 21143 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Lefort ii anterior intrusion CPT 21150 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Left compres band >=3" <5"/yd HCPCS A6449 | not published | not published | $3.55 – $4.70 | 4 |
| Left compres band <3"/yd HCPCS A6448 | not published | not published | $2.33 – $4.71 | 7 |
| Left compres band >=5"/yd HCPCS A6450 | not published | not published | $3.55 – $61.10 | 7 |
| Leg Artery Ultrasound (complete, both legs) CPT 93925 | $990.00 | $1,980.00 | $365.36 – $1,786.61 | 18 |
| Leg CT Scan (with contrast, both legs) CPT 73701 | $1,110.00 | $2,220.00 | $269.08 – $1,424.00 | 18 |
| Leg CT Scan (without contrast, both legs) CPT 73700 | $980.00 | $1,960.00 | $160.73 – $1,256.00 | 18 |
| Legg perthes orth newington HCPCS L1710 | not published | not published | $3,461.22 – $8,433.43 | 7 |
| Legg perthes orthosis trilat HCPCS L1720 | not published | not published | $2,577.22 – $6,280.41 | 7 |
| Legg perthes orth scottish r HCPCS L1730 | not published | not published | $2,175.74 – $5,302.63 | 7 |
| Legg perthes patten bottom t HCPCS L1755 | not published | not published | $3,128.09 – $7,620.17 | 7 |
| Legion pneumo dna dir prob CPT 87540 | not published | not published | $20.05 – $108.70 | 14 |
| Legion pneumo dna quant CPT 87542 | not published | not published | $41.76 – $230.34 | 14 |
| Leg perthes orth toronto typ HCPCS L1700 | not published | not published | $2,718.10 – $6,623.57 | 7 |
| Leg vein fusion 34530 CPT 34530 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $845.00 | $1,690.00 | $365.36 – $1,491.83 | 18 |
| Leishmania antibody CPT 86717 | not published | not published | $12.25 – $66.42 | 14 |
| Lengthening of hand tendon CPT 26478 | not published | not published | $3,126.00 – $6,493.91 | 8 |
| Lengthening of palate CPT 42227 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Lengthening of palate+pharyngeal flap 42226 CPT 42226 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Lengthening of thigh bone CPT 27466 | not published | not published | $12,700.00 – $25,111.00 | 4 |
| Lengthening of thigh tendon CPT 27393 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Lengthening of thigh tendons CPT 27394 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Lengthening of thigh tendons CPT 27395 | not published | not published | $4,904.26 – $18,102.00 | 8 |
| Lengthening or shortening - tibia and fibula 27715 CPT 27715 | not published | not published | $12,700.00 – $25,111.00 | 4 |
| Lengthen metacarpal/finger CPT 26568 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Lengthen radius or ulna CPT 25391 | not published | not published | $9,155.00 – $25,752.25 | 8 |
| Lengthen radius & ulna CPT 25393 | not published | not published | $9,155.00 – $18,102.00 | 8 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | not published | not published | $207.16 – $2,279.95 | 7 |
| Lens iol ant chamb 10.5 HCPCS V2630 | not published | not published | $207.16 – $2,279.95 | 7 |
| Lepirudin HCPCS J1945 | not published | not published | $246.61 – $1,141.08 | 9 |
| Leucovorin calcium 100 mg solution for injection (1 mg rounding) HCPCS J0640 | not published | not published | $7.31 – $14.97 | 6 |
| Leukacyte transfusion CPT 86950 | not published | not published | $143.50 – $342.97 | 14 |
| Leukocyte phagocytosis CPT 86344 | not published | not published | $10.39 – $47.62 | 14 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | not published | not published | $225.36 – $1,217.53 | 13 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | not published | not published | $1,652.11 – $5,657.88 | 13 |
| Leuprolide acetate implant HCPCS J9219 | not published | not published | $9,639.64 – $28,854.16 | 5 |
| Leuprolide acetate injeciton HCPCS J9218 | not published | not published | $7.67 – $18.40 | 6 |
| Leuprolide depot cipla 7.5mg HCPCS J1954 | not published | not published | $320.08 – $3,760.72 | 13 |
| Leuprolide inj, camcevi, 1mg HCPCS J1952 | not published | not published | $74.54 – $188.06 | 10 |
| Lev 1 hosp type b ed visit HCPCS G0380 | not published | not published | $127.07 – $168.26 | 4 |
| Lev 2 hosp type b ed visit HCPCS G0381 | not published | not published | $167.26 – $221.48 | 4 |
| Lev 3 hosp type b ed visit HCPCS G0382 | not published | not published | $282.03 – $373.45 | 4 |
| Lev 4 hosp type b ed visit HCPCS G0383 | not published | not published | $431.61 – $571.51 | 4 |
| Lev 5 hosp type b ed visit HCPCS G0384 | not published | not published | $610.48 – $808.36 | 4 |
| Levalbuterol comp unit HCPCS J7615 | not published | not published | $2.88 – $6.76 | 6 |
| Levalbuterol non-comp con HCPCS J7612 | not published | not published | $0.45 – $0.91 | 6 |
| Levalbuterol non-comp unit HCPCS J7614 | not published | not published | $0.08 – $0.17 | 6 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $0.94 | $1.88 | $0.10 – $4.47 | 14 |
| Levetiracetam therapeutic drug level CPT 80177 | $92.50 | $185.00 | $13.25 – $148.00 | 18 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | not published | not published | $1.55 – $3.18 | 6 |
| Levonorgestrel implant sys HCPCS J7306 | not published | not published | $638.22 – $1,307.38 | 6 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $20.16 | $40.31 | $15.88 – $41.61 | 14 |
| L hrt cath chd nm/abn nt cnj CPT 93595 | not published | not published | $4,861.63 – $18,102.00 | 11 |
| Lidocaine injection HCPCS J2001 | not published | not published | $0.05 – $2.35 | 7 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | not published | not published | $0.02 – $0.02 | 2 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | not published | not published | $0.01 – $0.01 | 4 |
| Lidocaine therapeutic drug level CPT 80176 | $95.00 | $190.00 | $14.69 – $152.00 | 18 |
| Lift assist for elbow HCPCS L6635 | not published | not published | $361.44 – $879.08 | 7 |
| Lift heel adj small gl60404sm HCPCS L3332 | not published | not published | $128.86 – $314.96 | 7 |
| Lift heel adjustable med HCPCS L3334 | not published | not published | $66.63 – $164.54 | 7 |
| Lifts elevation metal extens HCPCS L3330 | not published | not published | $988.71 – $2,406.86 | 7 |
| Ligate esophagus veins CPT 43400 | not published | not published | $12,700.00 – $25,111.00 | 4 |
| Ligate leg veins open CPT 37761 | not published | not published | $3,070.00 – $6,299.55 | 8 |
| Ligate leg veins radical 37760 CPT 37760 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Ligate/staple esophagus CPT 43405 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Ligate/strip long leg vein CPT 37722 | not published | not published | $4,757.47 – $17,439.00 | 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.