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 |
|---|---|---|---|---|
| Ligate/strip short leg vein CPT 37718 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | not published | not published | $4,805.89 – $12,362.00 | 8 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | not published | not published | $2,449.01 – $6,181.00 | 8 |
| Ligation common iliac vein CPT 37660 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Ligation/divis of long saph vein 37700 CPT 37700 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligation external carotid artery 37600 CPT 37600 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligation internal/common carotid artery 37605 CPT 37605 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligation internal jugular vein 37565 CPT 37565 | not published | not published | $3,070.00 – $6,299.55 | 8 |
| Ligation major artery chest CPT 37616 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Ligation/major artery/extremity 37618 CPT 37618 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Ligation major artery neck CPT 37615 | not published | not published | $3,070.00 – $6,299.55 | 8 |
| Ligation nasal sinus artery CPT 30915 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligation of abdomen artery 37617 CPT 37617 | not published | not published | $8,821.00 – $17,439.00 | 4 |
| Ligation of femoral vein CPT 37650 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligation of inf vena cava CPT 37619 | not published | not published | $8,170.76 – $25,111.00 | 8 |
| Ligation of neck artery CPT 37606 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligation of salivary duct CPT 42665 | not published | not published | $4,901.93 – $12,362.00 | 8 |
| Ligation of shunt CPT 49428 | not published | not published | $3,126.00 – $6,181.00 | 4 |
| Ligation upper jaw artery CPT 30920 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Lig/band angioaccess av fistula CPT 37607 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Lig&div&compl strpg saph vn CPT 37735 | not published | not published | $4,757.47 – $17,439.00 | 8 |
| Liletta, 52 mg HCPCS J7297 | not published | not published | $1,756.97 – $3,599.13 | 6 |
| Limb exercise test CPT 95875 | not published | not published | $236.49 – $562.35 | 7 |
| Limb nerve surgery add-on CPT 64783 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Limited ankle motion ea jnt HCPCS L2200 | not published | not published | $87.78 – $216.24 | 7 |
| Limited autopsy CPT 88036 | not published | not published | $9.00 – $432.81 | 7 |
| Limited autopsy CPT 88037 | not published | not published | $8.00 – $346.57 | 7 |
| Limited motion knee joint HCPCS L2184 | not published | not published | $202.36 – $493.60 | 7 |
| Limited visual field xm CPT 92081 | not published | not published | $89.78 – $314.96 | 7 |
| Lincomycin injection HCPCS J2010 | not published | not published | $16.42 – $33.63 | 9 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $26.50 | $53.00 | $4.32 – $174.18 | 14 |
| Lipase CPT 83690 | $67.50 | $135.00 | $6.89 – $108.00 | 18 |
| Lip exc/transverse wedge/w closure 40510 CPT 40510 | not published | not published | $4,901.93 – $12,362.00 | 8 |
| Lipoprotein blood high res frac & quant CPT 83701 | not published | not published | $33.86 – $153.28 | 14 |
| Lipoprotein blood quant CPT 83704 | $167.50 | $335.00 | $34.19 – $268.00 | 18 |
| Lipoprotein direct measurement hdl CPT 83718 | $57.50 | $115.00 | $8.19 – $92.00 | 18 |
| Lipoprotein direct measurement ldl CPT 83721 | $60.00 | $120.00 | $10.50 – $96.00 | 18 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | not published | not published | $34.19 – $173.94 | 13 |
| Lip surgery procedure CPT 40799 | not published | not published | $351.00 – $6,291.00 | 8 |
| Lisocabtagene mara car pos t HCPCS Q2054 | not published | not published | $785,371.70 – $1,677,798.91 | 8 |
| Listeria monocytogenes CPT 86723 | not published | not published | $13.19 – $71.50 | 11 |
| Lith ion batt cid, ear level HCPCS L8624 | not published | not published | $282.29 – $686.33 | 7 |
| Lith ion batt cid,non-earlvl HCPCS L8623 | not published | not published | $113.23 – $149.93 | 4 |
| Lithium ion battery charger HCPCS L7368 | not published | not published | $883.44 – $2,153.02 | 7 |
| Lithium therapeutic drug level CPT 80178 | $45.00 | $90.00 | $6.61 – $72.00 | 18 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $1,480.00 | $2,960.00 | $1,033.04 – $2,368.00 | 14 |
| Litt icr 1 traj 1 smpl les CPT 61736 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Litt icr mlt trj mlt/cplx ls CPT 61737 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | not published | not published | $176.19 – $2,287.24 | 10 |
| Liver elastography 91200 CPT 91200 | $427.50 | $855.00 | $214.00 – $684.00 | 18 |
| Liver Function Test CPT 80076 | $80.00 | $160.00 | $8.17 – $148.12 | 18 |
| Liver hem/re-expl wnd/remove pack 47362 CPT 47362 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Liver imaging CPT 78201 | $1,260.00 | $2,520.00 | $537.67 – $3,966.00 | 18 |
| Liver imaging (3d) CPT 78205 | not published | not published | $1,346.46 – $1,532.49 | 3 |
| Liver imag w/vasclr flow CPT 78202 | $1,310.00 | $2,620.00 | $633.27 – $3,966.00 | 18 |
| Liver/spleen imag static only CPT 78215 | $1,090.00 | $2,180.00 | $607.37 – $3,966.00 | 18 |
| Liver/spleen imag w/vasclr flow CPT 78216 | not published | not published | $607.37 – $897.88 | 8 |
| Lmtd oph exam general anes CPT 92019 | not published | not published | $359.34 – $12,362.00 | 11 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | not published | not published | $4,904.26 – $17,439.00 | 8 |
| Lockingelbow forearm cntrbal HCPCS L6693 | not published | not published | $4,969.59 – $12,109.53 | 7 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | not published | not published | $3.12 – $6.39 | 6 |
| Lomustine 10 mg HCPCS S0178 | not published | not published | $45.44 – $229.48 | 5 |
| Loncastuximab tesirine-lpyl 10 mg intravenous solution HCPCS J9359 | not published | not published | $314.28 – $697.67 | 10 |
| Long tongue stirrup HCPCS L2265 | not published | not published | $234.86 – $573.50 | 7 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $58.78 | $117.55 | $2.16 – $88.21 | 14 |
| Lo rig pos pnl l1-l5 pre ots HCPCS L0641 | not published | not published | $72.57 – $96.10 | 4 |
| Lo sag rig pnl stays pre cst HCPCS L0626 | not published | not published | $136.17 – $498.30 | 7 |
| Loudness balance test CPT 92562 | not published | not published | $148.69 – $623.25 | 7 |
| Low back disk surgery CPT 63030 | not published | not published | $10,797.81 – $25,111.00 | 8 |
| Low cost skin substitute app HCPCS C5271 | $1,030.00 | $2,060.00 | $84.00 – $1,648.00 | 18 |
| Low cost skin substitute app HCPCS C5273 | $2,600.00 | $5,200.00 | $84.00 – $4,160.00 | 18 |
| Low cost skin substitute app HCPCS C5275 | $1,030.00 | $2,060.00 | $84.00 – $1,648.00 | 18 |
| Low cost skin substitute app HCPCS C5277 | $1,030.00 | $2,060.00 | $84.00 – $1,648.00 | 18 |
| Low cost skin substitute app HCPCS C5272 | $515.00 | $1,030.00 | $84.00 – $824.00 | 14 |
| Low cost skin substitute app HCPCS C5274 | $650.00 | $1,300.00 | $84.00 – $1,040.00 | 14 |
| Low cost skin substitute app HCPCS C5276 | $515.00 | $1,030.00 | $84.00 – $824.00 | 14 |
| Low cost skin substitute app HCPCS C5278 | $515.00 | $1,030.00 | $84.00 – $824.00 | 14 |
| Low-Dose Lung Cancer Screening CT Scan CPT 71271 | $565.00 | $1,130.00 | $160.73 – $1,009.92 | 18 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,285.00 | $2,570.00 | $269.08 – $2,056.00 | 18 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $890.00 | $1,780.00 | $539.81 – $1,424.00 | 18 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $785.00 | $1,570.00 | $160.73 – $1,256.00 | 18 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,360.00 | $4,720.00 | $539.81 – $3,776.00 | 18 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,605.00 | $3,210.00 | $539.81 – $2,568.00 | 18 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,505.00 | $3,010.00 | $365.36 – $2,408.00 | 18 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $452.50 | $905.00 | $130.42 – $724.00 | 18 |
| Lower Back (Lumbar Spine) X-ray (4 or more views) CPT 72110 | $675.00 | $1,350.00 | $160.73 – $1,080.00 | 18 |
| Lower Back (Lumbar Spine) X-ray (with bending views) CPT 72114 | $745.00 | $1,490.00 | $160.73 – $1,192.00 | 18 |
| Lower jaw bone graft CPT 21215 | not published | not published | $8,941.57 – $18,102.00 | 8 |
| Lower Leg (Shin) X-ray (both sides) CPT 73590 | $340.00 | $680.00 | $94.95 – $634.00 | 18 |
| Low frequency non-thermal Ultrasound CPT 97610 | $137.50 | $275.00 | $84.00 – $397.69 | 18 |
| Loxapine for inhalation 1 mg HCPCS J2062 | not published | not published | $29.70 – $60.84 | 6 |
| Lsh uterus 250 g or less CPT 58541 | not published | not published | $12,700.00 – $25,111.00 | 8 |
| Lsh uterus above 250 g CPT 58543 | not published | not published | $12,700.00 – $25,111.00 | 8 |
| Lsh w/t/o ut 250 g or less CPT 58542 | not published | not published | $12,700.00 – $25,111.00 | 8 |
| Lsh w/t/o uterus above 250 g CPT 58544 | not published | not published | $12,700.00 – $25,111.00 | 8 |
| Lso corset front HCPCS L0972 | not published | not published | $169.94 – $413.69 | 7 |
| Lso flex no ri stays pre ots HCPCS L0628 | not published | not published | $78.10 – $535.91 | 7 |
| Lso full corset HCPCS L0976 | not published | not published | $261.20 – $345.87 | 4 |
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.