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 |
|---|---|---|---|---|
| Monitor elec vad, rep HCPCS Q0483 | not published | not published | $32,820.21 – $79,962.40 | 7 |
| Monitor reveal linq ii cardiac HCPCS C1764 | $9,834.60 | $19,669.20 | $6,510.33 – $15,593.60 | 14 |
| Monovisc inj per dose HCPCS J7327 | not published | not published | $766.44 – $2,203.25 | 10 |
| Monthly tx for dmht 20mins HCPCS G0553 | not published | not published | $194.79 – $257.93 | 4 |
| Mopath procedure level 1 CPT 81400 | $202.50 | $405.00 | $63.96 – $290.18 | 18 |
| Mopath procedure level 3 CPT 81402 | $755.00 | $1,510.00 | $150.33 – $944.00 | 18 |
| Mopath procedure level 5 CPT 81404 | $760.00 | $1,520.00 | $139.87 – $1,248.53 | 18 |
| Mopath procedure level 6 CPT 81405 | $1,770.00 | $3,540.00 | $301.35 – $1,369.07 | 18 |
| Mopath procedure level 7 CPT 81406 | $1,135.00 | $2,270.00 | $282.88 – $1,520.00 | 18 |
| Mopath procedure level 8 CPT 81407 | not published | not published | $846.27 – $3,845.30 | 10 |
| Mopath procedure level 9 CPT 81408 | $940.00 | $1,880.00 | $740.72 – $9,089.44 | 18 |
| Morphine 4 mg/ml injection (wrapper) HCPCS J2270 | $73.54 | $147.08 | $5.35 – $13.74 | 14 |
| Morphine 4 mg/ml injection (wrapper)|discarded drug not administered HCPCS J2272 | $64.40 | $128.79 | $7.51 – $102.73 | 14 |
| Morphine 500 mg HCPCS S0093 | not published | not published | $16.36 – $108.12 | 5 |
| Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr HCPCS J2274 | not published | not published | $17.29 – $35.42 | 6 |
| Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain CPT 88374 | not published | not published | $143.50 – $1,118.83 | 13 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted CPT 88361 | $367.50 | $735.00 | $283.41 – $719.96 | 18 |
| Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual CPT 88360 | $337.50 | $675.00 | $143.50 – $540.00 | 18 |
| Mosunetuzumab-axgb 1 mg/ml intravenous solution HCPCS J9350 | not published | not published | $946.48 – $5,730.40 | 13 |
| Motion analysis video/3d CPT 96000 | not published | not published | $487.37 – $1,061.97 | 7 |
| Motion test w/ft press meas CPT 96001 | not published | not published | $569.99 – $2,036.25 | 7 |
| Motor &/ sens nrve cndj test CPT 95905 | not published | not published | $603.15 – $798.66 | 4 |
| Mouth piece HCPCS A4617 | not published | not published | $6.28 – $14.10 | 7 |
| Mouth vestibule bx/w complex rpr 40814 CPT 40814 | not published | not published | $4,901.93 – $12,362.00 | 8 |
| M/phmtrc alys ishquant/semiq CPT 88373 | $315.00 | $630.00 | $47.28 – $1,063.05 | 14 |
| M/phmtrc alys ishquant/semiq CPT 88377 | $580.00 | $1,160.00 | $143.50 – $1,493.95 | 18 |
| M/phmtrc alysishquant/semiq CPT 88369 | $465.00 | $930.00 | $82.65 – $875.43 | 14 |
| M/phmtrc alys skeletal musc CPT 88355 | not published | not published | $143.50 – $1,130.51 | 14 |
| Mpl gene analysis common variants CPT 81338 | $605.00 | $1,210.00 | $150.33 – $968.00 | 18 |
| M.pneumon dna dir probe CPT 87580 | not published | not published | $20.05 – $108.70 | 14 |
| M.pneumon dna quant CPT 87582 | not published | not published | $202.38 – $1,375.02 | 14 |
| Mpsv4 vaccine subq CPT 90733 | not published | not published | $141.16 – $766.25 | 9 |
| MRA abdomen post contrast CPT 74185 | $2,360.00 | $4,720.00 | $1,096.00 – $2,408.00 | 14 |
| MRA aorta thoracic w/wo contrast CPT 71555 | $2,360.00 | $4,720.00 | $1,096.00 – $2,408.00 | 14 |
| MRA chest w IV cont HCPCS C8909 | not published | not published | $539.81 – $714.78 | 4 |
| MRA chest wo IV cont HCPCS C8910 | not published | not published | $365.36 – $483.79 | 4 |
| MRA chest wwo IV cont HCPCS C8911 | not published | not published | $539.81 – $714.78 | 4 |
| MRA ext low(run-off)pst cntrst CPT 73725 | $2,950.00 | $5,900.00 | $1,096.00 – $2,408.00 | 14 |
| MRA pelvis CPT 72198 | $2,360.00 | $4,720.00 | $1,096.00 – $2,408.00 | 14 |
| MRA pelvis w IV cont HCPCS C8918 | not published | not published | $539.81 – $714.78 | 4 |
| MRA pelvis wo IV cont HCPCS C8919 | not published | not published | $365.36 – $483.79 | 4 |
| MRA spinal canal CPT 72159 | $2,360.00 | $4,720.00 | $1,096.00 – $2,408.00 | 14 |
| MRA upper extremity post contrast-bil CPT 73225 | $2,360.00 | $4,720.00 | $1,096.00 – $3,776.00 | 14 |
| MRA w/cont, abd HCPCS C8900 | not published | not published | $539.81 – $714.78 | 4 |
| MRA w/cont, lwr ext HCPCS C8912 | not published | not published | $539.81 – $714.78 | 4 |
| Mra, w/dye, spinal canal HCPCS C8931 | not published | not published | $539.81 – $714.78 | 4 |
| Mra, w/dye, upper extremity HCPCS C8934 | not published | not published | $539.81 – $714.78 | 4 |
| MRA without cont, abd HCPCS C8901 | not published | not published | $365.36 – $483.79 | 4 |
| MRA without cont, lwr ext HCPCS C8913 | not published | not published | $365.36 – $483.79 | 4 |
| Mra, without dye, spinal canal HCPCS C8932 | not published | not published | $365.36 – $483.79 | 4 |
| Mra, without dye, upper extr HCPCS C8935 | not published | not published | $365.36 – $483.79 | 4 |
| MRA without fol w/cont, abd HCPCS C8902 | not published | not published | $539.81 – $714.78 | 4 |
| MRA without fol w/cont, lwr ext HCPCS C8914 | not published | not published | $539.81 – $714.78 | 4 |
| MRA without fol w/cont, pelvis HCPCS C8920 | not published | not published | $539.81 – $714.78 | 4 |
| Mra, w/o&w/dye, spinal canal HCPCS C8933 | not published | not published | $539.81 – $714.78 | 4 |
| Mra, w/o&w/dye, upper extr HCPCS C8936 | not published | not published | $539.81 – $714.78 | 4 |
| Mr elastography CPT 76391 | not published | not published | $365.36 – $483.79 | 4 |
| Mrgfus strtctc ablt trgt icr CPT 61715 | not published | not published | $18,848.99 – $24,958.66 | 4 |
| MRI brain w/dye CPT 70558 | not published | not published | $269.08 – $2,480.13 | 8 |
| MRI brain without dye CPT 70557 | not published | not published | $828.76 – $1,771.52 | 8 |
| MRI brain without & w/dye CPT 70559 | not published | not published | $269.08 – $2,480.13 | 8 |
| MRI breast c- unilateral CPT 77046 | $1,940.00 | $3,880.00 | $365.36 – $3,104.00 | 18 |
| MRI breast c-+ w/cad uni CPT 77048 | $2,340.00 | $4,680.00 | $1,096.00 – $3,744.00 | 14 |
| MRI breast without cont bi CPT 77047 | $2,425.00 | $4,850.00 | $365.36 – $3,880.00 | 18 |
| MRI breast w IV cont bi CPT 77049 | $2,920.00 | $5,840.00 | $1,096.00 – $4,672.00 | 14 |
| MRI cardiac morph & func wo IV cont CPT 75557 | $1,340.00 | $2,680.00 | $365.36 – $2,144.00 | 18 |
| MRI cardiac morph & func wwo IV cont CPT 75561 | $2,115.00 | $4,230.00 | $539.81 – $3,384.00 | 18 |
| MRI cardiac morph & func wwo IV cont w/stress img CPT 75563 | $2,115.00 | $4,230.00 | $1,096.00 – $3,384.00 | 18 |
| MRI chest without contrast CPT 71550 | $1,505.00 | $3,010.00 | $365.36 – $2,408.00 | 18 |
| MRI chest without & w/contrast CPT 71552 | $2,360.00 | $4,720.00 | $539.81 – $3,776.00 | 18 |
| MRI chest w IV cont CPT 71551 | $1,605.00 | $3,210.00 | $1,096.00 – $2,568.00 | 18 |
| MRI compatible system HCPCS L0859 | not published | not published | $1,990.05 – $4,846.64 | 7 |
| MRI fetal ea addl gestation CPT 74713 | $1,250.00 | $2,500.00 | $985.00 – $2,000.00 | 14 |
| MRI fetal sngl/1st gestation CPT 74712 | $1,560.00 | $3,120.00 | $365.36 – $2,496.00 | 18 |
| MRI guid ndl plc s&i CPT 77021 | not published | not published | $1,331.36 – $2,914.57 | 4 |
| MRI guid parenchymal tiss ablation CPT 77022 | not published | not published | $672.66 – $4,484.67 | 4 |
| MRI hyperpolarized xenon129 HCPCS C9791 | not published | not published | $1,890.14 – $2,502.81 | 4 |
| MRI loex nonjt w IV cont CPT 73719 | $1,605.00 | $3,210.00 | $539.81 – $2,568.00 | 18 |
| MRI lower extremity other than joint without contrast (both sides) CPT 73718 | $1,505.00 | $3,010.00 | $365.36 – $2,408.00 | 18 |
| MRI lower extremity other than joint without & w/contrast (both sides) CPT 73720 | $2,360.00 | $4,720.00 | $539.81 – $3,776.00 | 18 |
| MRI orbit fac&nck w IV cont CPT 70542 | $1,605.00 | $3,210.00 | $539.81 – $2,568.00 | 18 |
| MRI tmj CPT 70336 | $1,370.00 | $2,740.00 | $365.36 – $2,192.00 | 18 |
| MRI upper extremity other than joint without contrast (both sides) CPT 73218 | $1,880.00 | $3,760.00 | $365.36 – $2,408.00 | 18 |
| MRI upper extremity other than joint without & w/contrast (both sides) CPT 73220 | $2,360.00 | $4,720.00 | $539.81 – $3,776.00 | 18 |
| MRI upper extremity w/dye CPT 73219 | $1,605.00 | $3,210.00 | $539.81 – $2,568.00 | 18 |
| MRI w/cont, breast, bi HCPCS C8906 | not published | not published | $539.81 – $714.78 | 4 |
| MRI w/cont, breast, uni HCPCS C8903 | not published | not published | $269.08 – $356.30 | 4 |
| MRI without fol w/cont, breast HCPCS C8908 | not published | not published | $539.81 – $714.78 | 4 |
| MRI without fol w/cont, brst, un HCPCS C8905 | not published | not published | $539.81 – $714.78 | 4 |
| Mr safety determination physician/other qhp CPT 76016 | $260.00 | $520.00 | $133.09 – $1,613.00 | 18 |
| Mr safety implant elec prepj CPT 76018 | $462.50 | $925.00 | $138.74 – $1,613.00 | 18 |
| Mr safety implant&/fb assmt clin staff ea add 30 CPT 76015 | $25.00 | $50.00 | $19.70 – $1,613.00 | 14 |
| Mr safety implt pos&/immoblj CPT 76019 | $705.00 | $1,410.00 | $89.78 – $1,613.00 | 18 |
| Mr sfty implt&/fb asmt stf 1 CPT 76014 | $50.00 | $100.00 | $37.02 – $1,613.00 | 18 |
| Mr sfty med physics xm cstmz CPT 76017 | $1,095.00 | $2,190.00 | $365.36 – $1,752.00 | 18 |
| Mr spectroscopy CPT 76390 | $950.00 | $1,900.00 | $133.09 – $1,683.20 | 18 |
| Msh2 gene dup/delete variant CPT 81297 | not published | not published | $213.30 – $968.77 | 10 |
| Msh2 gene full seq CPT 81295 | not published | not published | $381.70 – $1,735.15 | 10 |
| Msh2 gene known variants CPT 81296 | not published | not published | $337.73 – $1,534.25 | 10 |
| Msh6 gene dup/delete variant CPT 81300 | not published | not published | $238.00 – $1,081.86 | 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.