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 |
|---|---|---|---|---|
| Ped term dev, hand, vol clos HCPCS L6714 | not published | not published | $2,316.30 – $5,645.79 | 7 |
| Ped term dev, hand, vol open HCPCS L6713 | not published | not published | $2,734.73 – $6,661.18 | 7 |
| Ped term dev, hook, vol clos HCPCS L6712 | not published | not published | $2,166.87 – $5,279.12 | 7 |
| Ped term dev, hook, vol open HCPCS L6711 | not published | not published | $1,176.85 – $2,867.55 | 7 |
| Pegademase bovine, 25 iu HCPCS J2504 | not published | not published | $262.53 – $1,353.87 | 9 |
| Pegaptanib sodium injection HCPCS J2503 | not published | not published | $1,541.18 – $4,911.22 | 9 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $13,774.47 – $91,310.23 | 13 |
| Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector HCPCS J2506 | not published | not published | $62.28 – $12,922.78 | 13 |
| Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe HCPCS Q5122 | not published | not published | $131.34 – $269.05 | 10 |
| Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe HCPCS Q5111 | not published | not published | $197.26 – $561.25 | 10 |
| Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5127 | not published | not published | $332.21 – $12,922.78 | 13 |
| Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe HCPCS Q5108 | not published | not published | $150.37 – $499.43 | 10 |
| Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe HCPCS Q5130 | not published | not published | $216.36 – $12,922.78 | 13 |
| Peginesatide injection HCPCS J0890 | not published | not published | $16.40 – $16.40 | 2 |
| Peg interferon alfa-2a/180 HCPCS S0145 | not published | not published | $2,271.38 – $2,271.38 | 2 |
| Pegloticase 8 mg/ml intravenous solution HCPCS J2507 | not published | not published | $5,276.35 – $11,651.06 | 10 |
| Pegunigalsidase alfa-iwxj HCPCS J2508 | not published | not published | $333.90 – $775.81 | 13 |
| Pelv band/spread bar thigh c HCPCS L1640 | not published | not published | $827.05 – $2,016.68 | 7 |
| Pelvic band & belt thigh fla HCPCS L2192 | not published | not published | $582.45 – $1,419.67 | 7 |
| Pelvic control band & belt b HCPCS L2640 | not published | not published | $548.96 – $1,339.77 | 7 |
| Pelvic control band & belt u HCPCS L2630 | not published | not published | $404.51 – $987.19 | 7 |
| Pelvic control hip heavy dut HCPCS L2620 | not published | not published | $436.77 – $1,062.40 | 7 |
| Pelvic control pelvic sling HCPCS L2580 | not published | not published | $758.15 – $1,847.46 | 7 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,285.00 | $2,570.00 | $269.08 – $2,056.00 | 18 |
| Pelvic CT scan (with contrast) CPT 72193 | $890.00 | $1,780.00 | $269.08 – $1,424.00 | 18 |
| Pelvic CT scan (without contrast) CPT 72192 | $785.00 | $1,570.00 | $160.73 – $1,256.00 | 18 |
| Pelvic exenteration CPT 45126 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pelvic & hip control thigh c HCPCS L1680 | not published | not published | $1,990.36 – $4,851.34 | 7 |
| Pelvic MRI (with and without contrast) CPT 72197 | $2,360.00 | $4,720.00 | $539.81 – $3,776.00 | 18 |
| Pelvic MRI (with contrast) CPT 72196 | $1,605.00 | $3,210.00 | $539.81 – $2,568.00 | 18 |
| Pelvic MRI (without contrast) CPT 72195 | $1,505.00 | $3,010.00 | $365.36 – $2,408.00 | 18 |
| Pelvic ring fracture uni/bil HCPCS G0413 | not published | not published | $7,071.03 – $17,439.00 | 11 |
| Pelvic ring fx treat int fix HCPCS G0414 | not published | not published | $6,674.53 – $25,111.00 | 7 |
| Pelvic Ultrasound (complete) CPT 76856 | $880.00 | $1,760.00 | $160.73 – $1,408.00 | 18 |
| Pelvic Ultrasound (limited) CPT 76857 | $660.00 | $1,320.00 | $119.01 – $1,056.00 | 18 |
| Pelvis X-ray (1 to 2 views) CPT 72170 | $412.50 | $825.00 | $89.25 – $660.00 | 18 |
| Pelvis X-ray (complete, 4 or more views) CPT 72190 | $515.00 | $1,030.00 | $132.19 – $824.00 | 18 |
| Pelv & thor control gluteal HCPCS L2650 | not published | not published | $241.76 – $587.62 | 7 |
| Pembrolizumab 25 mg/ml intravenous solution HCPCS J9271 | not published | not published | $84.91 – $191.51 | 10 |
| Pemetrexed disodium 100 mg intravenous powder for solution HCPCS J9305 | not published | not published | $5.41 – $286.76 | 13 |
| Pemivibart infusion HCPCS M0224 | not published | not published | $680.93 – $901.65 | 4 |
| Peng benzathine/procaine inj HCPCS J0558 | not published | not published | $25.18 – $65.98 | 10 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $75.22 | $150.44 | $39.55 – $120.35 | 18 |
| Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr HCPCS J2540 | not published | not published | $1.53 – $3.14 | 6 |
| Penicillin g procaine inj HCPCS J2510 | not published | not published | $67.55 – $138.38 | 10 |
| Penile injection CPT 54235 | not published | not published | $367.61 – $6,291.00 | 8 |
| Penile vascular study CPT 93980 | $590.00 | $1,180.00 | $160.73 – $1,094.30 | 18 |
| Penile vascular study CPT 93981 | not published | not published | $160.73 – $822.66 | 9 |
| Penile venous occlusion CPT 37790 | not published | not published | $5,213.15 – $17,439.00 | 8 |
| Penis plastic surgery CPT 54360 | not published | not published | $5,213.15 – $18,102.00 | 8 |
| Penis study CPT 54240 | not published | not published | $470.68 – $6,291.00 | 8 |
| Pentamidine non-comp unit HCPCS J2545 | not published | not published | $141.59 – $290.04 | 9 |
| Pentastarch 10% solution HCPCS J2513 | not published | not published | $25.44 – $75.21 | 5 |
| Pentazocine injection HCPCS J3070 | not published | not published | $41.31 – $216.78 | 9 |
| Pentobarbital sodium inj HCPCS J2515 | not published | not published | $107.76 – $228.22 | 6 |
| Pentostatin 10 mg intravenous solution HCPCS J9268 | not published | not published | $3,688.65 – $8,668.48 | 13 |
| Perc cryo ablate renal tum CPT 50593 | $7,650.00 | $15,300.00 | $3,991.22 – $25,111.00 | 18 |
| Perc d-e cor revasc chro add HCPCS C9608 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Perc d-e cor revasc chro sin HCPCS C9607 | not published | not published | $24,003.00 – $47,462.00 | 8 |
| Perc d-e cor revasc t cabg b HCPCS C9605 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Perc d-e cor revasc t cabg s HCPCS C9604 | not published | not published | $17,141.37 – $47,462.00 | 8 |
| Perc d-e cor stent ather br HCPCS C9603 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Perc d-e cor stent ather s HCPCS C9602 | not published | not published | $24,003.00 – $47,462.00 | 8 |
| Perc drug-el cor stent bran HCPCS C9601 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Perc drug-el cor stent sing HCPCS C9600 | not published | not published | $17,141.37 – $47,462.00 | 8 |
| Perc rf ablate renal tumor CPT 50592 | $6,380.00 | $12,760.00 | $2,616.16 – $25,111.00 | 18 |
| Percut ablate liver rf CPT 47382 | $7,440.00 | $14,880.00 | $5,862.72 – $25,111.00 | 18 |
| Percutaneous islet celltrans HCPCS G0341 | not published | not published | $2,717.72 – $3,093.20 | 3 |
| Perflutren lipid microspheres 1.1 mg/ml intravenous suspension HCPCS Q9957 | $198.32 | $396.64 | $68.95 – $352.85 | 14 |
| Pericardial drain w/cath pq w/ct guid CPT 33019 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pericardiectomy/sub or com/w bypas 33031 CPT 33031 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pericardiocentesis wwo imaging CPT 33016 | $1,980.00 | $3,960.00 | $1,560.24 – $6,071.00 | 18 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Peri-implt capslc brst compl CPT 19371 | not published | not published | $5,787.99 – $17,439.00 | 8 |
| Perineoplasty rpr per nonob CPT 56810 | not published | not published | $4,805.89 – $12,362.00 | 8 |
| Peripheral vascular rehab CPT 93668 | $67.50 | $135.00 | $47.12 – $118.89 | 18 |
| Peri-proc device eval icd CPT 93287 | $135.00 | $270.00 | $94.23 – $250.13 | 14 |
| Peri-proc device eval pm CPT 93286 | $102.50 | $205.00 | $71.55 – $187.58 | 14 |
| Peritoneal cath sub q resv per CPT 49419 | not published | not published | $8,170.76 – $25,111.00 | 8 |
| Peritoneogram rs&i CPT 74190 | $640.00 | $1,280.00 | $153.07 – $1,097.39 | 18 |
| Perit-vens shunt pat tst CPT 78291 | not published | not published | $607.37 – $1,513.68 | 8 |
| Permanent tear duct plug HCPCS A4263 | not published | not published | $619.54 – $705.13 | 3 |
| Peroneal straps pair pre ots HCPCS L0980 | not published | not published | $29.84 – $70.51 | 7 |
| Perp bk ptb thermopls direct HCPCS L5520 | not published | not published | $2,763.13 – $6,731.69 | 7 |
| Perphenazine 4mg oral HCPCS Q0175 | not published | not published | $0.96 – $4.71 | 9 |
| Perphenazine injeciton HCPCS J3310 | not published | not published | $12.76 – $18.81 | 5 |
| Perq art m-thrombect &/nfs CPT 61645 | $7,365.00 | $14,730.00 | $3,181.00 – $11,784.00 | 14 |
| Perq clsr tcat l atr apndge CPT 33340 | $10,785.00 | $21,570.00 | $3,181.00 – $17,256.00 | 14 |
| Perq dev breast 1st mr guide CPT 19287 | $955.00 | $1,910.00 | $752.54 – $6,071.00 | 18 |
| Perq dev breast 1st strtctc CPT 19283 | not published | not published | $1,063.48 – $6,071.00 | 8 |
| Perq nl/pl lithotrp cplx>2cm CPT 50081 | not published | not published | $9,155.00 – $18,507.68 | 8 |
| Perq nl/pl lithotrp smpl<2cm CPT 50080 | $6,530.00 | $13,060.00 | $5,145.64 – $18,507.68 | 18 |
| Perq p-art revsc 1 abnor bi CPT 33903 | $24,880.00 | $49,760.00 | $17,141.37 – $47,462.00 | 18 |
| Perq p-art revsc 1 abnor uni CPT 33902 | $19,905.00 | $39,810.00 | $15,685.14 – $47,462.00 | 18 |
| Perq p-art revsc 1 nm nt bi CPT 33901 | $15,400.00 | $30,800.00 | $12,135.20 – $47,462.00 | 18 |
| Perq p-art revsc 1 nm nt uni CPT 33900 | $12,320.00 | $24,640.00 | $9,708.16 – $47,462.00 | 18 |
| Perq p-art revsc each addl CPT 33904 | $6,160.00 | $12,320.00 | $3,181.00 – $9,856.00 | 14 |
| Perq plmt bile duct stent CPT 47538 | $4,255.00 | $8,510.00 | $3,352.94 – $25,111.00 | 18 |
| Perq plmt bile duct stent CPT 47539 | $4,255.00 | $8,510.00 | $3,352.94 – $25,111.00 | 18 |
| Perq plmt bile duct stent CPT 47540 | $6,705.00 | $13,410.00 | $5,283.54 – $25,111.00 | 18 |
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.