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 |
|---|---|---|---|---|
| Pt wheelchair management each 15 minutes CPT 97542 | $85.00 | $170.00 | $45.69 – $469.00 | 18 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $3,915.51 – $25,111.00 | 11 |
| Pul art balloon repr percut CPT 92998 | not published | not published | $2,027.97 – $25,111.00 | 7 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $5,500.00 – $24,995.97 | 10 |
| Pulm endartercomy w/bypass 33916 CPT 33916 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pulmonary decortication partial 32225 CPT 32225 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pulmonary vent imaging CPT 78579 | $1,005.00 | $2,010.00 | $607.37 – $3,966.00 | 18 |
| Pulse ox continuous overnight monitoring CPT 94762 | $282.50 | $565.00 | $218.90 – $1,287.00 | 18 |
| Pulse ox multiple CPT 94761 | $80.00 | $160.00 | $49.56 – $1,287.00 | 14 |
| Pulse ox single CPT 94760 | $60.00 | $120.00 | $24.78 – $1,287.00 | 14 |
| Punc of shunt for asp or inj CPT 61070 | $900.00 | $1,800.00 | $709.20 – $6,071.00 | 18 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $125.00 | $250.00 | $98.50 – $6,291.00 | 18 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $402.50 | $805.00 | $317.17 – $6,291.00 | 18 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $4,901.93 – $12,362.00 | 8 |
| Puncture spinal lumbar diagnostic CPT 62270 | $1,215.00 | $2,430.00 | $957.42 – $6,071.00 | 18 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $349.59 – $716.12 | 6 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $155.83 – $319.21 | 6 |
| Pvb thoracic 2nd+ inj site CPT 64462 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pvb thoracic cont infusion CPT 64463 | not published | not published | $1,046.75 – $6,071.00 | 8 |
| Pvb thoracic single inj site CPT 64461 | not published | not published | $1,046.75 – $6,071.00 | 8 |
| Pwr adpt pneum vad, rep veh HCPCS Q0504 | not published | not published | $1,201.17 – $2,928.67 | 7 |
| Pwr pck base combo vad, rep HCPCS Q0489 | not published | not published | $28,453.35 – $69,324.26 | 7 |
| Pyelotomy complicated CPT 50135 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pyelotomy w/drg pyelostomy CPT 50125 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pyelotomy w/exploration CPT 50120 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pyelotomy w/removal calculus CPT 50130 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pyloroplasty 43800 CPT 43800 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Pyridoxine hcl 100 mg HCPCS J3415 | not published | not published | $16.65 – $35.28 | 6 |
| Pyruvate CPT 84210 | $60.00 | $120.00 | $14.48 – $96.00 | 18 |
| Pyruvate kinase CPT 84220 | $60.00 | $120.00 | $9.44 – $96.00 | 18 |
| Quadrilateral brim HCPCS L2188 | not published | not published | $489.23 – $1,194.03 | 7 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | not published | not published | $194.83 – $257.99 | 4 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | $1,705.00 | $3,410.00 | $813.60 – $3,966.00 | 18 |
| Quant diff pulm perf w/imaging CPT 78597 | $1,705.00 | $3,410.00 | $607.37 – $3,966.00 | 18 |
| Quest t3 uptake CPT 84479 | $30.00 | $60.00 | $6.47 – $48.00 | 18 |
| Quick disconn hook adapter o HCPCS L6628 | not published | not published | $996.32 – $2,425.67 | 7 |
| Quinupristin/dalfopristin HCPCS J2770 | not published | not published | $6.18 – $950.66 | 13 |
| Rabies ig heat-treated human im/subq 90376 CPT 90376 | not published | not published | $503.61 – $1,109.25 | 13 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $343.80 – $880.29 | 13 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $551.14 | $1,102.27 | $386.33 – $974.72 | 18 |
| Rabies vaccine id CPT 90676 | not published | not published | $383.48 – $1,165.83 | 11 |
| Radial keratotomy CPT 65771 | not published | not published | $6,296.00 – $12,362.00 | 4 |
| Radiation handling CPT 77790 | $580.00 | $1,160.00 | $121.24 – $2,429.00 | 14 |
| Radiation physics consult CPT 77336 | $525.00 | $1,050.00 | $200.68 – $2,429.00 | 18 |
| Radiation therapy dose plan CPT 77300 | $565.00 | $1,130.00 | $200.68 – $2,429.00 | 18 |
| Radiation therapy management CPT 77431 | not published | not published | $409.19 – $644.03 | 4 |
| Radiation treatment aid(s) CPT 77332 | $580.00 | $1,160.00 | $200.68 – $2,429.00 | 18 |
| Radiation treatment aid(s) CPT 77333 | $695.00 | $1,390.00 | $200.68 – $2,429.00 | 18 |
| Radiation treatment aid(s) CPT 77334 | $1,215.00 | $2,430.00 | $553.32 – $2,429.00 | 18 |
| Radiation treatment delivery CPT 77401 | not published | not published | $165.51 – $285.15 | 8 |
| Radiation treatment delivery CPT 77402 | $590.00 | $1,180.00 | $165.51 – $2,429.00 | 18 |
| Radiation treatment delivery CPT 77412 | $920.00 | $1,840.00 | $397.50 – $2,429.00 | 18 |
| Radiation tx management x5 CPT 77427 | not published | not published | $779.38 – $1,255.15 | 4 |
| Radical abdominal hysterectomy 58210 CPT 58210 | not published | not published | $3,181.00 – $6,291.00 | 4 |
| Radical rescj tumor clavicle CPT 23200 | not published | not published | $12,700.00 – $25,111.00 | 4 |
| Radical rescj tumor prox hum CPT 23220 | not published | not published | $12,700.00 – $25,111.00 | 4 |
| Radical rescj tumor scapula CPT 23210 | not published | not published | $12,700.00 – $25,111.00 | 4 |
| Radical resection of elbow CPT 24149 | not published | not published | $8,821.00 – $17,439.00 | 8 |
| Radical resection sternum 21630 CPT 21630 | not published | not published | $12,700.00 – $25,111.00 | 4 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $4,326.01 – $12,362.00 | 8 |
| Radiesse injection HCPCS Q2026 | not published | not published | $483.46 – $1,009.71 | 8 |
| Radiofq trsmtr for implt neu HCPCS L8683 | not published | not published | $9,432.98 – $22,982.72 | 7 |
| Radiof trsmtr implt scrl neu HCPCS L8684 | not published | not published | $1,480.15 – $3,605.60 | 7 |
| Radiology port images(s) CPT 77417 | $155.00 | $310.00 | $103.26 – $2,429.00 | 14 |
| Radiotherapy dose plan imrt CPT 77301 | $7,055.00 | $14,110.00 | $1,039.00 – $13,127.16 | 18 |
| Radium ra223 dichl ther/uci HCPCS A9606 | $215.00 | $430.00 | $169.42 – $558.31 | 18 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | $1,645.00 | $3,290.00 | $1,137.45 – $3,966.00 | 18 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | $2,465.00 | $4,930.00 | $1,708.48 – $3,966.00 | 18 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | $2,495.00 | $4,990.00 | $1,966.06 – $4,522.72 | 18 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | $1,645.00 | $3,290.00 | $1,163.92 – $3,966.00 | 18 |
| Radphm lcl tumor plr sgl day CPT 78800 | $820.00 | $1,640.00 | $607.37 – $3,966.00 | 18 |
| Radphm quant measure sgl area add-on CPT 78835 | $665.00 | $1,330.00 | $524.02 – $3,966.00 | 14 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $9,155.00 – $18,102.00 | 8 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $4,326.01 – $12,362.00 | 8 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $4,326.01 – $12,362.00 | 8 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $4,326.01 – $12,362.00 | 8 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $9,155.00 – $18,102.00 | 8 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $3,126.00 – $6,181.00 | 8 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | not published | not published | $107.96 – $240.86 | 10 |
| Range of motion measurements CPT 95852 | not published | not published | $30.13 – $79.91 | 7 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $132.11 – $465.19 | 10 |
| Rapid desensitization CPT 95180 | not published | not published | $603.15 – $798.66 | 4 |
| Rapid Strep Test CPT 87880 | not published | not published | $16.53 – $75.21 | 14 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $545.90 – $1,253.64 | 13 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $326.53 – $747.69 | 10 |
| Rb82 rubidium HCPCS A9555 | not published | not published | $767.84 – $1,572.92 | 6 |
| Rbc count only automated CPT 85041 | $20.00 | $40.00 | $3.02 – $32.00 | 18 |
| Rbc deglycerolized each unit HCPCS P9039 | $1,025.00 | $2,050.00 | $715.45 – $1,640.00 | 18 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $660.80 – $6,291.00 | 8 |
| Rbc irradiated each unit HCPCS P9038 | $560.00 | $1,120.00 | $216.37 – $896.00 | 18 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $8.60 – $38.69 | 14 |
| Rbc o2 co2 reduced HCPCS P9027 | not published | not published | $706.30 – $935.23 | 4 |
| Rbc osmotic fragility CPT 85555 | $82.50 | $165.00 | $7.47 – $132.00 | 18 |
| Rbc serum pretx incubj drugs CPT 86975 | $370.00 | $740.00 | $101.16 – $798.66 | 18 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $8,941.57 – $18,102.00 | 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.