Uchicago Medicine Adventhealth La Grange
5101 S Willow Springs Rd, La Grange, IL · AdventHealth · · NPI 1407889652
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 |
|---|---|---|---|---|
| Drainage of urinary leakage CPT 53080 | not published | not published | $658.00 – $1,210.52 | 8 |
| Drainage of urinary leakage CPT 53085 | not published | not published | $2,193.05 – $3,628.95 | 8 |
| Drain bladder by trocar/cath CPT 51101 | not published | not published | $900.92 – $1,490.79 | 8 |
| Drain blood from under nail 11740 CPT 11740 | $43.75 | $175.00 | $139.58 – $230.97 | 8 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | not published | not published | $658.00 – $2,867.21 | 8 |
| Drain cath image guided visceral pq CPT 49405 | $600.00 | $2,400.00 | $1,728.00 – $2,867.21 | 8 |
| Drain cerebro spinal fluid 62272 CPT 62272 | not published | not published | $430.00 – $1,225.43 | 8 |
| Drain chest lesion CPT 21502 | not published | not published | $576.00 – $5,680.26 | 8 |
| Drain finger abscess;simple 26010 CPT 26010 | $105.00 | $420.00 | $210.49 – $348.31 | 8 |
| Drain lower leg bursa CPT 27604 | not published | not published | $576.00 – $5,680.26 | 8 |
| Drain lower leg lesion 27603 CPT 27603 | not published | not published | $576.00 – $5,042.65 | 8 |
| Drain neck/chest lesion 21501 CPT 21501 | not published | not published | $576.00 – $5,042.65 | 8 |
| Drain open lung lesion 32200 CPT 32200 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drain ostomy pouch w/flange HCPCS A5063 | $1.08 | $4.34 | not published | 0 |
| Drain ovarn cyst abd CPT 58805 | not published | not published | $3,383.00 – $5,619.72 | 8 |
| Drain ovary abscess open CPT 58820 | not published | not published | $658.00 – $5,619.72 | 8 |
| Drain pancreatic pseudocyst 48510 CPT 48510 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drain penis lesion CPT 54015 | not published | not published | $813.00 – $2,867.21 | 8 |
| Drain shoulder bone lesion CPT 23035 | not published | not published | $658.00 – $2,791.51 | 8 |
| Drain shoulder bursa 23031 CPT 23031 | not published | not published | $658.00 – $5,042.65 | 8 |
| Drain shoulder lesion CPT 23030 | not published | not published | $430.00 – $5,042.65 | 8 |
| Drain thigh/knee lesion 27301 CPT 27301 | not published | not published | $658.00 – $5,042.65 | 8 |
| Drain thyroid/tongue cyst CPT 60000 | not published | not published | $430.00 – $2,693.58 | 8 |
| Drain to peritoneal cavity CPT 49062 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | not published | not published | $210.49 – $348.31 | 8 |
| Dress/debride pt-thick burn/<5% bs 16020 CPT 16020 | $105.00 | $420.00 | $210.49 – $348.31 | 8 |
| Dress/debrid prtl-thick burn l 16030 CPT 16030 | not published | not published | $426.48 – $705.72 | 8 |
| Dressing change not for burn w/anes 15852 CPT 15852 | not published | not published | $775.37 – $1,283.05 | 8 |
| Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm HCPCS Q4108 | not published | not published | $104.89 – $216.04 | 8 |
| Drill hole evac+/drg subdural hematoma 61108 CPT 61108 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drill hole implt ventricular cath/device 61107 CPT 61107 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drm agrft f/s/n/h/f/g/m ea CPT 15136 | not published | not published | $1,032.00 – $2,414.00 | 2 |
| Drm agrft t/a/l ea addl CPT 15131 | not published | not published | $1,032.00 – $2,414.00 | 2 |
| Drng appendix abscess open 44900 CPT 44900 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drng hand tendon sheath 26020 CPT 26020 | not published | not published | $576.00 – $5,680.26 | 8 |
| Drng of eyelid abscess 67700 CPT 67700 | not published | not published | $332.99 – $551.02 | 8 |
| Drng of finger abscess comp 26011 CPT 26011 | $600.00 | $2,400.00 | $430.00 – $2,867.21 | 8 |
| Drng of hydrocele 55000 CPT 55000 | not published | not published | $742.91 – $1,229.33 | 8 |
| Drng of mouth lesion 40801 CPT 40801 | not published | not published | $565.82 – $936.29 | 8 |
| Drng of ovarian cyst(s) 58800 CPT 58800 | not published | not published | $658.00 – $5,619.72 | 8 |
| Drng of palm multi bursas 26030 CPT 26030 | not published | not published | $576.00 – $5,680.26 | 8 |
| Drng of palm single bursa 26025 CPT 26025 | not published | not published | $430.00 – $5,680.26 | 8 |
| Drng of pelvic abscess transrectal 45000 CPT 45000 | not published | not published | $430.00 – $2,077.40 | 8 |
| Drng of salivary cyst 42409 CPT 42409 | not published | not published | $658.00 – $5,755.71 | 8 |
| Drng of scrotum abscess 55100 CPT 55100 | $600.00 | $2,400.00 | $430.00 – $2,867.21 | 8 |
| Drng open retroperitoneal abscess 49060 CPT 49060 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drng open subdiaphragmatic/subphrenic absc 49040 CPT 49040 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drng ovary abscess perqt 58822 CPT 58822 | not published | not published | $4,150.00 – $4,175.00 | 2 |
| Drng peritoneal abscess open 49020 CPT 49020 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Drng salivary gland simple 42300 CPT 42300 | not published | not published | $430.00 – $2,693.58 | 8 |
| Drng salivary gland submax/subling 42310 CPT 42310 | not published | not published | $430.00 – $936.29 | 8 |
| Dronabinol 2.5mg oral HCPCS Q0167 | $2.46 | $9.83 | $5.43 – $5.43 | 1 |
| Droperidol 2.5 mg/ml injection solution HCPCS J1790 | $30.78 | $123.11 | not published | 0 |
| Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm HCPCS Q4103 | $5.89 | $23.56 | $24.97 – $216.04 | 8 |
| Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm HCPCS Q4102 | $40.04 | $160.17 | $23.82 – $216.04 | 8 |
| Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm HCPCS Q4124 | $13.48 | $53.91 | $15.83 – $216.04 | 8 |
| Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm HCPCS Q4104 | $38.81 | $155.25 | $100.04 – $216.04 | 8 |
| Drug admin & hemodynmic meas CPT 93463 | not published | not published | $1,032.00 – $1,032.00 | 1 |
| Drug assay caffeine CPT 80155 | not published | not published | $15.29 – $62.48 | 8 |
| Drug assay posaconazole CPT 80187 | $37.50 | $150.00 | $26.54 – $43.92 | 8 |
| Drug assay rufinamide CPT 80210 | not published | not published | $26.54 – $43.92 | 8 |
| Drug assay vedolizumab CPT 80280 | not published | not published | $37.76 – $62.48 | 8 |
| Drug assay voriconazole CPT 80285 | not published | not published | $26.54 – $43.92 | 8 |
| Drug asy hydroxychloroquine CPT 80220 | not published | not published | $18.25 – $30.20 | 8 |
| Drug of abuse screen urine CPT 80305 | $35.00 | $140.00 | $12.34 – $20.41 | 8 |
| Drug screening tapentadol CPT 80372 | $25.00 | $100.00 | $25.87 – $161.55 | 2 |
| Drug screen quant tiagabine CPT 80199 | $37.50 | $150.00 | $19.51 – $43.92 | 8 |
| Drug/substance nos 4-6 CPT 80376 | not published | not published | $29.66 – $161.55 | 2 |
| Drug test def 15-21 classes HCPCS G0482 | not published | not published | $97.53 – $321.96 | 8 |
| Drug test def 1-7 classes HCPCS G0480 | not published | not published | $63.39 – $185.38 | 8 |
| Drug test def 22+ classes HCPCS G0483 | not published | not published | $97.53 – $400.01 | 8 |
| Drug test def 8-14 classes HCPCS G0481 | not published | not published | $97.53 – $253.68 | 8 |
| Drug test def simple all cl HCPCS G0659 | not published | not published | $60.84 – $100.67 | 8 |
| Drug test prsmv instrmnt CPT 80306 | $31.25 | $125.00 | $16.78 – $27.77 | 8 |
| Drug test(s) presumptive any class instrument chemistry analyzers CPT 80307 | $53.75 | $215.00 | $60.84 – $100.67 | 8 |
| Drvvt confirm - quest CPT 85597 | $25.00 | $100.00 | $17.60 – $29.13 | 8 |
| Dstrj extensive retinopathy CPT 67227 | not published | not published | $430.00 – $6,824.99 | 8 |
| Dstrj nulyt agt gnclr nrv CPT 64624 | $1,125.00 | $4,500.00 | $2,048.63 – $3,389.97 | 8 |
| Dstr mal les s/n/h/f/g >4.0 CPT 17276 | not published | not published | $426.48 – $705.72 | 8 |
| Dstr mal ls f/e/e/n/l/m2.1-3 CPT 17283 | not published | not published | $426.48 – $705.72 | 8 |
| Dstr mal ls f/e/e/n/l/m3.1-4 CPT 17284 | not published | not published | $430.00 – $1,283.05 | 8 |
| Dstr mal ls f/e/e/n/l/m>4.0 CPT 17286 | not published | not published | $775.37 – $1,283.05 | 8 |
| Dstry eye lesn,fdr vssl tech HCPCS G0186 | not published | not published | $430.00 – $954.81 | 8 |
| Ductogram sgl duct CPT 77053 | not published | not published | $63.45 – $414.22 | 8 |
| Duodenal exclusion CPT 48547 | not published | not published | $2,648.00 – $2,648.00 | 1 |
| Duodenal motility study CPT 91022 | not published | not published | $391.49 – $647.81 | 8 |
| Duplex scan bilateral study 93985 CPT 93985 | not published | not published | $250.32 – $414.22 | 8 |
| Duplex scan unilateral study 93986 CPT 93986 | $325.00 | $1,300.00 | $109.68 – $181.49 | 8 |
| Dup scan/hemodialysis access 93990 CPT 93990 | $325.00 | $1,300.00 | $109.68 – $181.49 | 8 |
| Dup scan/lwr xtr vasc stdy bilat 93924 CPT 93924 | $231.25 | $925.00 | $160.97 – $374.85 | 8 |
| Dup scan/ue art/graft/bilat/comp 93930 CPT 93930 | $500.00 | $2,000.00 | $190.54 – $414.22 | 8 |
| Durvalumab 50 mg/ml intravenous solution HCPCS J9173 | $710.30 | $2,841.18 | $83.33 – $137.89 | 8 |
| Dxa bone density axl vrt fx CPT 77085 | $92.50 | $370.00 | $64.56 – $181.49 | 8 |
| Dx bronchoscope/brush 31623 CPT 31623 | not published | not published | $576.00 – $3,089.94 | 8 |
| Dx bronchoscope/lavage 31624 CPT 31624 | not published | not published | $576.00 – $3,089.94 | 8 |
| Dx bronchoscope/wash 31622 CPT 31622 | not published | not published | $430.00 – $3,089.94 | 8 |
| Dx duod intub w/asp spec 43756 CPT 43756 | not published | not published | $430.00 – $1,574.55 | 8 |
| Dx duod intub w/asp specs CPT 43757 | not published | not published | $430.00 – $1,574.55 | 8 |
| Dx gastr intub w/asp spec CPT 43754 | not published | not published | $226.53 – $374.85 | 8 |
| Dx gastr intub w/asp specs CPT 43755 | not published | not published | $134.99 – $223.38 | 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.