Northwestern Medicine Palos Hospital
12251 S. 80th Ave., Palos Heights, IL · Nm · · NPI 1043600026
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 |
|---|---|---|---|---|
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $1,253.35 | $1,790.50 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $42,684.59 | $60,977.98 | not published | 0 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $52.67 | $75.25 | not published | 0 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $41.82 | $59.75 | not published | 0 |
| Lidocaine therapeutic drug level CPT 80176 | $296.10 | $423.00 | not published | 0 |
| Lifileucel til/dose 7.5b-72b snij HCPCS J9999 | $41.65 | $59.50 | not published | 0 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $22,118.99 | $31,598.56 | not published | 0 |
| Ligation/divis of long saph vein 37700 CPT 37700 | $26,966.46 | $38,523.51 | not published | 0 |
| Lig/band angioaccess av fistula CPT 37607 | $23,176.07 | $33,108.67 | not published | 0 |
| Liletta, 52 mg HCPCS J7297 | $2.80 | $4.00 | not published | 0 |
| Limb nerve surgery add-on CPT 64783 | $14,995.49 | $21,422.13 | not published | 0 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $72.62 | $103.75 | not published | 0 |
| Lipase CPT 83690 | $121.80 | $174.00 | not published | 0 |
| Lipoprotein blood high res frac & quant CPT 83701 | $89.60 | $128.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $96.60 | $138.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $124.60 | $178.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $63.70 | $91.00 | not published | 0 |
| Lipoprtn dir meas sd ldl chl CPT 83722 | $44.80 | $64.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $121.80 | $174.00 | not published | 0 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $6,616.40 | $9,452.00 | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $396.20 | $566.00 | not published | 0 |
| Liver elastography 91200 CPT 91200 | $242.20 | $346.00 | not published | 0 |
| Liver Function Test CPT 80076 | $189.70 | $271.00 | not published | 0 |
| Liver/spleen imag static only CPT 78215 | $1,417.50 | $2,025.00 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $50.05 | $71.50 | not published | 0 |
| Low back disk surgery CPT 63030 | $46,123.32 | $65,890.46 | not published | 0 |
| Low cost skin substitute app HCPCS C5271 | $1,207.50 | $1,725.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5275 | $2,969.40 | $4,242.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5272 | $1,210.30 | $1,729.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5276 | $3,444.00 | $4,920.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $3,717.00 | $5,310.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $3,506.30 | $5,009.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $3,083.50 | $4,405.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $4,706.80 | $6,724.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $4,172.70 | $5,961.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $3,837.40 | $5,482.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $651.70 | $931.00 | not published | 0 |
| Low frequency non-thermal Ultrasound CPT 97610 | $419.30 | $599.00 | not published | 0 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $50,804.79 | $72,578.27 | not published | 0 |
| Lso flex no ri stays pre ots HCPCS L0628 | $75.60 | $108.00 | not published | 0 |
| L/s ratio fetal lung CPT 83661 | $672.70 | $961.00 | not published | 0 |
| Lumbar diskogram s&i CPT 72295 | $2,509.50 | $3,585.00 | not published | 0 |
| Lung function test (mbc/mvv) CPT 94200 | $341.60 | $488.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $405.30 | $579.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $1,236.90 | $1,767.00 | not published | 0 |
| Lurbinectedin 4 mg intravenous solution HCPCS J9223 | $34,038.20 | $48,626.00 | not published | 0 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $923.30 | $1,319.00 | not published | 0 |
| Lutetium lu 177 vipivotide HCPCS A9607 | $526.40 | $752.00 | not published | 0 |
| Lymphatics/lymph node imaging CPT 78195 | $1,640.10 | $2,343.00 | not published | 0 |
| Lymphocyte transformation mitogen CPT 86353 | $704.90 | $1,007.00 | not published | 0 |
| Lymph vessel x-ray arm/leg CPT 75801 | $1,558.20 | $2,226.00 | not published | 0 |
| Lymph vessel x-ray arms/legs CPT 75803 | $1,635.90 | $2,337.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75805 | $898.10 | $1,283.00 | not published | 0 |
| Lymph vessel x-ray trunk CPT 75807 | $2,283.40 | $3,262.00 | not published | 0 |
| Macro exam dissect molec study ea CPT 88387 | $9,429.00 | $13,470.00 | $15.92 – $34.30 | 4 |
| Macroscopic exam arthropod CPT 87168 | $105.00 | $150.00 | not published | 0 |
| Macroscopic exam parasite CPT 87169 | $152.60 | $218.00 | not published | 0 |
| Magnesium CPT 83735 | $81.20 | $116.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $48.30 | $69.00 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $128.10 | $183.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $133.70 | $191.00 | not published | 0 |
| Mapping functional cort/subcort ea add'l hr CPT 95962 | $1,629.60 | $2,328.00 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $56,918.55 | $81,312.21 | not published | 0 |
| Map tachycard site(s) CPT 93609 | $8,255.80 | $11,794.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $757.40 | $1,082.00 | not published | 0 |
| Mastoids complete CPT 70130 | $531.30 | $759.00 | not published | 0 |
| M.avium-intra dna amp prob CPT 87561 | $235.90 | $337.00 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $217.70 | $311.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $224.00 | $320.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $181.30 | $259.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $409.50 | $585.00 | not published | 0 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $214.20 | $306.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $296.10 | $423.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $81.90 | $117.00 | not published | 0 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $207.20 | $296.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $119.00 | $170.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $105.70 | $151.00 | not published | 0 |
| Mayo amphu amphetamines definitive assay 3 or 4 urine CPT 80325 | $39.20 | $56.00 | not published | 0 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $45.50 | $65.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $589.40 | $842.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $692.30 | $989.00 | not published | 0 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $893.90 | $1,277.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $3,071.60 | $4,388.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $250.60 | $358.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $153.30 | $219.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $120.40 | $172.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $90.30 | $129.00 | not published | 0 |
| Mayo avwpr vw factor activity CPT 85397 | $194.60 | $278.00 | not published | 0 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $99.40 | $142.00 | not published | 0 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $40.60 | $58.00 | not published | 0 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $175.70 | $251.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $407.40 | $582.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative CPT 81208 | $289.80 | $414.00 | not published | 0 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $78.40 | $112.00 | not published | 0 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $97.30 | $139.00 | not published | 0 |
| Mayo brcmg brucella antibody igm CPT 86622 | $60.20 | $86.00 | not published | 0 |
| Mayo c1 esterase inhibitor CPT 83883 | $114.10 | $163.00 | not published | 0 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $238.00 | $340.00 | not published | 0 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $108.50 | $155.00 | not published | 0 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $231.70 | $331.00 | not published | 0 |
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.