Advocate Good Samaritan Hospital — CT scan prices
← Hospital overviewVerified from Advocate Good Samaritan Hospital’s published price file
Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
6 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| CT ABDOMEN & PELVIS W/DYE Outpatient | 74177 CPT | $3,560 | $1,780 | $540 – $2,848 | $3,437 | |
| CT ABDOMEN & PELVIS W/O DYE Outpatient | 74176 CPT | $3,140 | $1,570 | $365 – $2,512 | — | |
| CT ABDOMEN & PELVIS W/WO DYE Outpatient | 74178 CPT | $5,140 | $2,570 | $540 – $4,112 | — | |
| CT CHEST DX W/DYE Outpatient | 71260 CPT | $1,780 | $890 | $269 – $1,488 | — | |
| CT CHEST DX W/O DYE Outpatient | 71250 CPT | $1,570 | $785 | $161 – $1,256 | — | |
| CT HEAD W/O DYE Outpatient | 70450 CPT | $1,570 | $785 | $161 – $1,256 | $683 |