Advocate Good Samaritan Hospital — price list
← 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.
Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.
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.
5 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| 1213499 - PACEMAKER QUADRA ALLURE MP IS-1 IS4-LLLL CNCT PULSE GNTR MR Outpatient | C2621 HCPCS | $22,872 | $11,436 | $7,639 – $18,298 | — | |
| 1233329 - PACEMAKER PERCEPTA QD MRI SURESCAN RADOPQ GRMT 11MM 19.5CC Outpatient | C2621 HCPCS | $22,872 | $11,436 | $7,639 – $18,298 | — | |
| 1233330 - PACEMAKER SERENA QD SURESCAN OPTIVOL BLUETOOTH CNCT HOLE Outpatient | C2621 HCPCS | $22,872 | $11,436 | $7,639 – $18,298 | — | |
| 1242037 - PACEMAKER CRT-P 15.2 CC 30.6 GM VISIONIST X4 D.75 CM W4.45 Outpatient | C2621 HCPCS | $22,416 | $11,208 | $7,487 – $17,933 | — | |
| 3003643 - PACEMAKER VISIONIST X4 CARDIAC Outpatient | C2621 HCPCS | $22,416 | $11,208 | $7,487 – $17,933 | — |