ADVOCATE GOOD SAMARITAN HOSPITAL

Code	Description	Gross	Cash	Min payer	Max payer	# insurers
C1824	3012551 - GENERATOR NRSTM OPTMZ SMART MINI IMPL PULSE	$115,180	$57,590	—	—	15
33289	IMPLANT WRLESS PUL ART PRESS SENS	$98,310	$49,155	—	—	12
C2624	1168039 - SYSTEM PULM PRSS DLV SYS PA	$84,835	$42,417	—	—	15
C1767	1067995 - GENERATOR NRSTM	$80,737	$40,368	—	—	15
33249	INS/RPL ICD SINGLE GEN + LEAD(S)	$68,860	$34,430	—	—	12
33270	INS/RPL SUBQ GEN + LEAD W/EVAL	$68,090	$34,045	—	—	12
0408T	INS/RPL CCM GEN + LEAD(S)	$63,880	$31,940	—	—	13
93654	COMP EVAL W/ABLATION VT & 3D MAP/LAS	$63,000	$31,500	—	—	12
C1882	3043709 - DEFIBRILLATOR GALLANT HF DF4 IS-4 IS-1 CNCT THK12MM 51X74MM 34CC 76GM	$61,799	$30,899	—	—	15
C1815	1127802 - IMPLANT URO AMS 800 CNTRL PUMP INHBZN SIL-EL SPHNCR	$61,631	$30,815	—	—	15
33230	INS ICD GEN ONLY/EXIST DUAL LEADS	$60,350	$30,175	—	—	12
93656	COMP EVAL W/ABL PULM VEIN AFIB&3D MAP/ICE	$59,850	$29,925	—	—	12
93653	COMP EVAL W/ABLATION SVT & 3D MAP/LAS	$57,270	$28,635	—	—	12
C1722	3004542 - DEFIBRILLATOR RESONATE 29.5 ML 68.9 GM D.99 CM W5.37 CM X	$54,268	$27,134	—	—	15
C1813	1127816 - PROSTHESIS PENL AMS 700CX MS PUMP 21CM PRECNCT 2 CYL INHBZN	$51,759	$25,880	—	—	15
33264	REM/RPL ICD GEN/MULT SYSTEM	$50,600	$25,300	—	—	12
33263	REM/RPL ICD GEN/DUAL SYSTEM	$50,330	$25,165	—	—	12
33903	PULM ART REVASC INITIAL STNT BILATERAL	$49,760	$24,880	—	—	12
33262	REM/RPL ICD GEN/SINGLE SYSTEM	$49,240	$24,620	—	—	12
0571T	INS/RPL SUBSTERNAL ICD	$49,080	$24,540	—	—	12
C1721	1171278 - DFBR CBLT XT IMPL CARDVRT CARDIAC	$48,398	$24,199	—	—	15
C2616	YTTRIUM 90 SIR SPHERES PER SOURCE	$46,520	$23,260	—	—	15
93580	SEPTAL CLOSURE ATRIAL W IMPLANT	$42,830	$21,415	—	—	12
36837	AVF UPPER EXTREMITY CRTN SEPERATE ACCESS SITES WITH IMAGING	$41,810	$20,905	—	—	12
33231	INS ICD GEN ONLY/EXIST MULTI LEADS	$41,290	$20,645	—	—	12
C9774	REVASC TIB/PERONEAL INTRAVASC LITHO/ATHER	$40,600	$20,300	—	—	24
C9775	REVASC TIB/PERONEAL INTRAVASC LITHO/ATH/STNT	$40,600	$20,300	—	—	24
C9773	REVASC TIB/PERONEAL INTRAVASC LITHO/STNT	$40,600	$20,300	—	—	24
C9767	REVASC INTRAVASC LITHO/ATH/STNT	$40,600	$20,300	—	—	24
C9797	VASC EMB/OCC W/PRS CATH	$40,480	$20,240	—	—	12
33902	PULM ART REVASC INITIAL STNT UNILATERAL	$39,810	$19,905	—	—	12
37231	ANGIO T/P + STENT/ATHERECTOMY	$39,400	$19,700	—	—	12
36903	DIALYSIS CIRCUIT ANGIO + STENT	$38,670	$19,335	—	—	12
0795T	INS DUAL LEADLESS PMK COMPLETE W IMG	$38,320	$19,160	—	—	12
C1817	1240880 - OCCLUDER CV RT ATR DISC 25 MM LT ATR DISC 18 MM RECOMMENDED	$37,655	$18,828	—	—	15
C1733	3037109 - CATHETER ABLT OTW 20 ELECTRODE FARAWAVE L115 CM L180 CM OD31	$37,434	$18,717	—	—	12
0238T	ATHERECTOMY ILIAC EA + S&I	$37,230	$18,615	—	—	12
93590	PERC TRANSCATH CLS MITRAL	$36,840	$18,420	—	—	12
93591	PERC TRANSCATH CLS AORTIC	$36,840	$18,420	—	—	12
36906	DIALYSIS CIRCUIT REMOVE CLOT+STENT	$36,210	$18,105	—	—	12
36836	AVF UPPER EXTREMITY CRTN SINGLE ACCESS WITH IMAGING	$35,840	$17,920	—	—	12
0643T	TCAT L VENTR RSTRJ DEV IMPLT	$35,690	$17,845	—	—	12
33274	INS/RPL LEADLESS PMKR SNG VENTR	$35,690	$17,845	—	—	12
0646T	TTVI IMPLANT OR REPLACE W PROS VALVE PERC	$35,690	$17,845	—	—	12
93582	CLOSURE PATENT DUCTUS ARTERIOSUS	$35,220	$17,610	—	—	12
0614T	REM/REPL SUBSTERNAL ICD PULSE GEN	$35,160	$17,580	—	—	12
92941	REVASC ACUTE DE MAJ ART SNG RI	$34,380	$17,190	—	—	12
92928	STENT/PTCA DE MAJ ART SNG RC	$33,610	$16,805	—	—	12
37244	VASCULAR EMBOLIZATION HEMORRHAGE	$32,750	$16,375	—	—	12
77372	RADIOSURGERY COMPLETE TREATMENT	$32,340	$16,170	—	—	13

Showing top 50 of 9,151 priced procedures, sorted by gross charge.

Data straight from this hospital's federally-mandated machine-readable file (45 CFR § 180). The compliance grade reflects how completely the hospital published the six required data elements, not the quality of care.