Supplies, drugs & other prices at Advocate Good Shepherd Hospital
Barrington, IL · every code in this section with a posted price and a Medicare benchmark.
57 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Asstv alg ECG rsk asmt cncrt (0764T) | $120 | $240 | 0.8× |
| Asstv alg ECG rsk asmt prev (0765T) | $120 | $240 | 0.8× |
| Catheterize for urine spec (P9612) | $87.50 | $175 | 9.4× |
| Diab manage trn per indiv (G0108) | $105 | $210 | 1.9× |
| Diab manage trn ind/group (G0109) | $25 | $50 | 1.6× |
| Direct refer hospital observ (G0379) | $207.50 | $415 | 0.3× |
| Drug test def 15-21 classes (G0482) | $322.50 | $645 | 1.6× |
| Drug test def 22+ classes (G0483) | $140 | $280 | 0.6× |
| Elec stim unattend for press (G0281) | $75 | $150 | 6.4× |
| Electrophysiologic Eval Icds W/Ss Electrode (0577T) | $2,070 | $4,140 | 1.6× |
| Fern test (Q0114) | $32.50 | $65 | 3.3× |
| Group mnt 2 or more 30 mins (G0271) | $45 | $90 | 2.6× |
| Group train w/o patient (G0543) | $37.50 | $75 | 1.2× |
| Hopd mntl hlt, 15-29 min (C7900) | $52.50 | $105 | 1.3× |
| Hopd mntl hlt, 30-60 min (C7901) | $105 | $210 | 1.0× |
| Hopd mntl hlt, grp (C7903) | $62.50 | $125 | 1.5× |
| Insertion of substernal implantable defibrillator electrode (0572T) | $6,340 | $12,680 | 0.7× |
| Insj/Rplcmt Icds W/Substernal Electrode (0571T) | $24,540 | $49,080 | 0.7× |
| Instlj fecal microbiota ssp (0780T) | $1,465 | $2,930 | 10.2× |
| Mnt subs tx for change dx (G0270) | $55 | $110 | 1.7× |
| Neuro csf prion prtn qual (0035U) | $845 | $1,690 | 1.6× |
| No pt prsnt train initial 30 (G0541) | $20 | $40 | 0.6× |
| Oth resp proc, group (G0239) | $67.50 | $135 | 1.7× |
| Oth resp proc, indiv (G0238) | $65 | $130 | 2.1× |
| Pathogen test for platelets (P9100) | $60 | $120 | 0.9× |
| Perq Sacral Augmt Bilat Inj (0201T) | $7,905 | $15,810 | 1.0× |
| Perq Sacral Augmt Unilat Inj (0200T) | $5,270 | $10,540 | 0.7× |
| Perq tcat ther rx dlvr ntrac rx balo 1 maj c art (0913T) unusually low: confirm this is the full procedure |
$5,700 | $11,400 | 0.5× |
| Place device/marker, non pro (C9728) | $1,870 | $3,740 | 1.3× |
| Prostate biopsy, any mthd (G0416) | $302.50 | $605 | 0.8× |
| Rbc DNA hea 35 ag 11 bld grp whl bld cmn allel (0001U) | $815 | $1,630 | 1.1× |
| Removal Ss Dfb Electrode (0573T) | $4,885 | $9,770 | 1.2× |
| Repos prev impl ss impltbl dfb pacing eltrd (0574T) | $5,125 | $10,250 | 1.3× |
| Revasc intra lithotrip-ather (C9766) | $12,710 | $25,420 | 0.6× |
| Revasc intra lithotrip-stent (C9765) | $12,710 | $25,420 | 0.6× |
| Revasc intravasc lithotripsy (C9764) | $6,565 | $13,130 | 0.5× |
| Revasc lith-sten-ath tib/per (C9775) | $20,300 | $40,600 | 1.0× |
| Revasc lithotr-ather tib/per (C9774) | $20,300 | $40,600 | 1.0× |
| Revasc lithotr-stent tib/per (C9773) | $20,300 | $40,600 | 1.0× |
| Revasc lithotrip tibi/perone (C9772) | $13,925 | $27,850 | 1.1× |
| Revasc lithotrip-stent-ather (C9767) | $20,300 | $40,600 | 1.0× |
| Rmvl Substernal Impltbl Dfb Pulse Generator Only (0580T) | $4,885 | $9,770 | 1.2× |
| Rmvl&Rplcmt Substernal Impltbl Defibrillator Pg (0614T) | $17,580 | $35,160 | 0.7× |
| Sim ang w/prs cath rad emb (C8004) | $15,000 | $30,000 | 1.2× |
| Tcat insj perm 1chmbr ldls pacemaker r atrial (0823T) | $17,845 | $35,690 | 0.9× |
| Tcat insj perm 2chmbr ldls pm r atr pm compnt (0796T) | $19,160 | $38,320 | 0.9× |
| Tcat Insj Perm Dual Chamber Ldls Pm Compl Sys (0795T) | $19,160 | $38,320 | 0.9× |
| Tcat rmvl perm 1chmbr ldls pacemaker r atrial (0824T) | $3,540 | $7,080 | 1.0× |
| Tcat rmvl&rplcmt perm 2chmbr ldls pm 2chmbr sys (0801T) | $17,845 | $35,690 | 0.9× |
| Therapeutic procd strg endur (G0237) | $60 | $120 | 1.9× |
| Tomosynthesis, mammo (G0279) | $152.50 | $305 | 12.0× |
| Trauma respons w/hosp criti (G0390) | $3,155 | $6,310 | 2.2× |
| Trluml perip athrc abd aorta (0236T) | $17,205 | $34,410 | 1.4× |
| Trluml Perip Athrc Brchiocph (0237T) unusually low: confirm this is the full procedure |
$6,070 | $12,140 | 0.5× |
| Trluml Perip Athrc Iliac Art (0238T) unusually low: confirm this is the full procedure |
$8,870 | $17,740 | 0.4× |
| Unsched dialysis esrd pt hos (G0257) | $1,025 | $2,050 | 1.4× |
| Vasc emb/occ w/prs cath (C9797) | $20,240 | $40,480 | 1.0× |