Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
INS DUAL LEADLESS PMK COMPLETE W IMG
Downers Grove, IL
See all hospitals reporting CPT 0795T →Price type
Advocate Good Samaritan Hospital’s median price of $28.3k is 42% above the median hospital's median price ($19.9k), higher than 81% of the 1,503 hospitals reporting CPT 0795T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 13 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Cigna commercial percent of total billed charges · outpatientfrom % of charges | $19,543 | $19,543 | $19,160 – $19,926 |
| 2 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $20,674 | $20,674 | $20,674 – $20,674 |
| 3 | Blue Cross Blue Shield managed care percent of total billed charges · outpatientfrom % of charges | $23,337 | $23,337 | $23,337 – $23,337 |
| 4 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $23,835 | $23,835 | $23,835 – $23,835 |
| 5 | Blue Cross Blue Shield commercial percent of total billed charges · outpatientfrom % of charges | $28,433 | $28,433 | $27,322 – $29,545 |
| 6 | Ambetter medicare advantage case rate · outpatient | $28,826 | $28,826 | $28,826 – $28,826 |
| 7 | Molina medicare advantage case rate · outpatient | $28,826 | $28,826 | $28,826 – $28,826 |
| 8 | Oscar medicare advantage case rate · outpatient | $29,820 | $29,820 | $29,820 – $29,820 |
| 9 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $30,656 | $30,656 | $30,656 – $30,656 |
| 10 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $30,656 | $30,656 | $30,656 – $30,656 |
| 11 | UnitedHealthcare commercial case rate · outpatient | $27,813 | $30,941 | $24,003 – $41,007 |
| 12 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $31,116 | $31,116 | $31,116 – $31,116 |
| 13 | UnitedHealthcare hmo case rate · outpatient | $47,462 | $47,462 | $47,462 – $47,462 |
Last updated: Nov 4, 2025
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