Biopsy roof of mouth at Northwestern Memorial Hospital
251 E. Huron, Chicago, IL · Nm · · NPI 1497859649
$2,534.00
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$3,620.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$676.94 with CIGNA HEALTH PLAN [178] vs $3,620.00 with UNITED HEALTHCARE [158] — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| CIGNA HEALTH PLAN [178] | NMH CIGNA ALTERNATIVE | $676.94 | ↓ -73% |
| AETNA HEALTH PLAN [171] | NMH AETNA NM EMPLOYEES | $702.28 | ↓ -72% |
| CURAECHOICE [6100] | NMHC CURAECHOICE | $847.08 | ↓ -67% |
| IMAGINE HEALTH [6032] | NMHC IMAGINE HEALTH | $977.40 | ↓ -61% |
| AETNA HEALTH PLAN [171] | NMHC IMAGINE HEALTH | $977.40 | ↓ -61% |
| AETNA HEALTH PLAN [171] | NMH AETNA BP | $1,086.00 | ↓ -57% |
| AETNA HEALTH PLAN [171] | NMH AETNA | $1,158.40 | ↓ -54% |
| AETNA HEALTH PLAN [171] | NMH AETNA ASA | $1,277.86 | ↓ -50% |
| HUMANA HEALTH PLAN [130] | NMH CHS IPA | $1,448.00 | ↓ -43% |
| HUMANA HEALTH PLAN [130] | NMH ADVOCATE IPA | $1,448.00 | ↓ -43% |
| BLUE CROSS BLUE SHIELD [1401] | NMHC SCPP IPA | $1,629.00 | ↓ -36% |
| BLUE CROSS BLUE SHIELD [1401] | NMHC CHWN IPA | $1,629.00 | ↓ -36% |
| HUMANA HEALTH PLAN [130] | NMHC SCPP IPA | $1,629.00 | ↓ -36% |
| CIGNA HEALTH PLAN [178] | NMH CIGNA BROAD | $1,679.68 | ↓ -34% |
| HUMANA HEALTH PLAN [130] | NMHC UIC IPA | $1,810.00 | ↓ -29% |
| HEALTHLINK [125] | NMH SEIU HEALTHLINK | $1,810.00 | ↓ -29% |
| BLUE CROSS BLUE SHIELD [1401] | NMHC UIC IPA | $1,810.00 | ↓ -29% |
| GLOBAL MEDICAL MANAGEMENT INC [6090] | NMHC GMMI | $2,099.60 | ↓ -17% |
| HEALTH'S FINEST NETWORK [126] | NMH HFN PLATINUM/CHC ELITE | $2,353.00 | ↓ -7% |
| MEDPARTNERS [6038] | NMHC MEDPARTNERS | $2,534.00 | ↑ +0% |
| CIGNA HEALTH PLAN [178] | NMH CIGNA BEHAVIORAL HEALTH (EVERNORTH) | $2,896.00 | ↑ +14% |
| MULTIPLAN/PHCS [142] | NMH PHCS PPO | $2,896.00 | ↑ +14% |
| HEALTH'S FINEST NETWORK [126] | NMH HFN/20 EPO | $2,968.40 | ↑ +17% |
| HEALTH'S FINEST NETWORK [126] | NMH HFN/10 PPO | $3,077.00 | ↑ +21% |
| MULTIPLAN/PHCS [142] | NMH NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| MULTIPLAN/PHCS [142] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| HEALTHLINK [125] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| FIRST HEALTH PLAN [6034] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| CIGNA HEALTH PLAN [178] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| BLUE CROSS BLUE SHIELD [1401] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| GALAXY HEALTH NETWORK [220] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| AETNA HEALTH PLAN [171] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| UNITED HEALTHCARE [158] | NMH UHC NON-CONTRACTED OON - ED ONLY | $3,620.00 | ↑ +43% |
| UNITED HEALTHCARE [158] | NMHC NON-CONTRACTED PAYORS | $3,620.00 | ↑ +43% |
| UNITED HEALTHCARE [158] | NMHC UHC REF LAB JOHN DEERE | $3,620.00 | ↑ +43% |
| CIGNA HEALTH PLAN [178] | NMH CIGNA LIFESOURCE TRANSPLANT | not published by hospital | — |
| AETNA HEALTH PLAN [171] | NMH AETNA TRANSPLANT | not published by hospital | — |
| HUMANA HEALTH PLAN [130] | NMH IL HEALTH PARTNERS IPA | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy roof of mouth at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Advocate Illinois Masonic Medical Center | Chicago | not published | $2,238.97 – $6,181.00 |
| Advocate Trinity Hospital | Chicago | not published | $2,238.97 – $6,181.00 |
| MercyOne Genesis Silvis Medical Center | Silvis | $292.20 | $448.04 – $1,399.60 |
| MercyOne Genesis Aledo Medical Center | Aledo | $292.20 | $2,970.16 – $2,970.16 |
| UnityPoint Health - Trinity Moline | Rock Island | $364.80 | $100.40 – $1,152.38 |
| SSM Health Good Samaritan Hospital - Mt. Vernon | Mount Vernon | $1,267.75 | $1,662.71 – $1,745.84 |
| SSM Health St. Mary's Hospital - Centralia | Centralia | $1,267.75 | not published |
| Northwestern Medicine Central DuPage Hospital | IL 60190 | $2,534.00 | not published |