Ot evaluation high complexity patient/family at Advocate Good Samaritan Hospital
3815 Highland Avenue, Downers Grove, IL · Advocate Health · · NPI 1578670543
$230.00
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.
$460.00
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.
$33.49 with Advocate Employee vs $469.00 with United Healthcare — 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 |
|---|---|---|---|
| Advocate Employee | Commercial | $33.49 | ↓ -85% |
| Cigna One Health | Commercial | $44.20 | ↓ -81% |
| Aetna | Commercial | $45.86 | ↓ -80% |
| Private Healthcare Systems | Commercial | $52.70 | ↓ -77% |
| Cigna | Commercial | $56.10 | ↓ -76% |
| Blue Cross Blue Shield Blue Precision | Managed Care | $65.71 | ↓ -71% |
| Blue Cross Blue Shield | HMO | $66.98 | ↓ -71% |
| Multiplan | Commercial | $68.00 | ↓ -70% |
| Ambetter | Medicare Advantage | $149.93 | ↓ -35% |
| Molina | Medicare Advantage | $149.93 | ↓ -35% |
| Oscar Health HMO | Medicare Advantage | $155.10 | ↓ -33% |
| HSTechnology | Medicare Advantage | $198.53 | ↓ -14% |
| United Healthcare Charter | Commercial | $238.00 | ↑ +3% |
| United Healthcare Nexus | Commercial | $274.00 | ↑ +19% |
| Blue Cross Blue Shield City of Chicago | Commercial | $384.11 | ↑ +67% |
| United Healthcare Core Navigate | Commercial | $405.00 | ↑ +76% |
| Blue Cross Blue Shield Choice | Commercial | $415.38 | ↑ +81% |
| Blue Cross Blue Shield | PPO | $437.18 | ↑ +90% |
| United Healthcare | HMO | $469.00 | ↑ +104% |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $249.00 | $44.80 – $278.27 |
| MercyOne Genesis Aledo Medical Center | Aledo | $258.60 | $69.30 – $72.38 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $100.00 | $100.32 – $166.00 |
| Advocate Christ Medical Center | Oak Lawn | $230.00 | $33.49 – $469.00 |
| Advocate Condell Medical Center | Libertyville | $230.00 | $33.49 – $295.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $241.64 | $87.28 – $156.21 |
| Uchicago Medicine Adventhealth La Grange | La Grange | $100.00 | $100.32 – $166.00 |
| SSM Health Good Samaritan Hospital - Mt. Vernon | Mount Vernon | $342.65 | $102.47 – $107.59 |