Complx repair enel addl 5cm/< 13153 at Advocate Sherman Hospital
1425 North Randall Road, Elgin, IL · Advocate Health · · NPI 1629026364
$465.00
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.
$930.00
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.
$284.58 with Blue Cross Blue Shield City of Chicago vs $837.00 with Multiplan — 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 |
|---|---|---|---|
| Blue Cross Blue Shield City of Chicago | Commercial | $284.58 | ↓ -39% |
| Blue Cross Blue Shield Choice | Commercial | $306.90 | ↓ -34% |
| Blue Cross Blue Shield | PPO | $323.64 | ↓ -30% |
| Advocate Employee | Commercial | $366.42 | ↓ -21% |
| Blue Cross Blue Shield Blue Precision | Managed Care | $455.70 | ↓ -2% |
| Blue Cross Blue Shield | HMO | $464.07 | ↓ -0% |
| Cigna One Health | Commercial | $483.60 | ↑ +4% |
| Aetna | Commercial | $538.19 | ↑ +16% |
| Private Healthcare Systems | Commercial | $753.30 | ↑ +62% |
| Multiplan | Commercial | $837.00 | ↑ +80% |
| Cigna | Commercial | not published by hospital | — |
| HSTechnology | Medicare Advantage | not published by hospital | — |
| United Healthcare Nexus | Commercial | not published by hospital | — |
| United Healthcare | HMO | not published by hospital | — |
| United Healthcare Charter | Commercial | not published by hospital | — |
| United Healthcare Core Navigate | Commercial | not published by hospital | — |
| Oscar Health HMO | Medicare Advantage | not published by hospital | — |
| Molina | Medicare Advantage | not published by hospital | — |
| Ambetter | Medicare Advantage | not published by hospital | — |
Visitor-reported prices
Comments
Complx repair enel addl 5cm/< 13153 at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $354.60 | $59.84 – $172.04 |
| MercyOne Genesis Aledo Medical Center | Aledo | $354.60 | $84.15 – $87.89 |
| Advocate Condell Medical Center | Libertyville | $465.00 | $366.42 – $744.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $541.50 | $122.18 – $324.17 |
| SSM Health Good Samaritan Hospital - Mt. Vernon | Mount Vernon | $455.40 | not published |
| Advocate Illinois Masonic Medical Center | Chicago | $465.00 | $366.42 – $747.72 |
| Advocate Childrens Hospital - Park Ridge | Park Ridge | $465.00 | $366.42 – $744.00 |
| SSM Health St. Mary's Hospital - Centralia | Centralia | $455.40 | not published |