New Patient Office Visit (level 5) at Advocate Sherman Hospital
1425 North Randall Road, Elgin, IL · Advocate Health · · NPI 1629026364
$207.50
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.
$415.00
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.
$105.00 with Cigna One Health vs $373.50 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 |
|---|---|---|---|
| Cigna One Health | Commercial | $105.00 | ↓ -49% |
| Cigna | Commercial | $111.00 | ↓ -47% |
| Blue Cross Blue Shield City of Chicago | Commercial | $115.38 | ↓ -44% |
| Blue Cross Blue Shield Choice | Commercial | $124.68 | ↓ -40% |
| Blue Cross Blue Shield | PPO | $131.24 | ↓ -37% |
| Advocate Employee | Commercial | $163.51 | ↓ -21% |
| United Healthcare Charter | Commercial | $197.13 | ↓ -5% |
| United Healthcare Core Navigate | Commercial | $218.29 | ↑ +5% |
| United Healthcare Nexus | Commercial | $224.10 | ↑ +8% |
| Blue Cross Blue Shield Blue Precision | Managed Care | $237.38 | ↑ +14% |
| Aetna | Commercial | $240.16 | ↑ +16% |
| Blue Cross Blue Shield | HMO | $241.95 | ↑ +17% |
| United Healthcare | HMO | $249.00 | ↑ +20% |
| Private Healthcare Systems | Commercial | $336.15 | ↑ +62% |
| Multiplan | Commercial | $373.50 | ↑ +80% |
| HSTechnology | Medicare Advantage | not published by hospital | — |
| Oscar Health HMO | Medicare Advantage | not published by hospital | — |
| Ambetter | Medicare Advantage | not published by hospital | — |
| Molina | Medicare Advantage | not published by hospital | — |
Visitor-reported prices
Comments
New Patient Office Visit (level 5) at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $277.80 | $68.61 – $261.28 |
| MercyOne Genesis Aledo Medical Center | Aledo | $277.80 | $463.00 – $2,970.16 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $166.25 | not published |
| Advocate Christ Medical Center | Oak Lawn | $207.50 | $105.00 – $332.00 |
| Northwestern Memorial Hospital | Chicago | $640.50 | not published |
| Advocate Condell Medical Center | Libertyville | $207.50 | $105.00 – $332.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $207.50 | $84.00 – $332.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $367.20 | $165.20 – $341.28 |