Complx repair enel addl 5cm/< 13153 at HSHS St. Joseph's Hospital
12866 TROXLER AVE, HIGHLAND, IL · Hshs · · NPI 1447352323
$185.04
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.
$257.00
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.
$51.40 with MOLINA HEALTHCARE vs $2,555.78 with MERIDIAN HEALTH PLAN — 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 |
|---|---|---|---|
| MOLINA HEALTHCARE | MOLINA MEDICARE | $51.40 | ↓ -72% |
| CLEAR SPRING HEALTH OF ILLINOIS | CLEAR SPRING HEALTH MEDICARE ADV | $51.40 | ↓ -72% |
| AETNA | AETNA MEDICARE | $51.40 | ↓ -72% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MEDICARE | $51.40 | ↓ -72% |
| SAE HOSPICE | SAE MEMORIAL HOSPICE | $51.40 | ↓ -72% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $51.40 | ↓ -72% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV | $51.40 | ↓ -72% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MMAI | $51.40 | ↓ -72% |
| HUMANA | HUMANA MEDICARE | $51.40 | ↓ -72% |
| AMISH COMMUNITY | PLAIN CHURCH MEDICAL GROUP | $71.96 | ↓ -61% |
| AMISH COMMUNITY | AMISH COMMUNITY DISCOUNT | $71.96 | ↓ -61% |
| NAPHCARE | ALL COMMERICAL NAPHCARE | $107.94 | ↓ -42% |
| CELTIC INSURANCE COMPANY | ALL COMMERCIAL EXCHANGE AMBETTER | $113.08 | ↓ -39% |
| HOPETRUST | ALL COMMERCIAL HOPETRUST | $128.50 | ↓ -31% |
| CLAIM DOC | ALL COMMERCIAL CLAIM DOC | $128.50 | ↓ -31% |
| AETNA | AETNA HSHS | $154.20 | ↓ -17% |
| WELLFIRST | ALL COMMERCIAL WELLFIRST | $164.53 | ↓ -11% |
| CIGNA | ALL COMMERCIAL CIGNA | $174.76 | ↓ -6% |
| AETNA | ALL COMMERCIAL AETNA | $179.64 | ↓ -3% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $189.92 | ↑ +3% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK | $218.45 | ↑ +18% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $218.45 | ↑ +18% |
| HEALTHLINK | ST CLAIR COUNTY HOUSING AUTHORITY | $218.45 | ↑ +18% |
| HEALTHLINK | HEALTHLINK CASINO QUEEN | $218.45 | ↑ +18% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK - PPO | $218.45 | ↑ +18% |
| PROVIDER NETWORK OF AMERICA | ALL COMMERCIAL PROVIDER NETWORK OF AMERICA | $231.30 | ↑ +25% |
| HEALTHCARE FINEST NETWORK (HFN) | ALL COMMERCIAL HFN | $231.30 | ↑ +25% |
| QTC MEDICAL GROUP OF ILLINOIS | QTC MEDICAL GROUP OF ILLINOIS | $257.00 | ↑ +39% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $257.00 | ↑ +39% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $257.00 | ↑ +39% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $257.00 | ↑ +39% |
| CONSOCIATE GROUP | ALL COMMERCIAL CONSOCIATE GROUP | $257.00 | ↑ +39% |
| CURRENT HEALTH SOLUTIONS | ALL COMMERCIAL CURRENT HEALTH SOLUTIONS | $257.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE KINGERY | $257.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MARKET PLACE | $257.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MEDICARE | $257.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE PPO | $257.00 | ↑ +39% |
| HEALTHSCOPE | ALL COMMERCIAL HEALTHSCOPE | $257.00 | ↑ +39% |
| ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | $257.00 | ↑ +39% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $257.00 | ↑ +39% |
| MENTAL HEALTH NETWORK | NETWORK HEALTH LIBERTAS | $257.00 | ↑ +39% |
| UNITED HEALTHCARE | UHC MEDICAID | $257.00 | ↑ +39% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $2,555.78 | ↑ +1281% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS OF ILLINOIS PPO | not published by hospital | — |
| BLUE CROSS SIHCA | BLUE CROSS BLUE SHIELD IL HMO SIHCA | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO 470 | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL HMO PHAI | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL BLUE CHOICE PLANS | 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 |
| Advocate Sherman Hospital | Elgin | $465.00 | $284.58 – $837.00 |