Biopsy roof of mouth at Northwestern Medicine McHenry Hospital
4201 Medical Center Drive, McHenry, IL · Nm · · NPI 1427065499
$22,752.43
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.
$32,503.47
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.
$698.66 with AETNA HEALTH PLAN [171] vs $3,620.00 with BLUE CROSS BLUE SHIELD [1401] — 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 |
|---|---|---|---|
| AETNA HEALTH PLAN [171] | NWR AETNA NM EMPLOYEES | $698.66 | ↓ -97% |
| CIGNA HEALTH PLAN [178] | NWR CIGNA ALTERNATIVE | $713.14 | ↓ -97% |
| UNITED HEALTHCARE [158] | NWR UHC CORE | $1,068.50 | ↓ -95% |
| MERCY CARE HEALTH PLANS [5013] | NWR MERCY CARE | $1,098.67 | ↓ -95% |
| CIGNA HEALTH PLAN [178] | NWR CIGNA BROAD | $1,118.58 | ↓ -95% |
| UNITED HEALTHCARE [158] | NWR UHC HMO/PPO | $1,187.00 | ↓ -95% |
| AETNA HEALTH PLAN [171] | NWR AETNA APCN/SP | $1,245.28 | ↓ -95% |
| AETNA HEALTH PLAN [171] | NWR AETNA IL PREFERRED | $1,285.10 | ↓ -94% |
| ALTERNATE BLUE CROSS [1402] | NWR BCBS HMO | $1,291.62 | ↓ -94% |
| BLUE CROSS BLUE SHIELD [1401] | NWR BCBS HMO | $1,291.62 | ↓ -94% |
| AETNA HEALTH PLAN [171] | NWR AETNA | $1,762.94 | ↓ -92% |
| HEALTHLINK [125] | NWR SEIU HEALTHLINK | $1,810.00 | ↓ -92% |
| AETNA HEALTH PLAN [171] | NWR AETNA ASA | $1,900.50 | ↓ -92% |
| CHOICECARE [177] | NWR CHOICE CARE | $1,925.84 | ↓ -92% |
| MULTIPLAN/PHCS [142] | NWR PHCS PPO | $1,991.00 | ↓ -91% |
| THE ALLIANCE [1703] | NWR THE ALLIANCE | $2,325.13 | ↓ -90% |
| HEALTH'S FINEST NETWORK [126] | NWR HFN PLATINUM EPO | $2,534.00 | ↓ -89% |
| HEALTH'S FINEST NETWORK [126] | NWR HFN PPO | $2,642.60 | ↓ -88% |
| CIGNA HEALTH PLAN [178] | NWR CIGNA BEHAVORIAL BHS | $2,715.00 | ↓ -88% |
| BEECHSTREET [176] | NWR BEECHSTREET | $2,896.00 | ↓ -87% |
| MULTIPLAN/PHCS [142] | NWR NON-CONTRACTED PAYORS | $3,620.00 | ↓ -84% |
| BLUE CROSS BLUE SHIELD [1401] | NWR BCBS PAR/INDEMNITY ADP | $3,620.00 | ↓ -84% |
| BLUE CROSS BLUE SHIELD [1401] | NWR BCBS BLUECHOICE OPTIONS | not published by hospital | — |
| GLOBAL EXCEL [1712] | NWR MEDICARE | not published by hospital | — |
| BLUE CROSS BLUE SHIELD [1401] | NWR BCBS PPO | not published by hospital | — |
| BLUE CROSS BLUE SHIELD [1401] | NWR BCBS BLUECHOICE PREFERRED | not published by hospital | — |
| ALTERNATE BLUE CROSS [1402] | NWR BCBS PPO | not published by hospital | — |
| ALTERNATE BLUE CROSS MEDICARE ADV [2304] | NWR BLUE CROSS MEDICARE ADVT | not published by hospital | — |
| ALTERNATE HUMANA MEDICARE ADV [2409] | NWR HUMANA MEDICARE ADVT | not published by hospital | — |
| BLUE CROSS BLUE SHIELD [1401] | NWR BCBS BLUECHOICE SELECT | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy roof of mouth at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| 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 |
| Northwestern Memorial Hospital | Chicago | $2,534.00 | not published |
| 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 |
| Northwestern Medicine Palos Hospital | Palos Heights | $2,534.00 | not published |