Egd/remov tum/polyp/hot bx forcep 43250 at Northwestern Medicine Palos Hospital
12251 S. 80th Ave., Palos Heights, IL · Nm · · NPI 1043600026
$5,427.69
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.
$7,753.84
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.
$716.00 with BLUE CROSS BLUE SHIELD [1401] vs $4,475.00 with CIGNA HEALTH PLAN [178] — 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 [1401] | PH BCBS BLUECHOICE PREFERRED | $716.00 | ↓ -87% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE OPTIONS | $716.00 | ↓ -87% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE OPTIONS SELECT | $716.00 | ↓ -87% |
| CIGNA HEALTH PLAN [178] | PH CIGNA ALTERNATIVE | $836.83 | ↓ -85% |
| ALTERNATE BLUE CROSS [1402] | PH BCBS PPO | $859.20 | ↓ -84% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS PPO | $859.20 | ↓ -84% |
| AETNA HEALTH PLAN [171] | PH AETNA NM EMPLOYEES | $962.13 | ↓ -82% |
| CIGNA HEALTH PLAN [178] | PH CIGNA BROAD | $1,324.60 | ↓ -76% |
| AETNA HEALTH PLAN [171] | PH AETNA IL PREFERRED | $1,517.03 | ↓ -72% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS HMO | $1,751.07 | ↓ -68% |
| ALTERNATE BLUE CROSS [1402] | PH BCBS HMO | $1,751.07 | ↓ -68% |
| AETNA HEALTH PLAN [171] | PH AETNA | $1,888.45 | ↓ -65% |
| FIRST HEALTH PLAN [6034] | PH AETNA | $1,888.45 | ↓ -65% |
| UNITED HEALTHCARE [158] | PH UHC CORE | $2,137.00 | ↓ -61% |
| CARELON BEHAVIORAL HEALTH [159] | PH VALUE OPTIONS BHO | $2,237.50 | ↓ -59% |
| HEALTHLINK [125] | PH SEIU HEALTHLINK | $2,237.50 | ↓ -59% |
| UNITED HEALTHCARE [158] | PH UHC ALL OTHER | $2,374.00 | ↓ -56% |
| MAGELLAN BEHAVIORAL HLTH [136] | PH MAGELLAN BHS | $2,685.00 | ↓ -51% |
| THE ALLIANCE [1703] | PH THE ALLIANCE | $2,874.29 | ↓ -47% |
| MULTIPLAN/PHCS [142] | PH MULTIPLAN/PHCS | $3,132.50 | ↓ -42% |
| COMPSYCH [112] | PH COMPSYCH | $3,356.25 | ↓ -38% |
| FIRST HEALTH PLAN [6034] | PH FIRST HEALTH | $3,356.25 | ↓ -38% |
| CIGNA HEALTH PLAN [178] | PH CIGNA BEHAVIORAL BHS | $3,580.00 | ↓ -34% |
| BEECHSTREET [176] | PH BEECHSTREET | $3,580.00 | ↓ -34% |
| HEALTH'S FINEST NETWORK [126] | PH HFN | $3,803.75 | ↓ -30% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS PAR/INDEMNITY ADP | $4,475.00 | ↓ -18% |
| GLOBAL EXCEL [1712] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| MULTIPLAN/PHCS [142] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| UNITED HEALTHCARE [158] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| UNITED HEALTHCARE [158] | PH UHC NON-CONTRACTED OON - ED ONLY | $4,475.00 | ↓ -18% |
| AETNA HEALTH PLAN [171] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| GALAXY HEALTH NETWORK [220] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| HEALTH ALLIANCE [181] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| HEALTHLINK [125] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| CIGNA HEALTH PLAN [178] | PH NON-CONTRACTED PAYORS | $4,475.00 | ↓ -18% |
| OPTUM/UNITED BEHAVIORAL HEALTH [157] | PH UBH BHS | not published by hospital | — |
| GLOBAL EXCEL [1712] | PH MEDICARE | not published by hospital | — |
| ALTERNATE BLUE CROSS MEDICARE ADV [2304] | PH MEDICARE | not published by hospital | — |
Visitor-reported prices
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Egd/remov tum/polyp/hot bx forcep 43250 at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $876.60 | $988.61 – $1,344.12 |
| MercyOne Genesis Aledo Medical Center | Aledo | $876.60 | $2,677.41 – $2,970.16 |
| Northwestern Memorial Hospital | Chicago | $12,889.18 | not published |
| UnityPoint Health - Trinity Moline | Rock Island | $1,059.20 | $151.30 – $1,475.78 |
| Northwestern Medicine Central DuPage Hospital | IL 60190 | $2,141.30 | not published |
| Northwestern Medicine Valley West Hospital | Sandwich | $12,889.18 | $249.70 – $249.70 |
| Northwestern Medicine Delnor Hospital | Geneva | $2,141.30 | not published |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | not published | $576.00 – $3,331.27 |