Established Patient Office Visit (level 3) at Northwestern Medicine Palos Hospital
12251 S. 80th Ave., Palos Heights, IL · Nm · · NPI 1043600026
$291.20
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.
$416.00
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.
$34.56 with BLUE CROSS BLUE SHIELD [1401] vs $216.00 with AETNA HEALTH PLAN [171] — 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 OPTIONS | $34.56 | ↓ -88% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE PREFERRED | $34.56 | ↓ -88% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE OPTIONS SELECT | $34.56 | ↓ -88% |
| CIGNA HEALTH PLAN [178] | PH CIGNA ALTERNATIVE | $40.39 | ↓ -86% |
| ALTERNATE BLUE CROSS [1402] | PH BCBS PPO | $41.47 | ↓ -86% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS PPO | $41.47 | ↓ -86% |
| AETNA HEALTH PLAN [171] | PH AETNA NM EMPLOYEES | $46.44 | ↓ -84% |
| CIGNA HEALTH PLAN [178] | PH CIGNA BROAD | $63.94 | ↓ -78% |
| AETNA HEALTH PLAN [171] | PH AETNA IL PREFERRED | $73.22 | ↓ -75% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS HMO | $84.52 | ↓ -71% |
| ALTERNATE BLUE CROSS [1402] | PH BCBS HMO | $84.52 | ↓ -71% |
| UNITED HEALTHCARE [158] | PH UHC CORE | $97.85 | ↓ -66% |
| HEALTHLINK [125] | PH SEIU HEALTHLINK | $108.00 | ↓ -63% |
| CARELON BEHAVIORAL HEALTH [159] | PH VALUE OPTIONS BHO | $108.00 | ↓ -63% |
| UNITED HEALTHCARE [158] | PH UHC ALL OTHER | $110.38 | ↓ -62% |
| AETNA HEALTH PLAN [171] | PH AETNA | $122.69 | ↓ -58% |
| FIRST HEALTH PLAN [6034] | PH AETNA | $122.69 | ↓ -58% |
| MAGELLAN BEHAVIORAL HLTH [136] | PH MAGELLAN BHS | $129.60 | ↓ -55% |
| THE ALLIANCE [1703] | PH THE ALLIANCE | $138.74 | ↓ -52% |
| MULTIPLAN/PHCS [142] | PH MULTIPLAN/PHCS | $151.20 | ↓ -48% |
| COMPSYCH [112] | PH COMPSYCH | $162.00 | ↓ -44% |
| FIRST HEALTH PLAN [6034] | PH FIRST HEALTH | $162.00 | ↓ -44% |
| CIGNA HEALTH PLAN [178] | PH CIGNA BEHAVIORAL BHS | $172.80 | ↓ -41% |
| BEECHSTREET [176] | PH BEECHSTREET | $172.80 | ↓ -41% |
| HEALTH'S FINEST NETWORK [126] | PH HFN | $183.60 | ↓ -37% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS PAR/INDEMNITY ADP | $216.00 | ↓ -26% |
| GLOBAL EXCEL [1712] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| MULTIPLAN/PHCS [142] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| UNITED HEALTHCARE [158] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| UNITED HEALTHCARE [158] | PH UHC NON-CONTRACTED OON - ED ONLY | $216.00 | ↓ -26% |
| CIGNA HEALTH PLAN [178] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| GALAXY HEALTH NETWORK [220] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| HEALTH ALLIANCE [181] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| HEALTHLINK [125] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| AETNA HEALTH PLAN [171] | PH NON-CONTRACTED PAYORS | $216.00 | ↓ -26% |
| OPTUM/UNITED BEHAVIORAL HEALTH [157] | PH UBH BHS | not published by hospital | — |
| ALTERNATE BLUE CROSS MEDICARE ADV [2304] | PH MEDICARE | not published by hospital | — |
| GLOBAL EXCEL [1712] | PH MEDICARE | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $117.60 | $62.72 – $149.96 |
| MercyOne Genesis Aledo Medical Center | Aledo | $117.60 | $77.00 – $92.12 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $87.50 | not published |
| Advocate Christ Medical Center | Oak Lawn | $147.50 | $102.96 – $236.00 |
| Northwestern Memorial Hospital | Chicago | $291.20 | not published |
| Advocate Condell Medical Center | Libertyville | $147.50 | $105.00 – $236.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $147.50 | $84.00 – $236.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $160.80 | $60.36 – $152.67 |