Pr biopsy skin punch single lesion at Northwestern Medicine Palos Hospital
12251 S. 80th Ave., Palos Heights, IL · Nm · · NPI 1043600026
$438.20
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.
$626.00
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.
$100.16 with BLUE CROSS BLUE SHIELD [1401] vs $626.00 with UNITED HEALTHCARE [158] — 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 | $100.16 | ↓ -77% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE PREFERRED | $100.16 | ↓ -77% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE OPTIONS SELECT | $100.16 | ↓ -77% |
| CIGNA HEALTH PLAN [178] | PH CIGNA ALTERNATIVE | $117.06 | ↓ -73% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS PPO | $120.19 | ↓ -73% |
| ALTERNATE BLUE CROSS [1402] | PH BCBS PPO | $120.19 | ↓ -73% |
| AETNA HEALTH PLAN [171] | PH AETNA NM EMPLOYEES | $134.59 | ↓ -69% |
| CIGNA HEALTH PLAN [178] | PH CIGNA BROAD | $185.30 | ↓ -58% |
| AETNA HEALTH PLAN [171] | PH AETNA IL PREFERRED | $212.21 | ↓ -52% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS HMO | $244.95 | ↓ -44% |
| ALTERNATE BLUE CROSS [1402] | PH BCBS HMO | $244.95 | ↓ -44% |
| HEALTHLINK [125] | PH SEIU HEALTHLINK | $313.00 | ↓ -29% |
| CARELON BEHAVIORAL HEALTH [159] | PH VALUE OPTIONS BHO | $313.00 | ↓ -29% |
| FIRST HEALTH PLAN [6034] | PH AETNA | $355.57 | ↓ -19% |
| AETNA HEALTH PLAN [171] | PH AETNA | $355.57 | ↓ -19% |
| MAGELLAN BEHAVIORAL HLTH [136] | PH MAGELLAN BHS | $375.60 | ↓ -14% |
| THE ALLIANCE [1703] | PH THE ALLIANCE | $402.08 | ↓ -8% |
| MULTIPLAN/PHCS [142] | PH MULTIPLAN/PHCS | $438.20 | ↑ +0% |
| COMPSYCH [112] | PH COMPSYCH | $469.50 | ↑ +7% |
| FIRST HEALTH PLAN [6034] | PH FIRST HEALTH | $469.50 | ↑ +7% |
| BEECHSTREET [176] | PH BEECHSTREET | $500.80 | ↑ +14% |
| CIGNA HEALTH PLAN [178] | PH CIGNA BEHAVIORAL BHS | $500.80 | ↑ +14% |
| HEALTH'S FINEST NETWORK [126] | PH HFN | $532.10 | ↑ +21% |
| BLUE CROSS BLUE SHIELD [1401] | PH BCBS PAR/INDEMNITY ADP | $626.00 | ↑ +43% |
| CIGNA HEALTH PLAN [178] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| GLOBAL EXCEL [1712] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| HEALTHLINK [125] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| UNITED HEALTHCARE [158] | PH UHC NON-CONTRACTED OON - ED ONLY | $626.00 | ↑ +43% |
| GALAXY HEALTH NETWORK [220] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| HEALTH ALLIANCE [181] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| MULTIPLAN/PHCS [142] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| AETNA HEALTH PLAN [171] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| UNITED HEALTHCARE [158] | PH NON-CONTRACTED PAYORS | $626.00 | ↑ +43% |
| ALTERNATE BLUE CROSS MEDICARE ADV [2304] | PH MEDICARE | not published by hospital | — |
| GLOBAL EXCEL [1712] | PH MEDICARE | not published by hospital | — |
| OPTUM/UNITED BEHAVIORAL HEALTH [157] | PH UBH BHS | not published by hospital | — |
Visitor-reported prices
Comments
Pr biopsy skin punch single lesion at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $371.40 | $68.61 – $624.72 |
| MercyOne Genesis Aledo Medical Center | Aledo | $201.60 | $1,149.82 – $2,970.16 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $175.00 | $426.48 – $705.72 |
| Advocate Christ Medical Center | Oak Lawn | $390.00 | $307.32 – $6,291.00 |
| Northwestern Memorial Hospital | Chicago | $1,533.00 | not published |
| Advocate Condell Medical Center | Libertyville | $402.50 | $317.17 – $4,528.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $212.50 | $167.45 – $6,291.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $393.84 | $42.21 – $310.82 |