Ampicillin-sulbactam 1.5 gram solution for injection at Northwestern Medicine Marianjoy Rehabilitation Hospital

26W171 Roosevelt Road, Wheaton, IL · Nm · · NPI 1083660658

Source: hospital's published price file ↗ · Published Apr 1, 2026 · Ingested Sep 17, 2026

$37.62

Cash price

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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.

$53.75

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$20.06 with AETNA HEALTH PLAN [171] vs $47.75 with HUMANA HEALTH PLAN [130] — 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 →

Payer
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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
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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] MRH IMAGINE HEALTH $20.06 ↓ -47%
IMAGINE HEALTH [6032] MRH IMAGINE HEALTH $20.06 ↓ -47%
AETNA HEALTH PLAN [171] MRH AETNA NM EMPLOYEES $22.44 ↓ -40%
UNITED HEALTHCARE [158] MRH UHC CORE $23.16 ↓ -38%
UNITED HEALTHCARE [158] MRH UHC ALL OTHER $23.21 ↓ -38%
CIGNA HEALTH PLAN [178] MRH CIGNA BROAD $23.88 ↓ -37%
THE ALLIANCE [1703] MRH THE ALLIANCE $25.95 ↓ -31%
BLUE CROSS BLUE SHIELD [1401] MRH BCBS BLUECHOICE OPTIONS $26.02 ↓ -31%
BLUE CROSS BLUE SHIELD [1401] MRH BCBS BLUECHOICE PREFERRED $26.02 ↓ -31%
BLUE CROSS BLUE SHIELD [1401] MRH BCBS BLUECHOICE SELECT $26.02 ↓ -31%
BLUE CROSS BLUE SHIELD [1401] MRH BCBS PAR/INDEMNITY ADP $26.69 ↓ -29%
FIRST HEALTH PLAN [6034] MRH AETNA $26.84 ↓ -29%
AETNA HEALTH PLAN [171] MRH AETNA $26.84 ↓ -29%
ALTERNATE BLUE CROSS [1402] MRH BCBS HMO $27.91 ↓ -26%
BLUE CROSS BLUE SHIELD [1401] MRH BCBS HMO $27.91 ↓ -26%
BLUE CROSS BLUE SHIELD [1401] MRH DREYER - IPA $28.65 ↓ -24%
HUMANA HEALTH PLAN [130] MRH DREYER - IPA $28.65 ↓ -24%
HUMANA HEALTH PLAN [130] MRH UNIVERSITY OF IL MED CENTER - IPA $28.65 ↓ -24%
BLUE CROSS BLUE SHIELD [1401] MRH UNIVERSITY OF IL MED CENTER - IPA $28.65 ↓ -24%
CIGNA HEALTH PLAN [178] MRH CIGNA NARROW $28.65 ↓ -24%
BLUE CROSS BLUE SHIELD [1401] MRH BCBS PPO $29.32 ↓ -22%
ALTERNATE BLUE CROSS [1402] MRH BCBS PPO $29.32 ↓ -22%
HEALTHLINK [125] MRH SEIU HEALTHLINK $30.08 ↓ -20%
BLUE CROSS BLUE SHIELD [1401] MRH LOYOLA UNIVERSITY MED CENTER - IPA $31.04 ↓ -17%
HUMANA HEALTH PLAN [130] MRH DUPAGE MEDICAL GROUP (IHP) $31.04 ↓ -17%
BLUE CROSS BLUE SHIELD [1401] MRH DUPAGE MEDICAL GROUP (IHP) $31.04 ↓ -17%
FIRST HEALTH PLAN [6034] MRH FIRST HEALTH $31.94 ↓ -15%
MULTIPLAN/PHCS [142] MRH PHCS $38.20 ↑ +2%
HEALTH'S FINEST NETWORK [126] MRH HFN $41.54 ↑ +10%
MULTIPLAN/PHCS [142] MRH NON-CONTRACTED PAYORS $47.75 ↑ +27%
FIRST HEALTH PLAN [6034] MRH NON-CONTRACTED PAYORS $47.75 ↑ +27%
UNITED HEALTHCARE [158] MRH NON-CONTRACTED PAYORS $47.75 ↑ +27%
AETNA HEALTH PLAN [171] MRH NON-CONTRACTED PAYORS $47.75 ↑ +27%
HUMANA HEALTH PLAN [130] MRH NON-CONTRACTED PAYORS $47.75 ↑ +27%
ALTERNATE HUMANA MEDICARE ADV [2409] MRH MEDICARE not published by hospital
ALTERNATE BLUE CROSS MEDICARE ADV [2304] MRH MEDICARE not published by hospital
GLOBAL EXCEL [1712] MRH MEDICARE not published by hospital

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Ampicillin-sulbactam 1.5 gram solution for injection at other Illinois hospitals

Hospital City Cash price Negotiated range
MercyOne Genesis Silvis Medical Center Silvis $87.97 $18.77 – $51.03
MercyOne Genesis Aledo Medical Center Aledo $87.97 $5.38 – $27.57
Uchicago Medicine Adventhealth Hinsdale Hinsdale $49.89 $3.92 – $3.92
Advocate Christ Medical Center Oak Lawn $64.48 $3.20 – $49.70
Northwestern Memorial Hospital Chicago $185.85 not published
Advocate Condell Medical Center Libertyville $64.50 $4.04 – $53.24
Advocate Good Samaritan Hospital Downers Grove $64.50 $3.20 – $51.70
UnityPoint Health - Trinity Moline Rock Island $74.79 $0.14 – $7.28

All Illinois hospitals for this procedure →