Biopsy vestibule of mouth 40808 at Northwestern Medicine Marianjoy Rehabilitation Hospital
26W171 Roosevelt Road, Wheaton, IL · Nm · · NPI 1083660658
$1,097.60
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.
$1,568.00
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.
$658.56 with IMAGINE HEALTH [6032] vs $1,568.00 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 |
|---|---|---|---|
| IMAGINE HEALTH [6032] | MRH IMAGINE HEALTH | $658.56 | ↓ -40% |
| AETNA HEALTH PLAN [171] | MRH IMAGINE HEALTH | $658.56 | ↓ -40% |
| AETNA HEALTH PLAN [171] | MRH AETNA NM EMPLOYEES | $736.96 | ↓ -33% |
| CIGNA HEALTH PLAN [178] | MRH CIGNA BROAD | $784.00 | ↓ -29% |
| THE ALLIANCE [1703] | MRH THE ALLIANCE | $852.21 | ↓ -22% |
| BLUE CROSS BLUE SHIELD [1401] | MRH BCBS BLUECHOICE SELECT | $854.56 | ↓ -22% |
| BLUE CROSS BLUE SHIELD [1401] | MRH BCBS BLUECHOICE OPTIONS | $854.56 | ↓ -22% |
| BLUE CROSS BLUE SHIELD [1401] | MRH BCBS BLUECHOICE PREFERRED | $854.56 | ↓ -22% |
| BLUE CROSS BLUE SHIELD [1401] | MRH BCBS PAR/INDEMNITY ADP | $876.51 | ↓ -20% |
| BLUE CROSS BLUE SHIELD [1401] | MRH BCBS HMO | $916.34 | ↓ -17% |
| ALTERNATE BLUE CROSS [1402] | MRH BCBS HMO | $916.34 | ↓ -17% |
| CIGNA HEALTH PLAN [178] | MRH CIGNA NARROW | $940.80 | ↓ -14% |
| BLUE CROSS BLUE SHIELD [1401] | MRH DREYER - IPA | $940.80 | ↓ -14% |
| HUMANA HEALTH PLAN [130] | MRH DREYER - IPA | $940.80 | ↓ -14% |
| BLUE CROSS BLUE SHIELD [1401] | MRH UNIVERSITY OF IL MED CENTER - IPA | $940.80 | ↓ -14% |
| HUMANA HEALTH PLAN [130] | MRH UNIVERSITY OF IL MED CENTER - IPA | $940.80 | ↓ -14% |
| UNITED HEALTHCARE [158] | MRH UHC CORE | $943.94 | ↓ -14% |
| ALTERNATE BLUE CROSS [1402] | MRH BCBS PPO | $962.75 | ↓ -12% |
| BLUE CROSS BLUE SHIELD [1401] | MRH BCBS PPO | $962.75 | ↓ -12% |
| HEALTHLINK [125] | MRH SEIU HEALTHLINK | $987.84 | ↓ -10% |
| BLUE CROSS BLUE SHIELD [1401] | MRH LOYOLA UNIVERSITY MED CENTER - IPA | $1,019.20 | ↓ -7% |
| FIRST HEALTH PLAN [6034] | MRH FIRST HEALTH | $1,048.99 | ↓ -4% |
| UNITED HEALTHCARE [158] | MRH UHC ALL OTHER | $1,052.13 | ↓ -4% |
| MULTIPLAN/PHCS [142] | MRH PHCS | $1,254.40 | ↑ +14% |
| HEALTH'S FINEST NETWORK [126] | MRH HFN | $1,364.16 | ↑ +24% |
| AETNA HEALTH PLAN [171] | MRH NON-CONTRACTED PAYORS | $1,568.00 | ↑ +43% |
| FIRST HEALTH PLAN [6034] | MRH NON-CONTRACTED PAYORS | $1,568.00 | ↑ +43% |
| HUMANA HEALTH PLAN [130] | MRH NON-CONTRACTED PAYORS | $1,568.00 | ↑ +43% |
| MULTIPLAN/PHCS [142] | MRH NON-CONTRACTED PAYORS | $1,568.00 | ↑ +43% |
| UNITED HEALTHCARE [158] | MRH NON-CONTRACTED PAYORS | $1,568.00 | ↑ +43% |
| GLOBAL EXCEL [1712] | MRH MEDICARE | not published by hospital | — |
| ALTERNATE HUMANA MEDICARE ADV [2409] | MRH MEDICARE | not published by hospital | — |
| ALTERNATE BLUE CROSS MEDICARE ADV [2304] | MRH MEDICARE | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy vestibule of mouth 40808 at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $262.80 | $402.96 – $1,235.24 |
| MercyOne Genesis Aledo Medical Center | Aledo | $262.80 | $2,970.16 – $2,970.16 |
| UnityPoint Health - Trinity Moline | Rock Island | $392.00 | $81.66 – $396.18 |
| OSF Saint Anthony Medical Center | Rockford | $799.20 | $195.24 – $2,022.84 |
| Northwestern Medicine Central DuPage Hospital | IL 60190 | $1,097.60 | not published |
| Northwestern Medicine Delnor Hospital | Geneva | $1,097.60 | not published |
| Northwestern Medicine Palos Hospital | Palos Heights | $1,097.60 | not published |
| Northwestern Lake Forest Hospital DBA Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital | Lake Forest | $1,097.60 | not published |