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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in IL

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Hospitals
44
Min
$128.08
Median
$188.80
Max
$454.08
Range multiplier
3.5×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield27120$88.36$188.80$511.445.8×
UnitedHealthcare2289$84.00$174.69$626.007.5×
Aetna2478$88.36$191.52$454.085.1×
Cigna2652$82.00$179.63$428.535.2×
Humana1434$94.01$156.86$390.434.2×
Multiplan1731$197.83$284.00$626.003.2×
Molina926$90.81$106.00$254.402.8×
Medicare Advantage121$119.50$174.69$192.161.6×
meridian718$31.50$126.39$454.0814.4×
advocate employee918$139.87$147.51$155.141.1×
private healthcare systems917$184.60$266.25$315.951.7×
healthlink614$127.24$300.95$455.403.6×
WellCare612$90.81$141.98$174.691.9×
Medicare27$119.50$174.69$174.691.5×
meridian health plan26$90.81$127.04$153.781.7×
prime health services36$120.07$211.42$276.752.3×
ecoh16$225.57$265.85$312.421.4×
paymentrate25$129.60$266.40$369.002.8×
Medicaid45$90.81$454.08$454.085.0×
deidentifiedhigher25$129.60$266.40$369.002.8×
deidentifiedlower25$129.60$266.40$369.002.8×
grosschargerate25$144.00$333.00$410.002.8×
hfn14$225.57$265.85$312.421.4×
community partners health plan (cphp)34$185.35$297.90$318.001.7×
health partners open network44$214.84$214.84$214.841.0×
amerivantage44$127.69$127.69$127.691.0×
health alliance24$121.61$229.73$346.612.9×
deaconess onecare24$126.39$136.50$153.781.2×
umwa23$126.39$126.39$153.781.2×
mychoice wi medical adv13$119.50$174.69$174.691.5×
Self-Pay (Cash)33$129.15$129.15$129.151.0×
alliance coal23$174.42$174.42$253.731.5×
noncontracted23$202.22$202.22$246.041.2×
zelis (hfn)12$455.40$455.40$455.401.0×
alliance premier network12$203.78$228.32$252.851.2×
alter-net medical services, inc.12$202.22$320.24$438.262.2×
care improvement plus22$128.92$142.89$156.851.2×
catepillar, inc.12$430.10$430.10$430.101.0×
county care22$454.08$454.08$454.081.0×
family health plan22$454.08$454.08$454.081.0×
First Health22$332.10$479.05$626.001.9×
harmony health plan22$454.08$454.08$454.081.0×
health's finest network [126]12$281.70$406.90$532.101.9×
illinicare22$454.08$454.08$454.081.0×
mytru advantage12$126.39$140.09$153.781.2×
paymentratepercent22$80.00$85.00$90.001.1×
quartz aso12$208.58$233.66$258.731.2×
quartz fully insured12$200.65$224.77$248.891.2×
the alliance12$210.82$236.20$261.581.2×
humana_hmo_ppo11$310.25$310.25$310.251.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
St. Alexius Medical CenterHoffman EstatesIL8$179.63$454.08$454.08
Alexian Brothers Medical CenterElk Grove VillageIL9$179.63$454.08$454.08
Valley West Community HospitalSandwichIL12$626.00$438.20$118.94$394.38$626.00
Presence Saints Mary & Elizabeth MedChicagoIL4$214.69$390.43$424.56
Kirby HospitalMonticelloIL13$506.00$303.60$88.36$323.34$495.88
Warner Hospital And Health ServicesClintonIL17$365.00$365.00$284.70$310.25$357.70
Marshall Browning HospitalDuquoinIL6$26.00$291.20$395.00
Presence Saint Joseph Hospital ElginElginIL1$852.00$281.16$290.40$290.40$429.44
Presence Saint Joseph Hosp-ChicagoChicagoIL1$852.00$281.16$290.40$290.40$429.44
Presence Saint Francis HospitalEvanstonIL1$852.00$281.16$290.40$290.40$429.44
Presence St. Marys HospitalKankakeeIL1$852.00$281.16$290.40$290.40$429.44
Hammond-Henry HospitalGeneseoIL5$90.00$240.30$410.00
Carle Eureka HospitalEurekaIL11$530.00$530.00$46.30$238.50$445.20
Trinity Rock IslandRock IslandIL12$362.00$289.60$121.61$233.00$444.52
Red Bud Regional HospitalRed BudIL6$369.00$129.15$129.15$221.40$287.82
Proctor HospitalPeoriaIL8$362.00$289.60$121.61$188.80$288.21
Pekin Memorial HospitalPekinIL8$362.00$289.60$121.61$188.80$288.21
Methodist Medical Ctr Of IllinoisPeoriaIL8$362.00$289.60$121.61$188.80$288.21
Advocate Sherman HospitalElginIL7$355.00$177.50$105.00$186.73$319.50
Alexian Brothers Behavioral HealthHoffman EstatesIL4$152.67$179.63$454.08
Carle Foundation HospitalUrbanaIL11$315.00$315.00$31.50$174.69$267.75
Carle Bromenn Medical CenterNormalIL11$530.00$530.00$53.00$174.69$397.50
Swedishamerican HospitalRockfordIL19$387.35$61.98$90.81$174.69$312.42
South Suburban HospitalHazelcrestIL7$355.00$177.50$105.00$173.33$345.77
Advocate Christ HospitalOak LawnIL7$355.00$177.50$105.00$173.33$284.00
Advocate Lutheran General HospitalPark RidgeIL7$355.00$177.50$105.00$173.33$315.95
Advocate Northside Health SystemChicagoIL7$355.00$177.50$105.00$173.33$288.97
Advocate Southland HospitalChicagoIL7$355.00$177.50$105.00$173.33$284.00
Condell Medical CenterLibertyvilleIL7$355.00$177.50$105.00$169.62$284.00
Good Shepherd HospitalBarringtonIL7$355.00$177.50$84.00$160.57$284.00
Advocate Good Samaritan HospitalDowners GroveIL7$355.00$177.50$84.00$160.57$284.00
Heartland Regional Medical CenterMarionIL23$369.00$129.15$90.81$153.78$438.26
Union County Hospital DistrictAnnaIL20$369.00$129.15$90.81$128.08$276.75
Washington County HospitalNashvilleIL0$457.00$368.00
Anderson HospitalMaryvilleIL0$509.30$254.65
Memorial Medical CenterSpringfieldIL0$384.00$384.00
Decatur Memorial HospitalDecaturIL0$616.00$616.00
Gateway RegionalGranite CityIL0$289.69$173.81
Jacksonville Memorial HospitalJacksonvilleIL0$384.00$384.00
Board Of Trustees Of The UniversityChicagoIL0$788.00$322.00
Jacksonville Memorial HospitalJacksonvilleIL0$661.00$661.00
Midwest Medical CenterGalenaIL0$345.00$313.95
Jackson Park HospitalChicagoIL0$447.26$357.81
Community Hospital Of StauntonStauntonIL0$316.70$158.35

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.