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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in IL

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Hospitals
43
Min
$172.14
Median
$257.00
Max
$576.45
Range multiplier
3.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield27122$108.27$236.34$747.566.9×
UnitedHealthcare2289$84.00$226.40$915.0010.9×
Aetna2478$120.16$234.19$634.105.3×
Cigna2652$82.00$242.89$540.546.6×
Humana1434$127.56$207.08$501.003.9×
Multiplan1731$269.01$332.00$915.003.4×
Molina926$108.60$131.20$314.882.9×
Medicare Advantage121$164.36$234.19$257.611.6×
meridian718$36.20$172.14$572.7615.8×
advocate employee918$163.51$172.44$181.361.1×
private healthcare systems917$215.80$311.25$369.351.7×
healthlink614$166.00$380.25$601.203.6×
WellCare612$123.49$190.13$234.201.9×
Medicare27$164.36$234.19$234.191.4×
meridian health plan26$123.49$172.80$202.951.6×
prime health services36$163.53$265.53$338.252.1×
ecoh16$293.89$340.67$394.341.3×
paymentrate25$154.35$312.80$441.002.9×
Medicaid45$123.49$572.76$572.764.6×
deidentifiedhigher25$154.35$312.80$441.002.9×
deidentifiedlower25$154.35$312.80$441.002.9×
grosschargerate25$171.50$391.00$490.002.9×
hfn14$293.89$340.67$394.341.3×
community partners health plan (cphp)34$213.00$372.30$393.601.8×
health partners open network44$279.38$279.38$279.381.0×
amerivantage44$173.46$173.46$173.461.0×
health alliance24$165.20$303.27$457.582.8×
deaconess onecare24$172.14$185.91$202.951.2×
umwa23$172.14$172.14$202.951.2×
mychoice wi medical adv13$164.36$234.19$234.191.4×
Self-Pay (Cash)33$157.85$157.85$157.851.0×
alliance coal23$237.55$237.55$334.861.4×
noncontracted23$275.42$275.42$324.721.2×
zelis (hfn)12$601.20$601.20$601.201.0×
alliance premier network12$276.64$305.57$334.491.2×
alter-net medical services, inc.12$275.42$426.91$578.402.1×
care improvement plus22$175.58$191.30$207.011.2×
catepillar, inc.12$567.80$567.80$567.801.0×
county care22$572.76$572.76$572.761.0×
family health plan22$572.76$572.76$572.761.0×
First Health22$405.90$660.45$915.002.3×
harmony health plan22$572.76$572.76$572.761.0×
health's finest network [126]12$411.75$594.75$777.751.9×
illinicare22$572.76$572.76$572.761.0×
mytru advantage12$172.14$187.55$202.951.2×
paymentratepercent22$80.00$85.00$90.001.1×
quartz aso12$284.13$313.47$342.801.2×
quartz fully insured12$273.33$301.55$329.771.2×
the alliance12$286.19$316.12$346.041.2×
humana_hmo_ppo11$393.55$393.55$393.551.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Valley West Community HospitalSandwichIL12$915.00$640.50$173.85$576.45$915.00
St. Alexius Medical CenterHoffman EstatesIL8$270.71$572.76$572.76
Alexian Brothers Medical CenterElk Grove VillageIL9$270.71$572.76$572.76
Presence Saints Mary & Elizabeth MedChicagoIL4$291.52$493.65$532.53
Kirby HospitalMonticelloIL13$668.00$400.80$120.16$426.85$654.64
Warner Hospital And Health ServicesClintonIL17$463.00$463.00$361.14$393.55$453.74
Presence Saint Joseph Hospital ElginElginIL1$1,106.00$364.98$366.30$366.30$541.68
Presence Saint Francis HospitalEvanstonIL1$1,106.00$364.98$366.30$366.30$541.68
Presence St. Marys HospitalKankakeeIL1$1,106.00$364.98$366.30$366.30$541.68
Presence Saint Joseph Hosp-ChicagoChicagoIL1$1,106.00$364.98$366.30$366.30$541.68
Marshall Browning HospitalDuquoinIL6$26.00$334.00$444.00
Carle Eureka HospitalEurekaIL11$656.00$656.00$58.50$295.20$551.04
Hammond-Henry HospitalGeneseoIL5$90.00$286.65$490.00
Alexian Brothers Behavioral HealthHoffman EstatesIL4$207.28$270.71$572.76
Red Bud Regional HospitalRed BudIL6$451.00$157.85$157.85$270.60$351.78
Pekin Memorial HospitalPekinIL8$459.00$367.20$165.20$257.00$376.67
Proctor HospitalPeoriaIL8$459.00$367.20$165.20$257.00$376.67
Methodist Medical Ctr Of IllinoisPeoriaIL8$459.00$367.20$165.20$257.00$376.67
Carle Foundation HospitalUrbanaIL11$362.00$362.00$36.20$234.20$307.70
Carle Bromenn Medical CenterNormalIL11$656.00$656.00$65.60$234.20$492.00
Swedishamerican HospitalRockfordIL19$531.30$85.01$123.49$234.19$394.34
Advocate Sherman HospitalElginIL7$415.00$207.50$105.00$218.29$373.50
Heartland Regional Medical CenterMarionIL23$451.00$157.85$123.49$202.95$578.40
Advocate Christ HospitalOak LawnIL7$415.00$207.50$105.00$202.63$332.00
Advocate Lutheran General HospitalPark RidgeIL7$415.00$207.50$105.00$202.63$369.35
South Suburban HospitalHazelcrestIL7$415.00$207.50$105.00$202.63$404.21
Advocate Northside Health SystemChicagoIL7$415.00$207.50$105.00$202.63$337.81
Advocate Southland HospitalChicagoIL7$415.00$207.50$105.00$202.63$332.00
Condell Medical CenterLibertyvilleIL7$415.00$207.50$105.00$191.94$332.00
Trinity Rock IslandRock IslandIL12$459.00$367.20$165.20$189.36$603.47
Good Shepherd HospitalBarringtonIL7$415.00$207.50$84.00$174.51$332.00
Advocate Good Samaritan HospitalDowners GroveIL7$415.00$207.50$84.00$174.51$332.00
Union County Hospital DistrictAnnaIL20$451.00$157.85$123.49$172.14$338.25
Community Hospital Of StauntonStauntonIL0$387.00$193.50
Anderson HospitalMaryvilleIL0$578.60$289.30
Decatur Memorial HospitalDecaturIL0$1,155.00$1,155.00
Gateway RegionalGranite CityIL0$317.50$190.50
Jacksonville Memorial HospitalJacksonvilleIL0$407.00$407.00
Memorial Medical CenterSpringfieldIL0$407.00$407.00
Jacksonville Memorial HospitalJacksonvilleIL0$832.00$832.00
Jackson Park HospitalChicagoIL0$562.21$449.77
Midwest Medical CenterGalenaIL0$425.40$387.11
Board Of Trustees Of The UniversityChicagoIL0$1,069.00$344.40

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.