▸ Hospital · IL · CCN 140080
Presence St Francis Hospital - Evanston
355 RIDGE AVENUE, EVANSTON, IL, 60202
146 bedsAcute Care Hospitals1
Compliance grade
A
100/100
Procedures tracked
164
of 209 target codes
Payers
13
with negotiated rates
Rates published
18,430
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 10 | — | — | $1,236 | $12,197 | $18,819 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 9 | $532 | $175.56 | $167.49 | $184.24 | $505.08 |
| Psychiatric eval with medical services | CPT | 90792 | 9 | $592 | $195.36 | $167.49 | $184.24 | $505.08 |
| Psychotherapy 30 minutes | CPT | 90832 | 9 | $217 | $71.61 | $143.55 | $175.86 | $271.33 |
| Psychotherapy 45 minutes | CPT | 90834 | 10 | $332 | $109.56 | $167.49 | $184.24 | $307.44 |
| Psychotherapy 60 minutes | CPT | 90837 | 9 | $473 | $156.09 | $167.49 | $184.24 | $451.4 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 9 | — | — | $167.49 | $175.86 | $271.33 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 9 | $473 | $156.09 | $44.55 | $96.38 | $148.7 |
| ED visit level 2 | CPT | 99282 | 9 | $923 | $304.59 | $85.8 | $173.33 | $267.43 |
| ED visit level 3 | CPT | 99283 | 9 | $1,381 | $455.73 | $136.95 | $303.07 | $467.6 |
| ED visit level 4 | CPT | 99284 | 9 | $2,598 | $857.34 | $252.45 | $466.07 | $719.09 |
| ED visit level 5 | CPT | 99285 | 9 | $4,023 | $1,327.59 | $376.2 | $671.07 | $1,035.36 |
| Critical care, first hour | CPT | 99291 | 9 | $5,953 | $1,964.49 | $518.1 | $922.27 | $1,422.93 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 10 | $4,076 | $1,345.08 | $76.49 | $121.94 | $2,404.84 |
| CT head with contrast | CPT | 70460 | 10 | $4,484 | $1,479.72 | $109.59 | $204.13 | $2,645.56 |
| CT head with and without contrast | CPT | 70470 | 10 | $4,932 | $1,627.56 | $131.28 | $204.13 | $2,909.88 |
| CT neck with contrast | CPT | 70491 | 10 | $2,025 | $668.25 | $137.89 | $204.13 | $1,194.75 |
| MRI brain without contrast | CPT | 70551 | 10 | $2,851 | $940.83 | $146.72 | $277.17 | $1,912.96 |
| MRI brain with contrast | CPT | 70552 | 10 | $3,137 | $1,035.21 | $215.85 | $409.51 | $2,142.32 |
| MRI brain with and without contrast | CPT | 70553 | 10 | $4,255 | $1,404.15 | $244.17 | $409.51 | $3,035.36 |
| Chest X-ray single view | CPT | 71045 | 10 | $550 | $181.5 | $19.48 | $96.38 | $324.5 |
| Chest X-ray 2 views | CPT | 71046 | 10 | $605 | $199.65 | $26.1 | $96.38 | $356.95 |
| Chest X-ray 3 views | CPT | 71047 | 10 | $667 | $220.11 | $32.72 | $100.97 | $393.53 |
| CT chest without contrast | CPT | 71250 | 10 | $1,825 | $602.25 | $94.88 | $121.94 | $1,076.75 |
| CT chest with contrast | CPT | 71260 | 10 | $2,464 | $813.12 | $129.44 | $204.13 | $1,453.76 |
| CT chest with and without contrast | CPT | 71270 | 10 | $3,036 | $1,001.88 | $158.49 | $204.13 | $1,791.24 |
| MRI chest without contrast | CPT | 71550 | 10 | $5,035 | $1,661.55 | $230.13 | $277.17 | $2,970.65 |
| MRI chest with contrast | CPT | 71551 | 10 | $6,146 | $2,028.18 | $335.75 | $905.93 | $3,626.14 |
| MRI chest with and without contrast | CPT | 71552 | 10 | $7,700 | $2,541 | $368.12 | $409.51 | $4,543 |
| Lumbosacral spine X-ray | CPT | 72100 | 10 | $431 | $142.23 | $32.72 | $116.39 | $272.68 |
| CT cervical spine without contrast | CPT | 72125 | 10 | $1,793 | $591.69 | $95.98 | $121.94 | $1,057.87 |
| CT thoracic spine without contrast | CPT | 72128 | 10 | $1,246 | $411.18 | $95.61 | $121.94 | $956.48 |
| CT lumbar spine without contrast | CPT | 72131 | 10 | $1,516 | $500.28 | $94.88 | $121.94 | $956.48 |
| MRI cervical spine without contrast | CPT | 72141 | 10 | $3,121 | $1,029.93 | $140.47 | $277.17 | $1,841.39 |
| MRI thoracic spine without contrast | CPT | 72146 | 10 | $2,877 | $949.41 | $140.1 | $277.17 | $1,805.6 |
| MRI lumbar spine without contrast | CPT | 72148 | 10 | $3,580 | $1,181.4 | $140.84 | $277.17 | $2,112.2 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 10 | $3,938 | $1,299.54 | $215.85 | $409.51 | $2,323.42 |
| MRI cervical spine with and without contrast | CPT | 72156 | 10 | $4,501 | $1,485.33 | $245.64 | $409.51 | $2,903.6 |
| MRI lumbar spine with contrast | CPT | 72158 | 10 | $4,336 | $1,430.88 | $244.91 | $409.51 | $2,867 |
| CT pelvis without contrast | CPT | 72192 | 10 | $1,671 | $551.43 | $94.51 | $121.94 | $985.89 |
| CT pelvis with contrast | CPT | 72193 | 10 | $2,197 | $725.01 | $178.55 | $204.13 | $1,296.23 |
| Shoulder X-ray | CPT | 73030 | 10 | $922 | $304.26 | $29.04 | $96.38 | $543.98 |
| Humerus X-ray | CPT | 73060 | 10 | $329 | $108.57 | $27.21 | $96.38 | $226.71 |
| Hand X-ray 3 views | CPT | 73130 | 10 | $820 | $270.6 | $32.35 | $96.38 | $483.8 |
| MRI upper extremity joint without contrast | CPT | 73221 | 10 | $6,325 | $2,087.25 | $160.7 | $277.17 | $3,731.75 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 10 | $7,543 | $2,489.19 | $329.13 | $409.51 | $4,450.37 |
| Hip X-ray 2 views | CPT | 73510 | 1 | — | — | $85.8 | $85.8 | $126.88 |
| Knee X-ray 1-2 views | CPT | 73560 | 10 | $216 | $71.28 | $29.41 | $96.38 | $245.1 |
| Ankle X-ray 3 views | CPT | 73610 | 10 | $797 | $263.01 | $31.62 | $96.38 | $470.23 |
| MRI lower extremity joint without contrast | CPT | 73721 | 10 | $5,957 | $1,965.81 | $160.33 | $277.17 | $3,514.63 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 10 | $7,017 | $2,315.61 | $327.66 | $409.51 | $4,140.03 |
| CT abdomen without contrast | CPT | 74150 | 10 | $3,678 | $1,213.74 | $93.4 | $121.94 | $2,170.02 |
| CT abdomen with contrast | CPT | 74160 | 10 | $5,655 | $1,866.15 | $178.55 | $204.13 | $3,336.45 |
| CT abdomen with and without contrast | CPT | 74170 | 10 | $6,223 | $2,053.59 | $178.55 | $204.13 | $3,671.57 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 10 | $3,904 | $1,288.32 | $118.04 | $277.17 | $2,303.36 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 10 | $6,385 | $2,107.05 | $250.43 | $409.51 | $3,767.15 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 10 | $7,026 | $2,318.58 | $283.16 | $409.51 | $4,145.34 |
| MRI abdomen without contrast | CPT | 74181 | 10 | $2,762 | $911.46 | $147.46 | $277.17 | $1,705.56 |
| MRI abdomen with and without contrast | CPT | 74183 | 10 | $6,155 | $2,031.15 | $271.39 | $409.51 | $3,631.45 |
| Abdominal ultrasound complete | CPT | 76700 | 10 | $2,926 | $965.58 | $87.51 | $121.94 | $1,726.34 |
| Abdominal ultrasound limited | CPT | 76705 | 10 | $1,741 | $574.53 | $66.19 | $121.94 | $1,027.19 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 10 | $1,787 | $589.71 | $81.64 | $121.94 | $1,054.33 |
| Obstetric ultrasound first trimester | CPT | 76801 | 10 | $1,440 | $475.2 | $78.69 | $121.94 | $849.6 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 10 | $1,737 | $573.21 | $98.91 | $121.94 | $1,024.83 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 10 | $1,163 | $383.79 | $98.53 | $277.17 | $821.11 |
| Transvaginal ultrasound | CPT | 76830 | 10 | $1,429 | $471.57 | $96.7 | $121.94 | $843.11 |
| Pelvic ultrasound complete | CPT | 76856 | 10 | $2,060 | $679.8 | $81.27 | $121.94 | $1,215.4 |
| Scrotal ultrasound | CPT | 76870 | 10 | $1,684 | $555.72 | $59.64 | $121.94 | $993.56 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $647 | $213.51 | $85.79 | $96.44 | $805.95 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $877 | $289.41 | $110.02 | $122.65 | $1,035.73 |
| Screening mammography bilateral | CPT | 77067 | 10 | $720 | $237.6 | $90.7 | $101.18 | $851.92 |
| EKG complete | CPT | 93000 | 1 | — | — | $54.45 | $54.45 | $80.52 |
| EKG tracing only | CPT | 93005 | 9 | $598 | $197.34 | $31.35 | $65.02 | $352.82 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $23.1 | $23.1 | $34.16 |
| Transthoracic echocardiogram complete | CPT | 93306 | 9 | $4,786 | $1,579.38 | $571.56 | $628.72 | $2,823.74 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $1,381 | $455.73 | $251.97 | $277.17 | $814.79 |
| Stress echocardiogram | CPT | 93350 | 9 | $3,770 | $1,244.1 | $536.25 | $600.14 | $2,224.3 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $12,996 | $13,646 | $21,054 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $9,212.18 | $9,672.79 | $14,924 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $7,010.8 | $7,361.34 | $11,358 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $5,339.19 | $5,606.15 | $8,649.49 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $6,702.26 | $7,037.37 | $10,858 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $5,226.91 | $5,488.26 | $8,467.59 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $13,340 | $14,008 | $21,612 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $7,643.69 | $8,025.87 | $12,383 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $6,013.65 | $6,314.33 | $9,742.11 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $10,677 | $11,211 | $17,296 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $7,060.7 | $7,413.73 | $11,438 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $4,707.13 | $4,942.49 | $7,625.55 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $10,013 | $10,514 | $16,221 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $6,118.44 | $6,424.36 | $9,911.87 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $4,707.96 | $4,943.36 | $7,626.9 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $8,155.98 | $8,563.78 | $13,213 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $5,242.72 | $5,504.86 | $8,493.21 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $6,483.54 | $6,807.72 | $10,503 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $13,038 | $13,690 | $21,121 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $9,649.62 | $10,132 | $15,632 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $6,732.2 | $7,068.81 | $10,906 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $16,155 | $16,963 | $26,171 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $8,510.26 | $8,935.77 | $13,787 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $174.9 | $174.9 | $258.64 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $239.25 | $239.25 | $353.8 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $351.45 | $351.45 | $519.72 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $130.35 | $130.35 | $192.76 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $188.1 | $188.1 | $278.16 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $422 | $139.26 | $8.46 | $9.31 | $35.42 |
| General health panel | CPT | 80050 | 5 | $750 | $247.5 | $35.77 | $52.71 | $170.8 |
| Electrolyte panel | CPT | 80051 | 11 | $111 | $36.63 | $4.34 | $7.71 | $28.6 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $596 | $196.68 | $10.56 | $11.62 | $43.59 |
| Lipid panel | CPT | 80061 | 11 | $175 | $57.75 | $11.58 | $14.73 | $55.85 |
| Renal function panel | CPT | 80069 | 11 | $144 | $47.52 | $8.68 | $9.55 | $36.78 |
| Hepatic function panel | CPT | 80076 | 11 | $206 | $67.98 | $7.59 | $8.99 | $34.05 |
| Urinalysis non-automated | CPT | 81002 | 11 | $9 | $2.97 | $2.61 | $3.83 | $14.98 |
| Urinalysis automated | CPT | 81003 | 11 | $58 | $19.14 | $1.69 | $2.48 | $9.53 |
| Glucose quantitative | CPT | 82947 | 11 | $48 | $15.84 | $1.28 | $4.32 | $16.35 |
| Hemoglobin A1c | CPT | 83036 | 11 | $118 | $38.94 | $7.28 | $10.68 | $40.86 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $183 | $60.39 | $12.6 | $18.48 | $69.47 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $304 | $100.32 | $5.83 | $8.55 | $32.69 |
| Complete blood count without differential | CPT | 85027 | 11 | $53 | $17.49 | $4.85 | $7.12 | $27.24 |
| Urine culture bacterial | CPT | 87086 | 11 | $89 | $29.37 | $6.05 | $8.88 | $34.05 |
| Urine culture identification | CPT | 87088 | 11 | $32 | $10.56 | $6.07 | $8.9 | $34.05 |
| Tissue exam by pathologist level IV | CPT | 88305 | 10 | $1,619 | $534.27 | $39.71 | $61.27 | $231.8 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 10 | $1,134 | $374.22 | $209.7 | $228.74 | $532.98 |
| Vaginal delivery only | CPT | 59409 | 1 | $4,865 | $1,605.45 | $2,286.55 | $2,286.55 | $2,286.55 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | $5,214 | $1,720.62 | $2,450.58 | $2,450.58 | $2,450.58 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 1 | $509 | $167.97 | $130.35 | $130.35 | $192.76 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 1 | $677 | $223.41 | $191.4 | $191.4 | $283.04 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 1 | $852 | $281.16 | $290.4 | $290.4 | $429.44 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 1 | $1,106 | $364.98 | $366.3 | $366.3 | $541.68 |
| Office visit, established patient, 5 min | CPT | 99211 | 1 | $250 | $82.5 | $41.25 | $41.25 | $61 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 1 | $509 | $167.97 | $79.2 | $79.2 | $117.12 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 1 | $677 | $223.41 | $117.15 | $117.15 | $173.24 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 1 | $852 | $281.16 | $176.55 | $176.55 | $261.08 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 1 | $1,106 | $364.98 | $254.1 | $254.1 | $375.76 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | — | — | $977.33 | $1,026.2 | $1,583.27 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | $3,966 | $1,308.78 | $977.33 | $1,050.63 | $1,864.02 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 9 | $1,378 | $454.74 | $647.66 | $997.9 | $1,539.62 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | — | — | $950.38 | $997.9 | $1,539.62 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | — | — | $950.38 | $997.9 | $1,539.62 |
| surgery | ||||||||
| Knee revision arthroplasty single component | CPT | 27486 | 1 | — | — | $9,156.6 | $9,156.6 | $9,156.6 |
| Knee revision arthroplasty all components | CPT | 27487 | 1 | — | — | $11,495 | $11,495 | $11,495 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $38,227 | $40,138 | $61,927 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $19,936 | $20,933 | $32,297 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $13,996 | $14,696 | $22,673 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $14,068 | $14,772 | $22,790 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $11,359 | $11,927 | $18,401 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $28,335 | $29,752 | $45,903 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $25,226 | $26,487 | $40,865 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $16,042 | $16,844 | $25,988 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $24,220 | $25,431 | $39,237 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $17,419 | $18,290 | $28,219 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $13,564 | $14,242 | $21,974 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $22,566 | $26,414 | $38,901 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $13,309 | $15,638 | $31,190 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $12,545 | $14,740 | $31,190 |
| Intravitreal injection | CPT | 67028 | 9 | — | — | $345.76 | $363.05 | $560.13 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $10,318 | $11,092 | $16,716 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $17,041 | $17,893 | $27,607 |
| PCI single major coronary artery | CPT | 92920 | 6 | $15,390 | $5,078.7 | $4,001.4 | $7,645 | $11,975 |
| PCI with drug-eluting stent | CPT | 92928 | 4 | $43,760 | $14,441 | $7,429 | $8,425 | $30,632 |
| PCI bypass graft | CPT | 92937 | 4 | $17,703 | $5,841.99 | $7,429 | $8,425 | $12,392 |
| Left heart catheterization | CPT | 93452 | 3 | $10,602 | $3,498.66 | $2,756.52 | $3,604.68 | $8,631 |
| Coronary angiography with cath | CPT | 93455 | 2 | $25,503 | $8,415.99 | $6,773 | $7,702 | $8,631 |
| Coronary angiography with bypass cath | CPT | 93458 | 3 | $26,001 | $8,580.33 | $6,760.26 | $7,546.66 | $9,360.36 |
Payer mix (top 13)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 157 | $253.28 |
| Aetna | 145 | $251.97 |
| UnitedHealthcare | 142 | $226.11 |
| smarthealth | 137 | $259.8 |
| Bright Health | 136 | $231.96 |
| Humana | 136 | $204.13 |
| Medicare | 136 | $204.13 |
| TRICARE | 136 | $185.57 |
| Ambetter | 136 | $300.62 |
| Cigna | 81 | $140.47 |
| imagine health | 17 | $11.85 |
| healthlink hmo | 3 | $12,392 |
| compsych | 1 | $195 |