facebook tracking Level 1 ICD and Similar Procedures cost in Illinois: 57 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in Illinois

What 57 hospitals in Illinois charged and were paid for level 1 icd and similar procedures (APC 5231), from 2024 Medicare claims.

APC 5231 Outpatient 2024 Medicare data
Average charge $103,801 Hospital list price billed
Average allowed $21,639 Medicare's payment + patient's share
Medicare paid $20,005 Average per service
State rank #21 of 34 1 = lowest average payment

Hospitals in Illinois billed an average of $103,801 for level 1 icd and similar procedures, about 4.8 times the average medicare-allowed amount of $21,639. That payment is 4% below the U.S. average of $22,647.

These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.

Paid $21,639Billed $103,801

About 21¢ was paid for every $1 hospitals in Illinois billed for this service.

Illinois hospitals: level 1 icd and similar procedures

Every Illinois hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
St Johns HospitalSpringfield 15 $94,300 $21,728 $20,090
Northwestern Memorial HospitalChicago 15 $129,761 $22,865 $21,233
Advocate Lutheran General HospitalPark Ridge 12 $97,238 $18,873 $17,241
Rush University Medical CenterChicago 11 $88,516 $22,865 $21,233
Alton Memorial HospitalAlton – – – –
Provena St Joseph Medical CenterJoliet – – – –
Evanston HospitalEvanston – – – –
Blessing HospitalQuincy – – – –
Copley Memorial HospitalAurora – – – –
Sherman HospitalElgin – – – –
Good Samaritan Regional Hlth CenterMt Vernon – – – –
Advocate Trinity HospitalChicago – – – –
West Suburban Hosp Med CenterOak Park – – – –
Palos Community HospitalPalos Heights – – – –
Rush Oak Park HospitalOak Park – – – –
Saint Francis Medical CenterPeoria – – – –
The University of Chicago Medical CenterChicago – – – –
Carle Foundation HospitalUrbana – – – –
OSF Heart of Mary Medical CenterUrbana – – – –
Northwestern Medicine McHenryMcHenry – – – –
Resurrection Medical CenterChicago – – – –
Hinsdale HospitalHinsdale – – – –
John H Stroger Jr HospitalChicago – – – –
Bromenn Healthcare SystemNormal – – – –
Lake Forest HospitalLake Forest – – – –
Memorial Medical CenterSpringfield – – – –
University of Illinois Hospital and ClinicsChicago – – – –
St Joseph Medical CenterBloomington – – – –
Memorial Hospital of CarbondaleCarbondale – – – –
St Marys HospitalDecatur – – – –
Little Company of Mary HospitalEvergreen Park – – – –
St Mary & Elizabeth Med Ctr-Division CampusChicago – – – –
Advocate Illinois Masonic Medical CenterChicago – – – –
Memorial HospitalBelleville – – – –
Riverside Medical CenterKankakee – – – –
St Elizabeth HospitalBelleville – – – –
Sarah Bush Lincoln Health CenterMattoon – – – –
Elmhurst Memorial HospitalElmhurst – – – –
Advocate Condell Medical CenterLibertyville – – – –
Humboldt Park HealthChicago – – – –
Advocate Christ Hospital & Medical CenterOak Lawn – – – –
Methodist Medical Center of IllinoisPeoria – – – –
Delnor Community HospitalGeneva – – – –
Silver Cross HospitalJoliet – – – –
Swedish American HospitalRockford – – – –
Edward HospitalNaperville – – – –
Saint Anthony Medical CenterRockford – – – –
Javon Bea HospitalRockford – – – –
Central Dupage HospitalWinfield – – – –
Northwest Community HospitalArlington Heights – – – –
Alexian Brothers Medical CenterElk Grove Village – – – –
Loyola University Medical CenterMaywood – – – –
Trinity Rock IslandRock Island – – – –
Kishwaukee Community HospitalDekalb – – – –
Advocate Good Samaritan HospitalDowners Grove – – – –
St Alexius Medical CenterSchaumburg – – – –
Advocate Good Shepherd HospitalBarrington – – – –
Level 1 ICD and Similar Procedures: all states All Illinois hospitals Illinois hospital finances
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Lowest and highest allowed amounts in Illinois

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

Advocate Lutheran General HospitalPark Ridge, IL$18,873
St Johns HospitalSpringfield, IL$21,728
Rush University Medical CenterChicago, IL$22,865
Northwestern Memorial HospitalChicago, IL$22,865

Highest

Rush University Medical CenterChicago, IL$22,865
Northwestern Memorial HospitalChicago, IL$22,865
St Johns HospitalSpringfield, IL$21,728
Advocate Lutheran General HospitalPark Ridge, IL$18,873

Level 1 ICD and Similar Procedures in other states

Georgia · $21,553 Indiana · $21,143 Iowa · $21,044 Mississippi · $21,084 Nebraska · $21,186 Pennsylvania · $21,882 Utah · $21,062 Wisconsin · $22,123

Questions

How much does level 1 icd and similar procedures cost in Illinois?

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 57 hospitals in Illinois was billed at $103,801 on average, while the average medicare-allowed amount was $21,639, of which Medicare paid $20,005. Your own cost depends on your insurance, deductible and the hospital.

Why are hospital charges so much higher than payments?

Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in Illinois, average charges were 4.8 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.

Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.