facebook tracking Level 4 Breast/Lymphatic Surgery and Related Procedures cost in Illinois: 35 hospitals compared (APC 5094)

Level 4 Breast/Lymphatic Surgery and Related Procedures in Illinois

What 35 hospitals in Illinois charged and were paid for level 4 breast/lymphatic surgery and related procedures (APC 5094), from 2024 Medicare claims.

APC 5094 Outpatient 2024 Medicare data
Average charge $86,146 Hospital list price billed
Average allowed $16,689 Medicare's payment + patient's share
Medicare paid $15,057 Average per service
State rank #17 of 23 1 = lowest average payment

Hospitals in Illinois billed an average of $86,146 for level 4 breast/lymphatic surgery and related procedures, about 5.2 times the average medicare-allowed amount of $16,689. That payment is 3% below the U.S. average of $17,182.

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 $16,689Billed $86,146

About 19¢ was paid for every $1 hospitals in Illinois billed for this service.

Illinois hospitals: level 4 breast/lymphatic surgery and related 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
Evanston HospitalEvanston 25 $64,826 $16,359 $14,727
Northwestern Memorial HospitalChicago 20 $112,796 $17,102 $15,470
Loyola Gottlieb Memorial HospitalMelrose Park – – – –
Herrin HospitalHerrin – – – –
Proctor HospitalPeoria – – – –
Copley Memorial HospitalAurora – – – –
Sherman HospitalElgin – – – –
St Anthonys Memorial HospitalEffingham – – – –
St Johns HospitalSpringfield – – – –
Palos Community HospitalPalos Heights – – – –
Rush Oak Park HospitalOak Park – – – –
Saint Francis Medical CenterPeoria – – – –
Rhc St Francis HospitalEvanston – – – –
The University of Chicago Medical CenterChicago – – – –
Midwestern Region Med CenterZion – – – –
Northwestern Medicine McHenryMcHenry – – – –
Rush University Medical CenterChicago – – – –
Hinsdale HospitalHinsdale – – – –
Bromenn Healthcare SystemNormal – – – –
Lake Forest HospitalLake Forest – – – –
University of Illinois Hospital and ClinicsChicago – – – –
Franciscan Health Olympia & Chicago HeightsOlympia Fields – – – –
Advocate Condell Medical CenterLibertyville – – – –
Advocate Christ Hospital & Medical CenterOak Lawn – – – –
Methodist Medical Center of IllinoisPeoria – – – –
Delnor Community HospitalGeneva – – – –
Silver Cross HospitalJoliet – – – –
Advocate Lutheran General HospitalPark Ridge – – – –
Swedish American HospitalRockford – – – –
Edward HospitalNaperville – – – –
Central Dupage HospitalWinfield – – – –
Northwest Community HospitalArlington Heights – – – –
Alexian Brothers Medical CenterElk Grove Village – – – –
Loyola University Medical CenterMaywood – – – –
Advocate Good Shepherd HospitalBarrington – – – –
Level 4 Breast/Lymphatic Surgery and Related Procedures: all states All Illinois hospitals Illinois hospital finances
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Level 4 Breast/Lymphatic Surgery and Related Procedures in other states

Arizona · $16,500 Delaware · $17,641 Florida · $15,930 Georgia · $15,586 Michigan · $16,268 Minnesota · $17,377 South Dakota · $16,487 Texas · $15,873

Questions

How much does level 4 breast/lymphatic surgery and related procedures cost in Illinois?

In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 35 hospitals in Illinois was billed at $86,146 on average, while the average medicare-allowed amount was $16,689, of which Medicare paid $15,057. 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 5.2 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.