AXA/HAA Preferred Partners: disclosed hospital rates

iDirect answer

Based on the published hospital price files, AXA/HAA Preferred Partners appears in disclosed negotiated rates across 1 hospital and 114 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

114 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
10-0 ETHILON BLACK 1X5 V75-3 Inpatient	University of Illinois Hospital and Clinics (UI Health)	A4649 HCPCS	$105	$73.79	$34.79 – $2,385	—
10-0 ETHILON BLACK 1X5 V75-3 Outpatient	University of Illinois Hospital and Clinics (UI Health)	A4649 HCPCS	$105	$73.79	$34.79 – $2,385	—
ARTIFASCIA DURA SUBSTITUTE 2.75 X 2.75 (7CM X 7CM) Inpatient	University of Illinois Hospital and Clinics (UI Health)	C1889 HCPCS	$5,513	$3,859	$1,929 – $5,513	—
ARTIFASCIA DURA SUBSTITUTE 2.75 X 2.75 (7CM X 7CM) Outpatient	University of Illinois Hospital and Clinics (UI Health)	C1889 HCPCS	$5,513	$3,859	$1,819 – $5,513	—
ASPIRATOR 3-HOLE 6 NDLE Inpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$485	$339	$170 – $485	—
ASPIRATOR 3-HOLE 6 NDLE Outpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$485	$339	$160 – $485	—
ASPIRATOR KIT 1-HOLE 4 NDLE Inpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$555	$388	$194 – $555	—
ASPIRATOR KIT 1-HOLE 4 NDLE Outpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$555	$388	$183 – $555	—
ASPIRATOR KIT 3-HOLE 4 NDLE Inpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$555	$388	$194 – $555	—
ASPIRATOR KIT 3-HOLE 4 NDLE Outpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$555	$388	$183 – $555	—
ASPIRATOR KIT 3-HOLE 6 NDLE Inpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$555	$388	$194 – $555	—
ASPIRATOR KIT 3-HOLE 6 NDLE Outpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$555	$388	$183 – $555	—
ASPIRATOR NEEDLE 1 HOLE 4 Inpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$485	$339	$170 – $485	—
ASPIRATOR NEEDLE 1 HOLE 4 Outpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$485	$339	$160 – $485	—
ASPIRATOR NEEDLE 3 HOLE 4 Inpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$485	$339	$170 – $485	—
ASPIRATOR NEEDLE 3 HOLE 4 Outpatient	University of Illinois Hospital and Clinics (UI Health)	C9362 HCPCS	$485	$339	$160 – $485	—
ASTATO XS 40 PERIPHERAL GUIDE WIRE 200CM 0.014 Inpatient	University of Illinois Hospital and Clinics (UI Health)	C1769 HCPCS	$2,800	$1,960	$924 – $2,800	—
ASTATO XS 40 PERIPHERAL GUIDE WIRE 200CM 0.014 Outpatient	University of Illinois Hospital and Clinics (UI Health)	C1769 HCPCS	$2,800	$1,960	$924 – $2,800	—
Cdsm Imaging Decision Support Inpatient	University of Illinois Hospital and Clinics (UI Health)	G1004 HCPCS	$0.01	$0.01	$0.01 – $218	—
Cdsm Imaging Decision Support Outpatient	University of Illinois Hospital and Clinics (UI Health)	G1004 HCPCS	$0.01	$0.01	$0.01 – $218	—
CILGAVIMAB 150 MG/1.5 ML IM SOLN Inpatient	University of Illinois Hospital and Clinics (UI Health)	Q0220 HCPCS	$0.01	$0.01	$0.01 – $2,385	—
CILGAVIMAB 150 MG/1.5 ML IM SOLN Outpatient	University of Illinois Hospital and Clinics (UI Health)	Q0220 HCPCS	$0.01	$0.01	$0.01 – $2,385	—
CLEAR MATERIAL 7.0MM DISTANCE FROM ENDOSCOPE DISTAL END 2 DRAINS STERILE SINGLE USE OUTSIDE DIAMETER 12.4MM DISTAL END DIAMETER OF COMPATIBLE ENDOSCOPES 10.5MM - 11.1MM Inpatient	University of Illinois Hospital and Clinics (UI Health)	A4649 HCPCS	$172	$120	$56.60 – $2,385	—
CLEAR MATERIAL 7.0MM DISTANCE FROM ENDOSCOPE DISTAL END 2 DRAINS STERILE SINGLE USE OUTSIDE DIAMETER 12.4MM DISTAL END DIAMETER OF COMPATIBLE ENDOSCOPES 10.5MM - 11.1MM Outpatient	University of Illinois Hospital and Clinics (UI Health)	A4649 HCPCS	$172	$120	$56.60 – $2,385	—
COUNTERSINK CANN 1/4 7.0 HEADED Inpatient	University of Illinois Hospital and Clinics (UI Health)	A4649 HCPCS	$2,275	$1,593	$751 – $2,385	—