Integrated Health Plan: disclosed hospital rates

iDirect answer

Based on the published hospital price files, Integrated Health Plan appears in disclosed negotiated rates across 2 hospitals and 188 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.

188 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	—
ACE STOMA STOPPER 10FR 60MM Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	67632 LOCAL	$140	$98.00	$23.80 – $8,500	—
ACETAMINOPHEN 160 MG CHEWABLE TABLET Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	46122-424-62 NDC	$0.55	$0.39	$0.09 – $8,500	—
ACUTE ANXIETY AND DELIRIUM STATES Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	756-3 APR-DRG	$29,978	$20,985	$900 – $28,479	—
ACUTE LEUKEMIA Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	690-4 APR-DRG	$381,397	$266,978	$900 – $362,327	—
ALLERGIC REACTIONS Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	811-1 APR-DRG	$15,443	$10,810	$900 – $14,671	—
ANNULOPLASTY RINGPHYSIO II TV 26MM Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	1579 LOCAL	$10,880	$7,616	$1,850 – $10,336	—
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	234-3 APR-DRG	$375,921	$263,145	$900 – $357,125	—
APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	234-2 APR-DRG	$113,849	$79,695	$900 – $108,157	—
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	—