National Provider Network: disclosed hospital rates

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Based on the published hospital price files, National Provider Network appears in disclosed negotiated rates across 1 hospital and 69 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.

69 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
5.5MM X 40MM TITANIUM ROD Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	33740 LOCAL	$1,372	$960	$508 – $2,656	—
ACUTE ANXIETY AND DELIRIUM STATES Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	756-2 APR-DRG	$56,798	$39,759	$900 – $53,958	—
ACUTE KIDNEY INJURY Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	469-1 APR-DRG	$34,365	$24,056	$900 – $32,647	—
ALLERGIC REACTIONS Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	811-1 APR-DRG	$15,443	$10,810	$900 – $14,671	—
ALLOGENEIC BONE MARROW TRANSPLANT Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	007-4 APR-DRG	$2,669,547	$1,868,683	$900 – $2,536,069	—
AMPUTATION OF LOWER LIMB EXCEPT TOES Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	305-4 APR-DRG	$131,632	$92,142	$900 – $125,050	—
ANCHOR SUTURE SWIVELOCK TIGERTAIL 4.75MM 22MM BIOCOMPOSITE Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	49618 LOCAL	$1,785	$1,250	$303 – $1,696	—
CANNULA CHANDELIER 25G Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	37848 LOCAL	$604	$423	$103 – $8,500	—
CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	163-2 APR-DRG	$478,890	$335,223	$900 – $454,946	—
CARDIOMYOPATHY Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	205-1 APR-DRG	$66,039	$46,227	$900 – $62,737	—
CATH INNERVISION W/SLIT TIP Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	11214 LOCAL	$594	$416	$220 – $2,656	—
CHRONIC KIDNEY DISEASE Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	470-3 APR-DRG	$118,514	$82,960	$900 – $112,589	—
CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	75907-189-35 NDC	$13.95	$9.76	$2.37 – $8,500	—
DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	0121-0978-10 NDC	$17.03	$11.92	$6.30 – $3,678	—
DISORDERS OF GALLBLADDER AND BILIARY TRACT Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	284-1 APR-DRG	$47,612	$33,328	$900 – $45,231	—
EYE INFECTIONS AND OTHER EYE DISORDERS Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	082-2 APR-DRG	$45,951	$32,165	$900 – $43,653	—
FEVER AND INFLAMMATORY CONDITIONS Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	722-3 APR-DRG	$72,637	$50,846	$900 – $69,005	—
FRACTURES AND DISLOCATIONS EXCEPT FEMUR PELVIS AND BACK Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	342-2 APR-DRG	$17,822	$12,476	$900 – $16,931	—
GELATIN CAPSULES (EMPTY) Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	3877-91-1122 NDC	$18.78	$13.15	$3.19 – $8,500	—
H BE MOLDD SCKT FLX HNGS TRICEP PAD Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	9175274 CDM	$4,083	$2,858	$694 – $3,879	—
H H5N8 VACCINE DRV CELL CUL ADJUVANTED FOR IM USE Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	6112281 CDM	$132	$92.40	$22.44 – $8,500	—
H INJECTION PROCEDURE CYSTOGRAPHY Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	7111137 CDM	$1,008	$706	$171 – $8,500	—
H IR 62303 INJ THORACIC & RSI Inpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	7115513 CDM	$2,215	$1,551	$820 – $3,678	—
H NIPPLE/AREOLA RECONSTRUCTION Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	5119350 CDM	$4,064	$2,845	$691 – $14,756	—
IMPLANT SYSTEM MIDSUBSTANCE ACHILLES SPEEDBRIDGE REPAIR Outpatient	Ann & Robert H. Lurie Children's Hospital of Chicago	45395 LOCAL	$4,095	$2,867	$696 – $3,890	—