Extended office visit (prolonged) cost in IL
What a extended office visit (prolonged) costs at IL hospitals — and the fair price to aim for.
Typical commercial prices here are +3% above the fair benchmark (1.03×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
This hospital prices routine shoppable procedures at 2.1× Medicare (median 1.08× Fair BaseRate) while upper-quartile commercial rates jump +43% to 1.54× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.68× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 17% of shoppable procedures (25/100 Cash Honesty)
- CMS clinical safety score (69/100 safety score) with 72% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.03× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 1.08× Fair BaseRate (2.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.54×) jump +43% above the median procedure ratio (Q50 1.08×)
- Consolidated metro market (HHI 9,662) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, IL hospitals charge about the fair price for this. how we calculate the BaseRate →
Compared with the rest of the country, IL’s fair BaseRate ($35) is about the same as the national fair price of $35.
Cheapest IL hospitals for a extended office visit (prolonged)
- Morrison Community Hospital · Morrison $21
- Kirby Medical Center · Monticello $28
- Sarah Bush Lincoln Health Center · Mattoon $28
- Morris Hospital & Healthcare Centers · Morris $28
- Washington County Hospital · Nashville $29
- Mc Donough District Hospital · Macomb $29
- Clay County Hospital · Flora $30
- Deaconess Illinois Crossroads · Mount Vernon $31
- Trinity Rock Island · Rock Island $31
- Carle Hoopeston Regional Health Center · Hoopeston $32
- Carle Eureka Hospital · Eureka $32
- Ferrell Hospital Community Foundations · Eldorado $32
- Crawford Memorial Hospital · Robinson $32
- Carle Health Pekin Hospital · Pekin $34
- Hamilton Memorial Hospital · McLeansboro $34
Audit a Bill or Quote at IL Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $30
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $30).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask IL Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $35 Fair BaseRate ($20 Medicare)
Your bill ($82) is $47 above the denoised Fair BaseRate ($35) and 4.1× the $20 Medicare rate.