CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Shirley Ryan Abilitylab

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $321
  • Cash Discount Price: $275
  • vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Shirley Ryan Abilitylab is $321. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $275. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.73x the Medicare baseline. Located in 355 E Erie St, Chicago, IL.
Cash / Self-Pay
$275

Average discount available for prompt cash payment at this facility.

Insurance Median
$321

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $275 (234%)
Insurance Median: $321 (273%)
Cash: $275 (234% of Medicare)
Ins. Median: $321 (273% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 273% of the Medicare baseline (a markup of 173%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Cigna $65 55%
Aetna $175 - $367 149%
Blue Cross Blue Shield $213 - $367 181%
Health Care Services Corporation $220 187%
Uic Physician Group-Campuscare $230 - $252 196%
Hfn $232 - $413 197%
Corvel Corporation $239 203%
Coventry Workers Comp $239 203%
Multiplan $239 203%
Personalcare Insurance Of Il/Firsthealth Grp Corp/Coventryhealth And Life Insurance Co $244 - $390 208%
State Of Illinois $244 208%
Uic Physician Group $252 - $372 214%
Union Health Service $257 219%
UnitedHealthcare $264 225%
Affordable Health Care Concepts $276 235%
Loyola University Physician Foundation $298 253%
Paradigm Health Corporation $298 253%
University Of Chicago Practice Plan $298 253%
Health Care Services Corporation Dba Managed Care Network Preferred $313 - $409 266%
Advocate And Advocate Health Partners $321 273%
Gallagher Benefit Administrators $344 293%
Health Care Services Corporation D/B/A Hmo Illinois $358 304%
Unicare Life And Health Insurance $358 304%
County Care $367 312%
Meridian Health Plan $367 312%
Private Healthcare Systems $367 312%
Resurrection Health Care Preferred $367 312%
Cofinity Aka Ppom $390 332%
Health Payors Organization $390 332%
Healthnetwork $404 - $436 344%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 355 E Erie St, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL