CMS Price Transparency Data

Review of medical records for care

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 90889 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90889
Insurance Median: $449
Cash Discount Price: $393
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Review of medical records for care at Ann & Robert H Lurie Childrens Hospital of Chicago is $449. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $393. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.

Cash / Self-Pay

$393

Average discount available for prompt cash payment at this facility.

Insurance Median

$449

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicare (plans)	$95 - $2,656	N/A
Mercycare Health	$208	N/A
Cigna	$236 - $398	N/A
Blue Cross Blue Shield	$243 - $449	N/A
Aetna	$280 - $439	N/A
Beacon Health Options	$280	N/A
La Rabida Childrens Hospital	$280	N/A
Centegra	$337	N/A
Independent Physicians At Mercy	$337	N/A
Advanced Physicians Association Ipa	$393	N/A
Health Plus	$393	N/A
Imagine Health	$393	N/A
Methodist First Choice	$393	N/A
Northwest Community Healthcare	$393	N/A
Presence Health Partners	$393	N/A
St. Francis	$393	N/A
Ui Health	$393	N/A
West Suburban Health Providers	$393	N/A
Shriners Hospital	$421	N/A
Swedish Covenant Physician Partners	$421	N/A
American Psych Systems	$449	N/A
Health Alliance	$449	N/A
Macneal Health	$449	N/A
Magellan	$449 - $900	N/A
Healthlink Inc.	$463	N/A
Cofinity	$477	N/A
Hfn Inc	$477 - $505	N/A
Humana	$477	N/A
Principal Healthcare	$477	N/A
St. Elizabeth	$477	N/A
First Health	$494	N/A
Healthstar	$494	N/A
Preferred Health Network	$494	N/A
Sagamore Health Network	$494	N/A
Beech Street	$505	N/A
Benchmark Health	$505	N/A
Employer'S Coalition On Health	$505	N/A
Private Health Care System	$505	N/A
Security Health Plan	$505	N/A
Swedish American	$505	N/A
Wellmark/Healthnetwork	$516	N/A
Health Smart	$533	N/A
Integrated Health Plan	$533	N/A
Multiplan	$533	N/A
National Provider Network	$533	N/A
Wea Insurance Group	$533	N/A
UnitedHealthcare	$599 - $643	N/A
Unicare	$3,678 - $8,500	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $393.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90889.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ann & Robert H Lurie Childrens Hospital of Chicago is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90889.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.