How many shoppable procedure prices are published for Northwestern Medicine McHenry?

Northwestern Medicine McHenry in McHenry, IL currently has 116 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Northwestern Medicine McHenry's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Northwestern Medicine McHenry's median negotiated commercial rate is 1.5× the regionally adjusted fair BaseRate benchmark.

What is Northwestern Medicine McHenry's CMS Care Compare overall star rating?

CMS Care Compare assigns Northwestern Medicine McHenry an overall hospital quality rating of 5 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Other 293 Beds · urban Updated: 2026-04-01

Northwestern Medicine McHenry

4201 Medical Center Drive, McHenry, IL 60050 · 116 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

High Markup · Shop Alternatives

1.49×vs. Fair Market Price

Typical commercial prices here are +49% above the fair benchmark (1.49×) even after accounting for local nurse/doctor wages and patient complexity.

84/100 · Corroborated

84/100Self-Pay Cash Beats Insurance 28% of the Time

File Completeness66

Price Logic92

Peer Alignment67

Clean Billing94

Real Cash Discount100

High-Markup · Check Safety

4-Star CMS clinical quality rating paired with 1.49× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Northwestern Medicine McHenry prices shoppable and inpatient services (2.1× to 1.1× Medicare, divergence 0.52×) in alignment with regional hospital peers (1.49× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#95 of 126 in IL · 74th State Percentile#2,613 of 3,385 in U.S. · 77th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 28% of shoppable procedures (99/100 Cash Honesty)
5-Star CMS clinical rating with 75% patient recommendation (75/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (48.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.8× markup over Medicare rates
Commercial insurance median sits at 1.39× Fair BaseRate (2.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.74×) jump +25% above the median procedure ratio (Q50 1.39×)
Unnegotiated chargemaster list prices average 13.5× Medicare (19¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.1× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.52× Divergence

1.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+25% Upper Tail

Q25 0.78× · Q50 1.39× · Q75 1.74×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

2.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.5× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

1.4× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

3.5× MedicareElevated

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.1× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

28% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 75/100Fair

Procedure Prices at Northwestern Medicine McHenry

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 116 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$150,356	$25,333	$30,775	0.8×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$42,871	$15,233	$19,087	0.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$66,627	$15,126	$19,432	0.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$70,547	$13,825	$17,936	0.8×
Rabies immune globulin HCPCS Code: `90375`	$7,932	$7,932	$322	24.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$24,073	$7,447	$6,109	1.2×
Trauma team activation HCPCS Code: `G0390`	$6,224	$6,224	$1,453	4.3×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$24,344	$6,114	$8,223	0.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$6,049	$6,049	$448	13.5×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$20,461	$5,868	$3,372	1.7×
Inguinal hernia repair CPT Code: `49505`	$27,070	$5,868	$3,629	1.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$5,385	$5,385	$511	10.5×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$4,802	$4,802	$303	15.8×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,558	$4,558	$1,021	4.5×
Cataract surgery with lens implant CPT Code: `66984`	$10,711	$3,975	$2,540	1.6×
MRI, brain (no contrast) CPT Code: `70551`	$3,887	$3,887	$343	11.3×
MRI, lower back (no contrast) CPT Code: `72148`	$3,837	$3,837	$338	11.4×
MRI, knee or other leg joint CPT Code: `73721`	$3,835	$3,835	$369	10.4×
Blood transfusion CPT Code: `36430`	$3,788	$3,788	$498	7.6×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,757	$3,757	$258	14.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$3,168	$3,168	$169	18.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$3,084	$3,084	$168	18.4×
Colonoscopy with biopsy CPT Code: `45380`	$7,790	$3,045	$1,256	2.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,951	$2,951	$583	5.1×
CT scan, head (with contrast) CPT Code: `70460`	$2,922	$2,922	$242	12.1×
Injection procedure for pain management HCPCS Code: `G0260`	$2,939	$2,939	$855	3.4×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,600	$2,893	$981	2.9×
CT scan, sinuses CPT Code: `70486`	$2,606	$2,606	$166	15.7×
CT scan, chest (no contrast) CPT Code: `71250`	$2,611	$2,611	$167	15.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$2,626	$2,626	$272	9.7×
CT scan, head (no contrast) CPT Code: `70450`	$2,475	$2,475	$160	15.5×
Upper endoscopy with biopsy CPT Code: `43239`	$7,163	$2,374	$987	2.4×
CT scan, pelvis CPT Code: `72192`	$2,157	$2,157	$163	13.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,772	$1,772	$134	13.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,604	$1,604	$126	12.7×
Ultrasound, pelvis CPT Code: `76856`	$1,510	$1,510	$130	11.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,343	$1,343	$132	10.2×
X-ray, lower back CPT Code: `72110`	$909	$909	$112	8.1×
Psychological testing by technician CPT Code: `96138`	$921	$921	$395	2.3×
Neurobehavioral status check CPT Code: `96116`	$805	$805	$231	3.5×
X-ray, chest (two views) CPT Code: `71046`	$674	$674	$93	7.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$666	$666	$93	7.2×
X-ray, shoulder CPT Code: `73030`	$623	$623	$92	6.8×
X-ray, foot CPT Code: `73630`	$594	$594	$92	6.5×
X-ray, pelvis CPT Code: `72170`	$576	$576	$110	5.2×
X-ray, hand CPT Code: `73130`	$547	$547	$93	5.9×
X-ray, chest (single view) CPT Code: `71045`	$538	$538	$92	5.8×
X-ray, ankle CPT Code: `73610`	$542	$542	$93	5.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$556	$556	$181	3.1×
X-ray, hip CPT Code: `73502`	$523	$523	$93	5.6×
Screening mammogram (both breasts) CPT Code: `77067`	$524	$524	$123	4.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$514	$514	$148	3.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$473	$473	$185	2.6×
Speech therapy (language evaluation) CPT Code: `92507`	$356	$356	$86	4.1×
New patient office visit (30-44 min) CPT Code: `99203`	$380	$380	$110	3.5×
Hepatitis B immune globulin HCPCS Code: `90371`	$363	$363	$151	2.4×
Breathing treatment (nebulizer) CPT Code: `94640`	$385	$385	$201	1.9×
Family therapy session CPT Code: `90847`	$319	$319	$173	1.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$281	$281	$123	2.3×
Psychotherapy session (45 minutes) CPT Code: `90834`	$274	$274	$166	1.7×
Physical therapy (manual therapy) CPT Code: `97140`	$214	$214	$34	6.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$238	$238	$64	3.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$221	$221	$87	2.5×
Speech therapy (group session) CPT Code: `92508`	$167	$167	$27	6.2×
Physical therapy (gait training) CPT Code: `97116`	$170	$170	$33	5.2×
Occupational therapy (self-care training) CPT Code: `97535`	$188	$188	$38	4.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$186	$186	$38	4.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$165	$165	$35	4.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$169	$169	$38	4.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$169	$169	$40	4.2×
Prosthetic fitting and training CPT Code: `97761`	$179	$179	$45	4.0×
Orthotic fitting and training CPT Code: `97760`	$181	$181	$51	3.5×
Group therapy session CPT Code: `90853`	$172	$172	$100	1.7×
Hospital observation (per hour) HCPCS Code: `G0378`	$129	$129	$86	1.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	$96	$96	$35	2.7×
Typhoid vaccine HCPCS Code: `90675`	$1,029	$1,029	$347	3.0×
Culture, blood CPT Code: `87040`	$433	$433	$11	39.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$387	$387	$111	3.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$307	$307	$11	27.9×
Pneumococcal vaccine HCPCS Code: `90732`	$313	$313	$140	2.2×
Blood test, basic metabolic panel CPT Code: `80048`	$220	$220	$9	24.4×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$214	$214	$20	10.7×
Drug screening test HCPCS Code: `G0480`	$218	$218	$116	1.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$184	$184	$14	13.1×
Blood test, vitamin D CPT Code: `82306`	$191	$191	$31	6.2×
Blood test, liver function panel CPT Code: `80076`	$139	$139	$9	15.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$162	$162	$18	9.0×
Culture, bacterial CPT Code: `87070`	$134	$134	$9	14.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$144	$144	$14	10.3×
Blood test, lipase CPT Code: `83690`	$96	$96	$7	13.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$117	$117	$10	11.7×
Blood test, vitamin B12 CPT Code: `82607`	$135	$135	$16	8.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$147	$147	$56	2.6×
Blood test, complete blood count (CBC) CPT Code: `85025`	$100	$100	$8	12.5×
Hepatitis C antibody test CPT Code: `86803`	$117	$117	$15	7.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$109	$109	$19	5.7×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$97	$97	$27	3.6×
Hepatitis B vaccine HCPCS Code: `90744`	$112	$112	$37	3.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$81	$81	$3	27.0×
Blood test, sodium CPT Code: `84295`	$74	$74	$5	14.8×
Blood test, amylase CPT Code: `82150`	$91	$91	$7	13.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$52	$52	$4	13.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$77	$77	$6	12.8×
Blood test, magnesium CPT Code: `83735`	$81	$81	$7	11.6×
Blood antibody screen CPT Code: `86850`	$99	$99	$46	2.2×
Blood test, calcium CPT Code: `82310`	$55	$55	$5	11.0×
Flu vaccine injection HCPCS Code: `G0008`	$67	$67	$48	1.4×
Pneumonia vaccine injection HCPCS Code: `G0009`	$62	$62	$49	1.3×
Blood test, hemoglobin CPT Code: `85018`	$33	$33	$3	11.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$43	$43	$4	10.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$52	$52	$5	10.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$49	$49	$5	9.8×
Blood test, potassium CPT Code: `84132`	$47	$47	$5	9.4×
Behavioral health outpatient services HCPCS Code: `H2015`	$50	$50	$16	3.1×
Flu vaccine (high dose) HCPCS Code: `90656`	$50	$50	$25	2.0×
Colorectal cancer screening HCPCS Code: `G0010`	$57	$57	$49	1.2×

Showing top 25 high-impact procedures of 116 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 48.4%

Audit a Bill or Quote at Northwestern Medicine McHenry (Zero PHI Required)

CMS CCN: 140116

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $150,356

Insurer Median $25,333

1. Amount on Your Bill or Quote ($) Pre-filled with Northwestern Medicine McHenry’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $103,874 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $103,874

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (48.4% of gross = $103,874).

Step 2 · Cash vs. Insurance Arbitrage Save $64,438 Paying Cash

Self-Pay Cash Rate ($150,356) Beats Your Bill

Northwestern Medicine McHenry's published 45 CFR § 180 self-pay cash rate is $150,356 (vs. $25,333 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$184,019 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($214,794) is $184,019 above the denoised Fair BaseRate ($30,775) and 9.1× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (48.4% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite75/100

Would Recommend75%

Rated 9 or 10 (HCAHPS)75%

Median ER Wait191 min

Left ER Before Seen2%

30-Day Mortality vs U.S.better

Unplanned Readmissionsame

Hip/Knee Complication Rate2.9%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (1,080 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Northwestern Medicine McHenry.

Price Index: 1.80× regional baseline

Quality: 83/100 CMS composite

Median Household Income$102,836U.S. Census ACS

Local Uninsured Share4.7%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 84/100 · Corroborated CMS CCN 140116

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 140116) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows4,537 (CMS v3.0.0)

File Integrity DigestVerified · CCN 140116

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy