CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Shirley Ryan Abilitylab

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $200
  • Cash Discount Price: $184
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Shirley Ryan Abilitylab is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.47x the Medicare baseline. Located in 355 E Erie St, Chicago, IL.
Cash / Self-Pay
$184

Average discount available for prompt cash payment at this facility.

Insurance Median
$200

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $184 (136%)
Insurance Median: $200 (147%)
Cash: $184 (136% of Medicare)
Ins. Median: $200 (147% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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.

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 48%
Health Care Services Corporation $140 - $147 103%
Aetna $140 - $367 103%
Blue Cross Blue Shield $143 - $367 105%
Hfn $155 - $276 114%
Multiplan $160 118%
Corvel Corporation $160 118%
Coventry Workers Comp $160 118%
Personalcare Insurance of Il/Firsthealth Grp Corp/Coventryhealth and Life Insurance Co $163 - $261 120%
State of Illinois $163 120%
Endeavor Health Sites 243/447 Northshore and Edwards $169 125%
Uic Physician Group-Campuscare $169 125%
Uic Physician Group $169 125%
Paradigm Health Corporation $170 - $200 125%
Union Health Service $172 127%
UnitedHealthcare $177 131%
University of Chicago Practice Plan $184 - $200 136%
Affordable Health Care Concepts $185 136%
Loyola University Physician Foundation $200 147%
Advocate and Advocate Health Partners $215 159%
Resurrection Health Care Preferred $230 - $246 170%
Gallagher Benefit Administrators $230 170%
Health Care Services Corporation D/B/A HMO Illinois $239 176%
Unicare Life and Health Insurance $239 176%
Private Healthcare Systems $246 181%
Cofinity Aka Ppom $261 192%
Health Payors Organization $261 192%
Health Care Services Corporation DBA Managed Care Network Preferred $273 201%
Healthnetwork $292 215%
Advocate Health Partners $307 226%
Meridian Health Plan $307 226%
County Care $367 271%

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