Illinois / Insight Hospital and Medical Center Chicago
CMS certification 140158 · Chicago, IL · 5 entries in CMS's price-transparency list
Insight Hospital and Medical Center Chicago: charges and Medicare payments
Insight Hospital and Medical Center Chicago reported 213 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 3.1 times what it was paid — among the lower ratios in Illinois, number 81 of 106 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 77 stays at an average charge of $68,564, 24% below the national average. It also billed 177 outpatient services, charging 8.44 times what Medicare paid.
- 1Medicare inpatient stays 213
- 2Charge ÷ paid, inpatient 3.1×
- 3Rank in IL (highest ratio = 1) 81 of 106
- 4CMS price-transparency actions 5
Inpatient stays
For the 9 DRGs that can be compared with the national average, Insight Hospital and Medical Center Chicago charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 77 | $68,564 | -24% | $19,938 |
| 885 Psychoses | 31 | $41,388 | -6% | $13,810 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 23 | $56,096 | -26% | $17,752 |
| 884 Organic Disturbances and Intellectual Disability | 21 | $50,513 | -19% | $17,366 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 14 | $166,256 | -27% | $62,424 |
| 291 Heart Failure and Shock with MCC | 13 | $45,668 | -19% | $12,503 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 12 | $42,651 | -16% | $11,558 |
| 193 Simple Pneumonia and Pleurisy with MCC | 11 | $56,159 | -6% | $14,603 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 11 | $203,981 | -37% | $76,495 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 117 | $20,020 | $2,599 |
| Level 4 Endovascular Procedures | 48 | $115,039 | $16,613 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 12 | $29,851 | $1,437 |
Against the Illinois average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Insight Hospital and Medical Center Chicago charged $68,564 on average, 7% less than the Illinois average of $73,987, and was paid $19,938 against a state average of $17,651. For Psychoses (DRG 885), Insight Hospital and Medical Center Chicago charged $41,388 on average, 34% more than the Illinois average of $30,984, and was paid $13,810 against a state average of $12,483. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Insight Hospital and Medical Center Chicago charged $56,096 on average, 13% less than the Illinois average of $64,281, and was paid $17,752 against a state average of $14,664. For Organic Disturbances and Intellectual Disability (DRG 884), Insight Hospital and Medical Center Chicago charged $50,513 on average, 20% more than the Illinois average of $42,167, and was paid $17,366 against a state average of $14,511. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $20,020 was 7% below the state average of $21,498. For Level 4 Endovascular Procedures (outpatient APC 5194), its average charge of $115,039 was 22% above the state average of $94,391. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $29,851 was 153% above the state average of $11,818.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Insight Hospital and Medical Center Chicago in Chicago, IL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-03-28 (CMS case 1522)
- Closure Notice — 2023-07-18 (CMS case 1522)
- CAP Request — 2025-05-23 (CMS case 4677)
- CAP Request — 2025-07-21 (CMS case 4677)
- Closure Notice — 2025-08-12 (CMS case 4677)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.