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Elmhurst Memorial Hospital

ELMHURST MEMORIAL HOSPITAL in Elmhurst, IL charges 7.7x the Medicare reimbursement rate across 121 analyzed procedures, reflecting the pricing structure at this for-profit healthcare facility.

Elmhurst, IL 60126 · Acute Care Hospitals · CMS Rating: 4/5

By Priya Iyengar , Senior Billing Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.

121 procedures analyzed
CMS price transparency data
Updated 2026-04-03
Median 5.4x3.1x15.0x
7.7x
Medicare markup ratio
IL lowestElmhurst Memorial Hosp...IL highest
7.7x
Avg markup ratio
7.3x
Median markup
121
Procedures
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Billing patterns — for-profit

For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.

Pricing grade

D

High

Avg markup vs Medicare

7.65x

Charge / Medicare rate

Max markup

14.14x

Worst procedure

Procedures analyzed

121

With pricing data

Outlier procedures

0%

Above 90th percentile

Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.

ProcedureCodeGross chargeCash priceMedicareMarkup
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC390$35,265$17,63214.1x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC310$26,940$13,47013.4x
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC191$53,130$26,56511.7x
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC069$44,907$22,45311.6x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC066$42,462$21,23111.5x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC247$120,753$60,37711.3x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O246$186,842$93,42110.4x
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC661$54,922$27,46110.4x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC419$81,040$40,52010.4x
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC192$30,355$15,17710.2x
SIMPLE PNEUMONIA AND PLEURISY WITH CC194$39,458$19,72910x
TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC086$77,329$38,6649.9x
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC234$252,068$126,0349.8x
SYNCOPE AND COLLAPSE312$47,586$23,7939.8x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS065$52,551$26,2769.7x
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC236$189,548$94,7749.7x
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC897$42,313$21,1579.5x
HYPERTENSION WITHOUT MCC305$32,090$16,0459.3x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC287$55,571$27,7859.3x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC309$36,300$18,1509.3x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC392$38,444$19,2229.2x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC331$89,950$44,9759.2x
GASTROINTESTINAL OBSTRUCTION WITH CC389$40,446$20,2239.1x
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC057$74,419$37,2109.1x
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC056$125,248$62,6248.8x
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC981$252,461$126,2308.6x
MEDICAL BACK PROBLEMS WITH MCC551$87,198$43,5998.6x
DISORDERS OF THE BILIARY TRACT WITH CC445$50,862$25,4318.6x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC872$48,569$24,2848.4x
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC982$137,590$68,7958.4x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC393$84,638$42,3198.4x
PULMONARY EMBOLISM WITHOUT MCC176$34,445$17,2228.3x
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC468$138,994$69,4978.3x
GASTROINTESTINAL HEMORRHAGE WITH CC378$46,419$23,2098.3x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC281$43,486$21,7438.2x
DIGESTIVE MALIGNANCY WITH CC375$59,437$29,7188.2x
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC439$36,719$18,3608.1x
MAJOR CHEST PROCEDURES WITH CC164$122,806$61,4038.1x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC394$38,246$19,1237.9x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC517$72,612$36,3067.9x
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC690$33,069$16,5347.9x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC418$77,273$38,6367.9x
OTHER DISORDERS OF NERVOUS SYSTEM WITH CC092$45,809$22,9047.9x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/321$151,098$75,5497.8x
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES483$116,154$58,0777.8x
MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC641$33,213$16,6077.7x
FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC563$35,768$17,8847.7x
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC699$41,493$20,7477.7x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC516$87,092$43,5467.7x
RED BLOOD CELL DISORDERS WITHOUT MCC812$38,703$19,3517.6x

Showing 50 of 121 procedures

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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — for-profit hospital billing

How much do for-profit hospitals typically charge compared to Medicare rates?
Based on data from 628 for-profit hospitals, the average markup is 7.8 times Medicare rates. This means charges are typically set at nearly 8 times what Medicare would pay for the same services.
Why do for-profit hospitals charge more than Medicare rates?
For-profit hospitals operate as businesses with shareholders and must generate revenue to cover operational costs and profit margins. Their pricing structure differs from Medicare's standardized payment rates, which are set by government formula rather than market conditions.
Does insurance typically pay the full hospital charge amount?
Most insurance companies negotiate contracted rates with hospitals that are lower than the posted charges. However, patients may still face significant out-of-pocket costs depending on their insurance coverage and deductible amounts.
What should I know about billing differences between hospital types?
For-profit hospitals generally have different pricing structures than non-profit or government-owned facilities due to their business model. Understanding your hospital's ownership type can provide context for potential billing differences when reviewing medical bills.

Related pricing data

Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.

Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.

This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use

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