Negotiation Prep

Provider: Northwestern Memorial Hospital · Payer: Humana · Generated: 2026-08-08 09:37 UTC

Your argument

1 of 10 procedures priced below market median with Humana. Lead with 99283 HB ED Visit Level 3 — $154 per procedure below the market median, the sharpest single-line gap.

Procedures analyzed

Below median

-$154

Total gap (per proc)

Rate Comparison by Procedure

CPT	Description	Your Rate	Median	Top Quartile	Gap to Median	Gap to Top Q	N
99283	HB ED Visit Level 3	$1,000.60	$1,154.40	$2,349.00	-153.80	-1,348.40	9
27130	HB Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	—	$13,721.12	$14,438.70	—	—	3
29881	HB Arthroscop Knee Med and Lat	$16,498.28	$16,498.28	$35,476.56	+0.00	-18,978.28	7
93005	Routine electrocardiogram (ECG) using at least 12 leads with tracing	—	$65.27	$242.64	—	—	6
99284	HB ED Visit Level 4	$2,313.80	$2,313.80	$3,674.30	+0.00	-1,360.50	9
74177	HB CT Abd & Pelv W/Contrast	$3,888.90	$3,433.77	$5,185.20	+455.14	-1,296.30	7
71250	HB CT Thorax, Diagnostic W/O Dye	$1,678.50	$981.47	$2,238.00	+697.03	-559.50	7
70553	HB MRI Brain Stem W/O & W/Dye	$3,461.85	$2,639.98	$4,615.80	+821.87	-1,153.95	7
70551	HB MRI Brain Stem W/O Dye	$2,498.85	$1,427.92	$3,331.80	+1,070.93	-832.95	7
43239	HB Egd Transoral Biopsy Single/Multiple	$5,905.79	$2,979.74	$7,396.22	+2,926.05	-1,490.44	9

Recommended Asks

Procedures where your rate sits below the market top quartile. Negotiating these to top-quartile is the standard ask.

CPT	Description	Current Rate	Target (Top Q)	Lift
99283	HB ED Visit Level 3	$1,000.60	$2,349.00	+1,348.40 (134.8%)
29881	HB Arthroscop Knee Med and Lat	$16,498.28	$35,476.56	+18,978.28 (115.0%)
99284	HB ED Visit Level 4	$2,313.80	$3,674.30	+1,360.50 (58.8%)
74177	HB CT Abd & Pelv W/Contrast	$3,888.90	$5,185.20	+1,296.30 (33.3%)
71250	HB CT Thorax, Diagnostic W/O Dye	$1,678.50	$2,238.00	+559.50 (33.3%)
70553	HB MRI Brain Stem W/O & W/Dye	$3,461.85	$4,615.80	+1,153.95 (33.3%)
70551	HB MRI Brain Stem W/O Dye	$2,498.85	$3,331.80	+832.95 (33.3%)
43239	HB Egd Transoral Biopsy Single/Multiple	$5,905.79	$7,396.22	+1,490.44 (25.2%)

Anonymized Peer Comparison

Peer hospitals are anonymized to "Peer Hospital A/B/C…" sorted by rate (highest first). Real hospital identities are never included in this report.

CPT	Description	Peer rates
99283	HB ED Visit Level 3	Peer Hospital A $3,229.20 Peer Hospital B $3,001.80 Peer Hospital C $2,349.00 Peer Hospital D $1,550.54 Peer Hospital E $1,154.40 Peer 6 $955.64 Peer 7 $784.14 Peer 8 $326.16
27130	HB Arthrp Acetblr/Prox Fem Prostc Agrft/Algrft	Peer Hospital A $14,438.70 Peer Hospital B $13,721.12 Peer Hospital C $13,721.12
29881	HB Arthroscop Knee Med and Lat	Peer Hospital A $38,937.49 Peer Hospital B $35,476.56 Peer Hospital C $29,330.27 Peer Hospital D $3,640.99 Peer Hospital E $3,460.04 Peer 6 $3,460.04
93005	Routine electrocardiogram (ECG) using at least 12 leads with tracing	Peer Hospital A $261.00 Peer Hospital B $242.64 Peer Hospital C $67.20 Peer Hospital D $63.34 Peer Hospital E $44.44 Peer 6 $44.44
99284	HB ED Visit Level 4	Peer Hospital A $8,067.60 Peer Hospital B $7,326.89 Peer Hospital C $3,674.30 Peer Hospital D $3,495.00 Peer Hospital E $2,164.20 Peer 6 $1,999.55 Peer 7 $1,738.55 Peer 8 $501.59
74177	HB CT Abd & Pelv W/Contrast	Peer Hospital A $5,185.20 Peer Hospital B $5,185.20 Peer Hospital C $3,433.77 Peer Hospital D $793.39 Peer Hospital E $793.39 Peer 6 $420.68
71250	HB CT Thorax, Diagnostic W/O Dye	Peer Hospital A $2,238.00 Peer Hospital B $2,238.00 Peer Hospital C $981.47 Peer Hospital D $317.63 Peer Hospital E $317.63 Peer 6 $125.26
70553	HB MRI Brain Stem W/O & W/Dye	Peer Hospital A $4,615.80 Peer Hospital B $4,615.80 Peer Hospital C $2,639.98 Peer Hospital D $820.16 Peer Hospital E $820.16 Peer 6 $420.68
70551	HB MRI Brain Stem W/O Dye	Peer Hospital A $3,331.80 Peer Hospital B $3,331.80 Peer Hospital C $1,427.92 Peer Hospital D $515.94 Peer Hospital E $515.94 Peer 6 $284.73
43239	HB Egd Transoral Biopsy Single/Multiple	Peer Hospital A $19,987.32 Peer Hospital B $19,571.32 Peer Hospital C $7,396.22 Peer Hospital D $2,979.74 Peer Hospital E $2,758.20 Peer 6 $999.81 Peer 7 $755.72 Peer 8 $755.72