CMS Price Transparency Data

Blood test, calcium

Facility: Decatur Memorial Hospital

Billing Code: 82310 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82310
Insurance Median: $77
Cash Discount Price: $166
vs. Medicare Baseline: 14.92x Medicare

The contracted insurance negotiated median rate for a Blood test, calcium at Decatur Memorial Hospital is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $5.16, this hospital’s rate is 14.92x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$5.16

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.16 (100%)

Cash / Self-Pay: $166 (3217%)

Insurance Median: $77 (1492%)

Cash: $166 (3217% of Medicare)

Ins. Median: $77 (1492% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.16 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1492% of the Medicare baseline (a markup of 1392%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$5 - $111	97%
Blue Cross Blue Shield	$5 - $166	97%
Coventry	$5 - $84	97%
Health Alliance	$5 - $110	97%
Humana	$5 - $108	97%
Medicare (plans)	$5	97%
Tricare	$5	97%
UnitedHealthcare	$5 - $166	97%
Veterans Administration	$5	97%
Wellcare	$5	97%
Caterpillar	$6	116%
Medicaid / KanCare	$6	116%
Plain Church Medical Group	$7 - $75	136%
Illinois Workers Compensation	$25 - $59	484%
Hfn	$55 - $124	1066%
Commercial Workers Compensation	$56	1085%
Mennonite Churches	$58	1124%
Health Alliance Mh Employee Plan	$76	1473%
Cigna	$77	1492%
6 Degrees Health	$100	1938%
Hopetrust	$100	1938%
Hst	$100	1938%
Phcs Savility	$108	2093%
Phcs Multiplan Ppo	$113	2190%
Healthlink	$114	2209%
Corvel	$120	2326%
Consociate	$123	2384%
Liability	$166	3217%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $166.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82310.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Decatur Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82310.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.