CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Decatur Memorial Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $1,006
Cash Discount Price: $3,590
vs. Medicare Baseline: 9.42x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Decatur Memorial Hospital is $1,006. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,590. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.42x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$3,590

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,006

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $3,590 (3361%)

Insurance Median: $1,006 (942%)

Cash: $3,590 (3361% of Medicare)

Ins. Median: $1,006 (942% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 942% of the Medicare baseline (a markup of 842%). 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	$99 - $2,409	93%
Blue Cross Blue Shield	$99 - $3,590	93%
Coventry	$99 - $1,820	93%
Health Alliance	$99 - $2,387	93%
Humana	$99 - $988	93%
Medicare (plans)	$99 - $110	93%
UnitedHealthcare	$99 - $3,590	93%
Veterans Administration	$99 - $110	93%
Tricare	$101 - $112	95%
Wellcare	$110	103%
Plain Church Medical Group	$136 - $1,616	127%
Caterpillar	$252	236%
Medicaid / KanCare	$382 - $389	358%
Illinois Workers Compensation	$877 - $1,024	821%
Hfn	$963 - $2,692	902%
Commercial Workers Compensation	$973	911%
Cigna	$1,216 - $1,673	1138%
Mennonite Churches	$1,256	1176%
Health Alliance Mh Employee Plan	$1,651	1546%
6 Degrees Health	$2,154	2017%
Hopetrust	$2,154	2017%
Hst	$2,154	2017%
Phcs Savility	$2,334	2185%
Phcs Multiplan Ppo	$2,441	2285%
Healthlink	$2,463	2306%
Corvel	$2,585	2420%
Consociate	$2,657	2488%
Liability	$3,590	3361%

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 $3,590.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

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 70450.
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.