CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Decatur Memorial Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,411
Cash Discount Price: $3,694
vs. Medicare Baseline: 7.87x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Decatur Memorial Hospital is $1,411. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,694. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.87x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$3,694

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,411

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)

Cash / Self-Pay: $3,694 (2061%)

Insurance Median: $1,411 (787%)

Cash: $3,694 (2061% of Medicare)

Ins. Median: $1,411 (787% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 787% of the Medicare baseline (a markup of 687%). 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	$139 - $2,479	78%
Blue Cross Blue Shield	$139 - $3,694	78%
Coventry	$139 - $1,873	78%
Health Alliance	$139 - $2,457	78%
Humana	$139 - $988	78%
Medicare (plans)	$139 - $185	78%
UnitedHealthcare	$139 - $3,694	78%
Veterans Administration	$139 - $185	78%
Tricare	$141 - $188	79%
Wellcare	$185	103%
Plain Church Medical Group	$244 - $1,662	136%
Medicaid / KanCare	$382 - $389	213%
Caterpillar	$423	236%
Illinois Workers Compensation	$875 - $1,690	488%
Cigna	$1,216 - $1,721	679%
Mennonite Churches	$1,293	722%
Hfn	$1,589 - $2,770	887%
Commercial Workers Compensation	$1,606	896%
Health Alliance Mh Employee Plan	$1,699	948%
6 Degrees Health	$2,216	1237%
Hopetrust	$2,216	1237%
Hst	$2,216	1237%
Phcs Savility	$2,401	1340%
Phcs Multiplan Ppo	$2,512	1402%
Healthlink	$2,534	1414%
Corvel	$2,660	1484%
Consociate	$2,734	1526%
Liability	$3,694	2061%

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 $3,694.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

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 70460.
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.