CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Decatur Memorial Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$6,897

about 1.2× the $5,676 Medicare rate · typically $6,322–$8,483

modeled estimate · not a bill or quote

What this hospital charges insurers

$6,550

About the fair price

about $347 under the fair price · 1.2× Medicare

Medicare pays $5,676 Fair price $6,897 This hospital $6,550

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $4,941 Priciest $6,550

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Digestive disorders treatment (inpatient stay) is about $6,897 (about 1.2× the $5,676 Medicare rate). Decatur Memorial Hospital charges insurers about $6,550 — about the fair price. Located in Decatur, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$6,550 - $16,863	115%
Blue Cross Blue Shieldmajor	$6,353 - $6,550	112%
Aetnamajor	$6,550 - $10,758	115%
Cignamajor	$7,548	133%
Humanamajor	$5,354 - $5,858	94%
HealthLink	$6,581	116%
WellCare	$6,550	115%
+ 5 smaller / regional plans	$4,678 - $8,237

Government programs also on file: Medicare, Military & VA.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Decatur Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Decatur Memorial Hospital

Compare: Digestive disorders treatment (inpatient stay) at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.