CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Decatur Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,565
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Decatur Memorial Hospital is $6,565. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.16x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,565

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Insurance Median: $6,565 (116%)
Ins. Median: $6,565 (116% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 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.

Out-of-Pocket Cost Estimator

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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Corvel $1,433 25%
Health Alliance $4,678 - $8,237 82%
Phcs Savility $4,764 84%
Mennonite Churches $4,900 86%
Plain Church Medical Group $5,105 90%
Hfn $5,145 - $7,902 91%
Humana $5,354 - $5,858 94%
Consociate $6,062 107%
Blue Cross Blue Shield $6,353 - $6,550 112%
Coventry $6,550 - $6,915 115%
UnitedHealthcare $6,550 - $16,863 115%
Wellcare $6,550 115%
Healthlink $6,581 116%
Caterpillar $6,623 117%
Tricare $6,648 117%
Aetna $6,714 - $10,758 118%
Medicare (plans) $6,714 118%
Veterans Administration $6,714 118%
Cigna $7,548 133%
Commercial Workers Compensation $7,987 141%
Illinois Workers Compensation $8,407 148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 North Edward Street, Decatur, IL 62526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals