CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Decatur Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $1,637
  • Cash Discount Price: $6,550
  • vs. Medicare Baseline: 6.72x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Decatur Memorial Hospital is $1,637. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,550. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.72x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
$6,550

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,637

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $6,550 (2687%)
Insurance Median: $1,637 (672%)
Cash: $6,550 (2687% of Medicare)
Ins. Median: $1,637 (672% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 672% of the Medicare baseline (a markup of 572%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $178 - $4,395 73%
Blue Cross Blue Shield $178 - $6,550 73%
Coventry $178 - $3,321 73%
Health Alliance $178 - $4,356 73%
Humana $178 - $1,561 73%
Medicare (plans) $178 - $252 73%
UnitedHealthcare $178 - $6,550 73%
Veterans Administration $178 - $252 73%
Tricare $181 - $256 74%
Wellcare $252 103%
Plain Church Medical Group $279 - $2,948 114%
Medicaid / KanCare $303 - $309 124%
Caterpillar $575 236%
Illinois Workers Compensation $1,566 - $1,679 642%
Hfn $1,579 - $4,912 648%
Commercial Workers Compensation $1,596 655%
Cigna $1,854 - $3,052 761%
Mennonite Churches $2,292 940%
Health Alliance Mh Employee Plan $3,013 1236%
6 Degrees Health $3,930 1612%
Hopetrust $3,930 1612%
Hst $3,930 1612%
Phcs Savility $4,258 1747%
Phcs Multiplan Ppo $4,454 1827%
Healthlink $4,493 1843%
Corvel $4,716 1935%
Consociate $4,847 1988%
Liability $6,550 2687%

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