CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Decatur Memorial Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $574
  • Cash Discount Price: $1,569
  • vs. Medicare Baseline: 5.37x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Decatur Memorial Hospital is $574. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,569. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.37x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
$1,569

Average discount available for prompt cash payment at this facility.

Insurance Median
$574

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: $1,569 (1469%)
Insurance Median: $574 (537%)
Cash: $1,569 (1469% of Medicare)
Ins. Median: $574 (537% 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 537% of the Medicare baseline (a markup of 437%). 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 $80 - $1,053 75%
Blue Cross Blue Shield $80 - $1,569 75%
Coventry $80 - $795 75%
Health Alliance $80 - $1,043 75%
Humana $80 - $1,020 75%
Medicare (plans) $80 - $110 75%
UnitedHealthcare $80 - $1,569 75%
Veterans Administration $80 - $110 75%
Tricare $81 - $112 76%
Wellcare $110 103%
Plain Church Medical Group $136 - $706 127%
Medicaid / KanCare $137 - $140 128%
Caterpillar $252 236%
Illinois Workers Compensation $269 - $605 252%
Mennonite Churches $549 514%
Hfn $568 - $1,177 532%
Commercial Workers Compensation $574 537%
Health Alliance Mh Employee Plan $722 676%
Cigna $731 684%
6 Degrees Health $941 881%
Hopetrust $941 881%
Hst $941 881%
Phcs Savility $1,020 955%
Phcs Multiplan Ppo $1,067 999%
Healthlink $1,076 1007%
Corvel $1,130 1058%
Consociate $1,161 1087%
Liability $1,569 1469%

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