CMS Price Transparency Data

X-ray, hand

Facility: Decatur Memorial Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $245
Cash Discount Price: $802
vs. Medicare Baseline: 2.76x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Decatur Memorial Hospital is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $802. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.76x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$802

Average discount available for prompt cash payment at this facility.

Insurance Median

$245

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $802 (902%)

Insurance Median: $245 (276%)

Cash: $802 (902% of Medicare)

Ins. Median: $245 (276% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 276% of the Medicare baseline (a markup of 176%). 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	$35 - $538	39%
Blue Cross Blue Shield	$35 - $802	39%
Coventry	$35 - $407	39%
Health Alliance	$35 - $533	39%
Humana	$35 - $521	39%
Medicare (plans)	$35 - $92	39%
UnitedHealthcare	$35 - $802	39%
Veterans Administration	$35 - $92	39%
Tricare	$36 - $93	40%
Medicaid / KanCare	$70 - $72	79%
Plain Church Medical Group	$75 - $361	84%
Wellcare	$92	103%
Illinois Workers Compensation	$97 - $178	109%
Hfn	$168 - $602	189%
Commercial Workers Compensation	$169	190%
Caterpillar	$210	236%
Mennonite Churches	$281	316%
Health Alliance Mh Employee Plan	$369	415%
Cigna	$374	421%
6 Degrees Health	$481	541%
Hopetrust	$481	541%
Hst	$481	541%
Phcs Savility	$521	586%
Phcs Multiplan Ppo	$545	613%
Healthlink	$550	619%
Corvel	$577	649%
Consociate	$593	667%
Liability	$802	902%

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 $802.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

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 73130.
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.