CMS Price Transparency Data

X-ray, hip

Facility: Decatur Memorial Hospital

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73502
Insurance Median: $396
Cash Discount Price: $870
vs. Medicare Baseline: 4.45x Medicare

The contracted insurance negotiated median rate for a X-ray, hip at Decatur Memorial Hospital is $396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $870. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.45x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$870

Average discount available for prompt cash payment at this facility.

Insurance Median

$396

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: $870 (979%)

Insurance Median: $396 (445%)

Cash: $870 (979% of Medicare)

Ins. Median: $396 (445% 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 445% of the Medicare baseline (a markup of 345%). 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	$45 - $584	51%
Blue Cross Blue Shield	$45 - $870	51%
Coventry	$45 - $441	51%
Health Alliance	$45 - $579	51%
Humana	$45 - $566	51%
Medicare (plans)	$45 - $92	51%
UnitedHealthcare	$45 - $870	51%
Veterans Administration	$45 - $92	51%
Tricare	$46 - $93	52%
Medicaid / KanCare	$70 - $72	79%
Plain Church Medical Group	$75 - $392	84%
Wellcare	$92	103%
Illinois Workers Compensation	$138 - $463	155%
Caterpillar	$210	236%
Mennonite Churches	$304	342%
Health Alliance Mh Employee Plan	$400	450%
Cigna	$405	456%
Hfn	$435 - $652	489%
Commercial Workers Compensation	$440	495%
6 Degrees Health	$522	587%
Hopetrust	$522	587%
Hst	$522	587%
Phcs Savility	$566	637%
Phcs Multiplan Ppo	$592	666%
Healthlink	$597	671%
Corvel	$626	704%
Consociate	$644	724%
Liability	$870	979%

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 $870.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73502.

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 73502.
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.