CMS Price Transparency Data

X-ray, lower back

Facility: Decatur Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $270
  • Cash Discount Price: $1,135
  • vs. Medicare Baseline: 2.53x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Decatur Memorial Hospital is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,135. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.53x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
$1,135

Average discount available for prompt cash payment at this facility.

Insurance Median
$270

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: $1,135 (1063%)
Insurance Median: $270 (253%)
Cash: $1,135 (1063% of Medicare)
Ins. Median: $270 (253% 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 253% of the Medicare baseline (a markup of 153%). 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 $49 - $762 46%
Blue Cross Blue Shield $49 - $1,135 46%
Coventry $49 - $575 46%
Health Alliance $49 - $755 46%
Humana $49 - $738 46%
Medicare (plans) $49 - $110 46%
UnitedHealthcare $49 - $1,135 46%
Veterans Administration $49 - $110 46%
Tricare $50 - $112 47%
Medicaid / KanCare $70 - $72 66%
Wellcare $110 103%
Plain Church Medical Group $136 - $511 127%
Illinois Workers Compensation $177 - $263 166%
Hfn $248 - $851 232%
Commercial Workers Compensation $250 234%
Caterpillar $252 236%
Mennonite Churches $397 372%
Health Alliance Mh Employee Plan $522 489%
Cigna $529 495%
6 Degrees Health $681 638%
Hopetrust $681 638%
Hst $681 638%
Phcs Savility $738 691%
Phcs Multiplan Ppo $772 723%
Healthlink $779 729%
Corvel $817 765%
Consociate $840 786%
Liability $1,135 1063%

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