CMS Price Transparency Data

Injection procedure for pain management

Facility: St Marys Hospital

Billing Code: G0260 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$753

about 1.0× the $721 Medicare rate · typically $669–$910

modeled estimate · not a bill or quote

What this hospital charges insurers

$775

About the fair price

about $22 over the fair price · 1.1× Medicare

Medicare pays $721 Fair price $753 This hospital $775 Cash price $5,523 Hospital's list price $7,671

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $246 Priciest $775

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Injection procedure for pain management is about $753 (about 1.0× the $721 Medicare rate). St Marys Hospital charges insurers about $775, or about $5,523 in cash — about the fair price. Located in Decatur, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$756 - $9,205	105%
Blue Cross Blue Shieldmajor	$756	105%
Aetnamajor	$756 - $5,063	105%
Cignamajor	$3,744 - $7,364	519%
Humanamajor	$756	105%
HealthLink	$4,370 - $9,205	606%
Meridian	$437	61%
Molina	$418 - $794	58%
+ 16 smaller / regional plans	$756 - $9,205

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 5,523), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the HCPCS code on your bill matches exactly: G0260.

Insurance Before you use insurance

Call your insurance company to confirm St Marys Hospital is in-network.
Ask your insurer whether prior approval is required for HCPCS code G0260.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Marys Hospital

Compare: Injection procedure for pain management at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.