Established Patient Office Visit (level 4) at HSHS St. Mary's Hospital
1800 E. LAKE SHORE DRIVE, DECATUR, IL · Hshs · · NPI 1326041229
$439.92
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$611.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$171.08 with AMISH COMMUNITY vs $611.00 with UNITED HEALTHCARE — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| AMISH COMMUNITY | PLAIN CHURCH MEDICAL GROUP | $171.08 | ↓ -61% |
| AMISH COMMUNITY | AMISH COMMUNITY DISCOUNT | $171.08 | ↓ -61% |
| AETNA | ALL COMMERCIAL AETNA | $222.40 | ↓ -49% |
| WELLFIRST | ALL COMMERCIAL WELLFIRST | $288.88 | ↓ -34% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $313.00 | ↓ -29% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $313.00 | ↓ -29% |
| AETNA | AETNA HSHS | $336.05 | ↓ -24% |
| CURRENT HEALTH SOLUTIONS | ALL COMMERCIAL CURRENT HEALTH SOLUTIONS | $366.60 | ↓ -17% |
| CIGNA | ALL COMMERCIAL CIGNA | $372.71 | ↓ -15% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $427.70 | ↓ -3% |
| CONSOCIATE GROUP | ALL COMMERCIAL CONSOCIATE GROUP | $427.70 | ↓ -3% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $451.53 | ↑ +3% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK - PPO | $482.69 | ↑ +10% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK | $482.69 | ↑ +10% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $488.80 | ↑ +11% |
| CIGNA | CIGNA BEHAVIORAL HEALTH | $488.80 | ↑ +11% |
| HEALTHCARE FINEST NETWORK (HFN) | ALL COMMERCIAL HFN | $519.35 | ↑ +18% |
| PROVIDER NETWORK OF AMERICA | ALL COMMERCIAL PROVIDER NETWORK OF AMERICA | $549.90 | ↑ +25% |
| WEXFORD | WEXFORD HEALTH SOURCES | $611.00 | ↑ +39% |
| UNITED HEALTHCARE | UNITED HEALTHCARE BEHAVIORAL HEALTH | $611.00 | ↑ +39% |
| CITY OF SPRINGFIELD | CITY OF SPRINGFIELD WORKCOMP | $611.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE KINGERY | $611.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MARKET PLACE | $611.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MEDICARE | $611.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE PPO | $611.00 | ↑ +39% |
| HEALTHLINK | HEALTHLINK CASINO QUEEN | $611.00 | ↑ +39% |
| HEALTHLINK | ST CLAIR COUNTY HOUSING AUTHORITY | $611.00 | ↑ +39% |
| HEALTHSCOPE | ALL COMMERCIAL HEALTHSCOPE | $611.00 | ↑ +39% |
| ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | $611.00 | ↑ +39% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $611.00 | ↑ +39% |
| UNITED HEALTHCARE | UHC MEDICAID | $611.00 | ↑ +39% |
| BLUE CROSS SIHCA | BLUE CROSS BLUE SHIELD IL HMO SIHCA | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO 470 | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL HMO PHAI | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL BLUE CHOICE PLANS | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS OF ILLINOIS PPO | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $145.80 | $68.61 – $210.68 |
| MercyOne Genesis Aledo Medical Center | Aledo | $145.80 | $103.05 – $107.63 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $112.50 | not published |
| Advocate Christ Medical Center | Oak Lawn | $177.50 | $105.00 – $284.00 |
| Advocate Condell Medical Center | Libertyville | $177.50 | $105.00 – $284.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $177.50 | $84.00 – $284.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $192.00 | $88.83 – $215.71 |
| Uchicago Medicine Adventhealth La Grange | La Grange | $112.50 | not published |