Occupational Therapy Evaluation (moderate complexity) at HSHS St. Mary's Hospital
1800 E. LAKE SHORE DRIVE, DECATUR, IL · Hshs · · NPI 1326041229
$398.88
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.
?
What you pay up front if you don't use insurance.
$554.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$96.48 with BLUE CROSS BLUE SHIELD OF ILLINOIS vs $554.00 with HEALTH ALLIANCE MEDICAL PLANS — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD OF ILLINOIS MEDICARE ADV | $96.48 | ↓ -76% |
| AETNA | AETNA MEDICARE | $96.48 | ↓ -76% |
| COVENTRY | COVENTRY MEDICARE ADVANTRA | $96.48 | ↓ -76% |
| UNITED HEALTHCARE | UNITED HEALTH CARE MEDICARE | $96.48 | ↓ -76% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MEDICARE | $96.48 | ↓ -76% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS IL MMAI | $96.48 | ↓ -76% |
| HUMANA | HUMANA MEDICARE | $96.48 | ↓ -76% |
| CLEAR SPRING HEALTH OF ILLINOIS | CLEAR SPRING HEALTH MEDICARE ADV | $96.48 | ↓ -76% |
| MOLINA HEALTHCARE | MOLINA MEDICARE | $101.30 | ↓ -75% |
| AMISH COMMUNITY | AMISH COMMUNITY DISCOUNT | $155.12 | ↓ -61% |
| AMISH COMMUNITY | PLAIN CHURCH MEDICAL GROUP | $155.12 | ↓ -61% |
| MOLINA HEALTHCARE | MOLINA MEDICAID | $188.94 | ↓ -53% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK | $189.00 | ↓ -53% |
| HEALTHLINK | ALL COMMERCIAL HEALTHLINK - PPO | $189.00 | ↓ -53% |
| MERIDIAN HEALTH PLAN | MERIDIAN HMO MCD | $197.94 | ↓ -50% |
| CIGNA | ALL COMMERCIAL CIGNA | $200.00 | ↓ -50% |
| AETNA | ALL COMMERCIAL AETNA | $201.66 | ↓ -49% |
| CELTIC INSURANCE COMPANY | ALL COMMERCIAL EXCHANGE AMBETTER | $212.26 | ↓ -47% |
| CLAIM DOC | ALL COMMERCIAL CLAIM DOC | $241.20 | ↓ -40% |
| HOPETRUST | ALL COMMERCIAL HOPETRUST | $241.20 | ↓ -40% |
| WELLFIRST | ALL COMMERCIAL WELLFIRST | $261.93 | ↓ -34% |
| UNITED HEALTHCARE | ALL COMMERCIAL UNITED HEALTHCARE | $281.00 | ↓ -30% |
| CATERPILLAR, INC. | UHC CATERPILLAR EMPLOYER GROUP | $281.00 | ↓ -30% |
| AETNA | AETNA HSHS | $304.70 | ↓ -24% |
| CURRENT HEALTH SOLUTIONS | ALL COMMERCIAL CURRENT HEALTH SOLUTIONS | $332.40 | ↓ -17% |
| CHOICECARE | ALL COMMERCIAL CHOICE CARE | $387.80 | ↓ -3% |
| CONSOCIATE GROUP | ALL COMMERCIAL CONSOCIATE GROUP | $387.80 | ↓ -3% |
| FIRST HEALTH | ALL COMMERCIAL FIRST HEALTH NETWORK | $409.41 | ↑ +3% |
| CIGNA | CIGNA BEHAVIORAL HEALTH | $443.20 | ↑ +11% |
| MULTIPLAN/PHCS | ALL COMMERCIAL MULTIPLAN | $443.20 | ↑ +11% |
| HEALTHCARE FINEST NETWORK (HFN) | ALL COMMERCIAL HFN | $470.90 | ↑ +18% |
| PROVIDER NETWORK OF AMERICA | ALL COMMERCIAL PROVIDER NETWORK OF AMERICA | $498.60 | ↑ +25% |
| HEALTHLINK | HEALTHLINK CASINO QUEEN | $554.00 | ↑ +39% |
| HEALTHLINK | ST CLAIR COUNTY HOUSING AUTHORITY | $554.00 | ↑ +39% |
| HEALTHSCOPE | ALL COMMERCIAL HEALTHSCOPE | $554.00 | ↑ +39% |
| CITY OF SPRINGFIELD | CITY OF SPRINGFIELD WORKCOMP | $554.00 | ↑ +39% |
| ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | ILLINOIS BREAST AND CERVICAL CANCER PROGRAM | $554.00 | ↑ +39% |
| INTERPLAN | ALL COMMERCIAL INTERPLAN HEALTH GROUP | $554.00 | ↑ +39% |
| WEXFORD | WEXFORD HEALTH SOURCES | $554.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE PPO | $554.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MARKET PLACE | $554.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE KINGERY | $554.00 | ↑ +39% |
| UNITED HEALTHCARE | UHC MEDICAID | $554.00 | ↑ +39% |
| UNITED HEALTHCARE | UNITED HEALTHCARE BEHAVIORAL HEALTH | $554.00 | ↑ +39% |
| HEALTH ALLIANCE MEDICAL PLANS | HEALTH ALLIANCE MEDICARE | $554.00 | ↑ +39% |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BCBS OF ILLINOIS PPO | 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 | BLUE CROSS BLUE SHIELD IL HMO | not published by hospital | — |
| BLUE CROSS BLUE SHIELD OF ILLINOIS | BLUE CROSS BLUE SHIELD IL HMO 470 | not published by hospital | — |
| BLUE CROSS SIHCA | BLUE CROSS BLUE SHIELD IL HMO SIHCA | not published by hospital | — |
Visitor-reported prices
Comments
Occupational Therapy Evaluation (moderate complexity) at other Illinois hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Silvis Medical Center | Silvis | $225.60 | $44.80 – $278.27 |
| MercyOne Genesis Aledo Medical Center | Aledo | $223.80 | $65.70 – $68.62 |
| Uchicago Medicine Adventhealth Hinsdale | Hinsdale | $87.50 | $94.45 – $156.30 |
| Advocate Christ Medical Center | Oak Lawn | $225.00 | $31.52 – $469.00 |
| Northwestern Memorial Hospital | Chicago | $381.50 | not published |
| Advocate Condell Medical Center | Libertyville | $225.00 | $31.52 – $295.00 |
| Advocate Good Samaritan Hospital | Downers Grove | $225.00 | $31.52 – $469.00 |
| UnityPoint Health - Trinity Moline | Rock Island | $231.94 | $87.28 – $152.79 |