Carlinville, IL
33
In-network payers
184
Disclosed rate categories
25
Beds
3
Care quality
Carlinville Area Hospital is a 25-bed voluntary non-profit - private hospital in Carlinville, IL. Below you'll find publicly disclosed negotiated rates and facility details, including 33 in-network payers and 184 disclosed rate categories.
CCN (Medicare provider number)
141347
NPI
1053425124
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
25
Care Quality
3
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Carlinville Area Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
CT imaging
CPT 74177
$360 - $4,214
from 4 insurers · median $3,210
Typical for a hospital with this service line
CT imaging
CPT 70450
$125 - $2,059
from 3 insurers · median $1,876
Typical for a hospital with this service line
CT imaging
CPT 74176
$216 - $4,217
from 4 insurers · median $3,222
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$209 - $3,164
from 4 insurers · median $2,557
Typical for a hospital with this service line
CT imaging
CPT 71275
$299 - $3,374
from 4 insurers · median $2,678
Typical for a hospital with this service line
MRI imaging
CPT 70553
$479 - $5,284
from 4 insurers · median $3,911
Typical for a hospital with this service line
Mammography
CPT 77067
$111 - $1,147
from 4 insurers · median $365
Typical for a hospital with this service line
MRI imaging
CPT 72148
$287 - $3,499
from 4 insurers · median $2,759
Typical for a hospital with this service line
MRI imaging
CPT 70551
$294 - $3,184
from 4 insurers · median $2,556
Typical for a hospital with this service line
Ultrasound
CPT 76705
$77 - $1,418
from 4 insurers · median $890
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$379 - $4,137
from 4 insurers · median $3,171
Hospital reports nuclear medicine services to CMS
Digestive procedures
CPT 45385
$1,372 - $1,781
from 3 insurers · median $1,571
Typical for a hospital with this service line
MRI imaging
CPT 74183
$510 - $4,525
from 4 insurers · median $3,422
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,351 - $1,753
from 3 insurers · median $1,547
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93971
$112 - $1,459
from 4 insurers · median $1,135
Typical for a hospital with this service line
Ultrasound
CPT 76856
$92 - $1,446
from 4 insurers · median $1,104
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$25 - $1,165
from 4 insurers · median $164
Typical for a hospital with this service line
Ultrasound
CPT 76830
$104 - $1,365
from 4 insurers · median $903
Typical for a hospital with this service line
X-ray and bone density
CPT 77080
$33 - $1,262
from 4 insurers · median $647
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$1,392 - $1,806
from 3 insurers · median $1,594
Typical for a hospital with this service line
Ultrasound
CPT 76770
$95 - $1,428
from 4 insurers · median $1,058
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$664 - $862
from 3 insurers · median $761
Typical for a hospital with this service line
Laboratory and pathology
CPT 85025
$7 - $150
from 3 insurers · median $136
Typical for a hospital with this service line
X-ray and bone density
CPT 73630
$30 - $1,208
from 4 insurers · median $391
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 23 | 1077% | 11 | 5 |
| Insurer B* | 23 | 887% | 17 | 3 |
| Insurer C* | 24 | 873% | 11 | 7 |
| Insurer D* | 20 | 93% | 0 | 20 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Carlinville Area Hospital.
20733 North Broad Street, Carlinville, IL 62626
(217) 854-3141
The nearest hospitals of similar type and size. Their rates are compared with Carlinville Area Hospital for the same insurers and services above.
Hshs St. Francis Hospital
â–² Rates typically 23% higher than Carlinville Area Hospital (20 services)
Community Hospital Of Staunton
â–¼ Rates typically 24% lower than Carlinville Area Hospital (24 services)
Hillsboro Area Hospital
â–² Rates typically 9% higher than Carlinville Area Hospital (24 services)
Thomas H Boyd Critical Acc Hospital
â–¼ Rates typically 20% lower than Carlinville Area Hospital (19 services)
Taylorville Memorial Hospital
â–² Rates typically 11% higher than Carlinville Area Hospital (20 services)
St. Josephs Hospital-Highland Il
Rates about the same as Carlinville Area Hospital (24 services)
Wabash General Hospital
Northwestern Medicine Valley West Hospital
Harvard Memorial Hospital
About Carlinville Area Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Carlinville Area Hospital range from $479 to $5,284 across 4 insurers. Blue Cross Blue Shield of Illinois's rate is $4,786. The median at nearby comparable hospitals is $2,748. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Carlinville Area Hospital range from $360 to $4,214 across 4 insurers. Aetna's rate is $360. The median at nearby comparable hospitals is $2,438. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Carlinville Area Hospital range from $1,372 to $1,781 across 3 insurers. UnitedHealthcare's rate is $1,781. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Carlinville Area Hospital range from $111 to $1,147 across 4 insurers. Cigna's rate is $1,147. The median at nearby comparable hospitals is $357. What a patient pays depends on their plan's deductible, coinsurance and network status.
Carlinville Area Hospital has 25 beds. Facility type: Critical Access Hospital.
Carlinville Area Hospital is located at 20733 North Broad Street, Carlinville, IL 62626. Its main phone number is (217) 854-3141.
Carlinville Area Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 141347.
The National Provider Identifier (NPI) on file for Carlinville Area Hospital is 1053425124.
Carlinville Area Hospital lists 33 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
184 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers