Carle Foundation Hospital
CARLE FOUNDATION HOSPITAL in Urbana, IL charges 6.2x the Medicare reimbursement rate on average across 144 analyzed procedures at this nonprofit-private facility.
Urbana, IL 61801 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Pricing grade
D
High
Avg markup vs Medicare
6.18x
Charge / Medicare rate
Max markup
11.4x
Worst procedure
Procedures analyzed
144
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $46,037 | $23,019 | — | 11.4x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC | 083 | $98,283 | $49,142 | — | 10.5x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | 436 | $73,283 | $36,642 | — | 10.3x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC | 087 | $56,491 | $28,245 | — | 10.2x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $40,811 | $20,406 | — | 9.6x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $77,967 | $38,984 | — | 8.5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $54,238 | $27,119 | — | 8.4x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $107,905 | $53,953 | — | 8.3x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $49,825 | $24,912 | — | 8.2x |
| NERVOUS SYSTEM NEOPLASMS WITH MCC | 054 | $75,416 | $37,708 | — | 8.2x |
| DIGESTIVE MALIGNANCY WITH CC | 375 | $59,080 | $29,540 | — | 7.9x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $104,419 | $52,210 | — | 7.8x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $50,895 | $25,448 | — | 7.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $41,074 | $20,537 | — | 7.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $25,015 | $12,508 | — | 7.5x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $49,807 | $24,904 | — | 7.5x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $27,305 | $13,653 | — | 7.5x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $215,364 | $107,682 | — | 7.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $52,208 | $26,104 | — | 7.4x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $47,130 | $23,565 | — | 7.4x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $45,081 | $22,541 | — | 7.3x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $53,790 | $26,895 | — | 7.3x |
| MAJOR CHEST TRAUMA WITH CC | 184 | $49,504 | $24,752 | — | 7.3x |
| MEDICAL BACK PROBLEMS WITH MCC | 551 | $77,872 | $38,936 | — | 7.3x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $36,443 | $18,222 | — | 7.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $94,336 | $47,168 | — | 7.2x |
| PNEUMOTHORAX WITH CC | 200 | $52,973 | $26,487 | — | 7.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $36,849 | $18,425 | — | 7.1x |
| SYNCOPE AND COLLAPSE | 312 | $41,112 | $20,556 | — | 7.1x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $90,655 | $45,328 | — | 7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $36,855 | $18,428 | — | 7x |
| DIGESTIVE MALIGNANCY WITH MCC | 374 | $105,439 | $52,720 | — | 6.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | 322 | $90,823 | $45,411 | — | 6.9x |
| CHEST PAIN | 313 | $35,178 | $17,589 | — | 6.9x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $84,437 | $42,219 | — | 6.9x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $53,260 | $26,630 | — | 6.8x |
| OTHER VASCULAR PROCEDURES WITHOUT CC/MCC | 254 | $75,479 | $37,739 | — | 6.7x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $45,021 | $22,511 | — | 6.6x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $41,565 | $20,783 | — | 6.6x |
| RESPIRATORY NEOPLASMS WITH CC | 181 | $52,556 | $26,278 | — | 6.6x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $77,584 | $38,792 | — | 6.6x |
| DIABETES WITH MCC | 637 | $62,903 | $31,452 | — | 6.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $41,736 | $20,868 | — | 6.6x |
| MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATIO | 809 | $51,684 | $25,842 | — | 6.6x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $71,558 | $35,779 | — | 6.6x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $50,115 | $25,058 | — | 6.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $128,276 | $64,138 | — | 6.5x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $37,595 | $18,797 | — | 6.5x |
| CELLULITIS WITHOUT MCC | 603 | $39,178 | $19,589 | — | 6.4x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $103,398 | $51,699 | — | 6.4x |
Showing 50 of 144 procedures
How CARLE FOUNDATION HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use