Carle Health Proctor Hospital
CARLE HEALTH PROCTOR HOSPITAL in Peoria, IL charges 7.2x the Medicare reimbursement rate across 23 analyzed procedures, representing a significant markup for this nonprofit-private facility.
Peoria, IL 61354 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Pricing grade
D
High
Avg markup vs Medicare
7.24x
Charge / Medicare rate
Max markup
10.9x
Worst procedure
Procedures analyzed
23
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 |
|---|---|---|---|---|---|
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $143,172 | $71,586 | — | 10.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $28,828 | $14,414 | — | 9.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $61,145 | $30,573 | — | 9.2x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $42,110 | $21,055 | — | 8.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $53,309 | $26,655 | — | 8.7x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $88,745 | $44,372 | — | 8.3x |
| RENAL FAILURE WITH CC | 683 | $34,276 | $17,138 | — | 8.3x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $53,049 | $26,524 | — | 8x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $26,981 | $13,491 | — | 8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $37,720 | $18,860 | — | 7.9x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $90,740 | $45,370 | — | 7.8x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $47,125 | $23,562 | — | 7.1x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $27,277 | $13,638 | — | 7x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $113,387 | $56,694 | — | 6.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $39,723 | $19,861 | — | 6.5x |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $133,394 | $66,697 | — | 6.3x |
| REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | 468 | $90,964 | $45,482 | — | 6.1x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $50,165 | $25,082 | — | 5.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $59,092 | $29,546 | — | 5.7x |
| REHABILITATION WITH CC/MCC | 945 | $51,716 | $25,858 | — | 5.7x |
| RENAL FAILURE WITH MCC | 682 | $40,269 | $20,135 | — | 5.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $53,934 | $26,967 | — | 4.9x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $15,740 | $7,870 | — | 4.1x |
How CARLE HEALTH PROCTOR 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