Carle Health Methodist Hospital: charges and Medicare payments

Carle Health Methodist Hospital reported 1,602 Medicare inpatient stays across 60 DRGs in 2024. Across them it charged 4.76 times what it was paid — among the higher ratios in Illinois, number 28 of 106 hospitals with at least 100 stays (state median 4.06×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 258 stays at an average charge of $91,632, 1% above the national average. It also billed 1,812 outpatient services, charging 9.13 times what Medicare paid.

1Medicare inpatient stays 1,602
2Charge ÷ paid, inpatient 4.76×
3Rank in IL (highest ratio = 1) 28 of 106
4CMS price-transparency actions 0

Average charge per stay at Carle Health Methodist Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 60 DRGs that can be compared with the national average, Carle Health Methodist Hospital charged more than the national average in 18 (30%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	258	$91,632	+1%	$18,007
291 Heart Failure and Shock with MCC	128	$54,688	-3%	$11,545
853 Infectious and Parasitic Diseases with O.R. Procedures with...	58	$177,449	-22%	$40,228
189 Pulmonary Edema and Respiratory Failure	46	$54,507	-5%	$10,623
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	46	$54,447	+11%	$10,760
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	43	$57,741	+4%	$9,255
378 Gastrointestinal Hemorrhage with CC	41	$51,725	+7%	$10,293
683 Renal Failure with CC	40	$38,192	-6%	$8,168
682 Renal Failure with MCC	37	$55,915	-15%	$13,280
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	33	$63,218	-37%	$16,539
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	33	$38,443	-4%	$7,360
698 Other Kidney and Urinary Tract Diagnoses with MCC	33	$55,694	-24%	$14,536
330 Major Small and Large Bowel Procedures with CC	31	$105,372	-11%	$25,159
322 Percutaneous Cardiovascular Procedures with Intraluminal...	29	$88,366	-23%	$21,102
377 Gastrointestinal Hemorrhage with MCC	28	$80,156	-6%	$15,915
321 Percutaneous Cardiovascular Procedures with Intraluminal...	27	$102,444	-37%	$23,672
690 Kidney and Urinary Tract Infections without MCC	27	$33,704	-11%	$7,508
177 Respiratory Infections and Inflammations with MCC	25	$57,986	-18%	$13,854
286 Circulatory Disorders except AMI, with Cardiac...	25	$90,700	-19%	$17,828
208 Respiratory System Diagnosis with Ventilator Support <=96...	24	$101,734	-25%	$23,975
267 Endovascular Cardiac Valve Replacement and Supplement...	24	$263,793	+19%	$42,122
193 Simple Pneumonia and Pleurisy with MCC	23	$63,489	+6%	$11,720
309 Cardiac Arrhythmia and Conduction Disorders with CC	23	$35,431	-2%	$6,874
460 Spinal Fusion except Cervical without MCC	23	$178,199	+5%	$28,832
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	23	$50,728	-16%	$11,622
418 Laparoscopic Cholecystectomy without C.D.E. with CC	21	$94,504	+1%	$20,115
552 Medical Back Problems without MCC	20	$40,107	-18%	$8,989
287 Circulatory Disorders except AMI, with Cardiac...	19	$48,752	-24%	$9,809
329 Major Small and Large Bowel Procedures with MCC	19	$251,423	+17%	$63,729
101 Seizures without MCC	17	$55,402	+14%	$8,491
854 Infectious and Parasitic Diseases with O.R. Procedures with...	17	$90,627	-8%	$17,048
280 Acute Myocardial Infarction, Discharged Alive with MCC	16	$72,646	-4%	$14,411
331 Major Small and Large Bowel Procedures without CC/MCC	16	$78,830	-8%	$17,292
603 Cellulitis without MCC	16	$32,524	-13%	$8,173
069 Transient Ischemia without Thrombolytic	15	$47,999	-5%	$8,869
274 Percutaneous and Other Intracardiac Procedures without MCC	15	$144,459	-8%	$25,562
243 Permanent Cardiac Pacemaker Implant with CC	14	$109,466	-1%	$18,934
393 Other Digestive System Diagnoses with MCC	14	$59,552	-22%	$14,379
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	14	$81,008	+20%	$11,480
086 Traumatic Stupor and Coma <1 Hour with CC	13	$71,865	+5%	$11,881
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	13	$37,111	0%	$7,392
312 Syncope and Collapse	12	$44,094	-3%	$7,818
336 Peritoneal Adhesiolysis with CC	12	$95,082	-8%	$21,478
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	12	$51,118	-16%	$11,400
394 Other Digestive System Diagnoses with CC	12	$35,513	-25%	$8,374
419 Laparoscopic Cholecystectomy without C.D.E. without CC/MCC	12	$67,638	-13%	$11,098
689 Kidney and Urinary Tract Infections with MCC	12	$54,126	+5%	$13,340
100 Seizures with MCC	11	$111,842	+19%	$19,378
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	11	$57,886	-11%	$21,897
178 Respiratory Infections and Inflammations with CC	11	$43,465	-4%	$8,353
191 Chronic Obstructive Pulmonary Disease with CC	11	$49,201	+24%	$7,903
308 Cardiac Arrhythmia and Conduction Disorders with MCC	11	$50,084	-12%	$10,680
375 Digestive Malignancy with CC	11	$66,706	+9%	$10,856
389 Gastrointestinal Obstruction with CC	11	$38,767	0%	$7,486
454 Combined Anterior and Posterior Spinal Fusion with CC	11	$213,285	-24%	$47,661
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	11	$211,236	+4%	$36,114
659 Kidney and Ureter Procedures for Non-Neoplasm with MCC	11	$108,354	-9%	$22,103
812 Red Blood Cell Disorders without MCC	11	$46,258	+4%	$8,410
870 Septicemia or Severe Sepsis with MV >96 Hours	11	$251,517	-22%	$52,025
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	11	$207,267	-4%	$95,169

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Endovascular Procedures	240	$20,417	$2,989
Comprehensive Observation Services	143	$24,492	$2,530
Level 3 Endovascular Procedures	133	$66,363	$10,158
Level 2 Excision/ Biopsy/ Incision and Drainage	132	$12,866	$1,498
Level 1 Laparoscopy and Related Services	102	$49,278	$5,332
Level 1 Nerve Procedures	93	$20,428	$1,784
Level 4 Urology and Related Services	83	$32,315	$3,222
Level 5 Urology and Related Services	77	$48,517	$4,782
Level 3 Urology and Related Services	71	$24,556	$1,840
Level 4 Musculoskeletal Procedures	65	$53,365	$6,611
Level 2 Upper GI Procedures	56	$27,660	$1,759
Level 4 Endovascular Procedures	48	$96,317	$16,172
Level 3 Electrophysiologic Procedures	47	$133,151	$21,893
Level 1 Breast/Lymphatic Surgery and Related Procedures	44	$37,184	$3,523
Level 3 Vascular Procedures	43	$20,812	$2,932
Level 3 Pacemaker and Similar Procedures	37	$66,758	$9,861
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	37	$39,705	$3,197
Level 2 ICD and Similar Procedures	36	$169,880	$30,313
Level 2 Breast/Lymphatic Surgery and Related Procedures	31	$64,328	$6,027
Level 6 Urology and Related Services	31	$57,897	$8,512
Level 2 Pacemaker and Similar Procedures	30	$39,311	$7,851
Level 4 Airway Endoscopy	27	$36,572	$3,461
Level 5 Airway Endoscopy	25	$52,944	$6,325
Level 2 Endovascular Procedures	24	$39,615	$5,282
Level 3 Lower GI Procedures	23	$24,099	$2,595

Against the Illinois average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Carle Health Methodist Hospital charged $91,632 on average, 24% more than the Illinois average of $73,987, and was paid $18,007 against a state average of $17,651. For Heart Failure and Shock with MCC (DRG 291), Carle Health Methodist Hospital charged $54,688 on average, 18% more than the Illinois average of $46,293, and was paid $11,545 against a state average of $11,813. For Infectious and Parasitic Diseases with O.R. Procedures with MCC (DRG 853), Carle Health Methodist Hospital charged $177,449 on average, 3% less than the Illinois average of $183,276, and was paid $40,228 against a state average of $45,582. For Pulmonary Edema and Respiratory Failure (DRG 189), Carle Health Methodist Hospital charged $54,507 on average, 8% more than the Illinois average of $50,573, and was paid $10,623 against a state average of $11,480. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $20,417 was 18% below the state average of $25,004. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,492 was 14% above the state average of $21,498. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $66,363 was 2% below the state average of $68,014. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $12,866 was 9% above the state average of $11,818.

Price-transparency record

No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.

Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.

Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.