How many shoppable procedure prices are published for Madison County Memorial Hospital?

Madison County Memorial Hospital in Madison, FL currently has 81 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Madison County Memorial Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Madison County Memorial Hospital's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · rural Updated: 2026-04-30

Madison County Memorial Hospital

224 Nw Crane Ave, Madison, FL 32340 · 81 Priced Procedures

CMS Overall Rating No CMS Rating

Good Deal · Below Fair Market

0.81×vs. Fair Market Price

Typical commercial prices here are 19% below the fair benchmark (0.81×) after accounting for local nurse/doctor wages and patient complexity.

67/100 · Caution

67/100Self-Pay Cash Beats Insurance 46% of the Time

File Completeness61

Price Logic56

Peer Alignment58

Clean Billing69

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Madison County Memorial Hospital prices routine shoppable procedures near 0.9× Medicare (p50 0.55×) while skewing captive emergency, lab, and upper-quartile codes to 1.4× Medicare (p75 1.40×, +155% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#12 of 165 in FL · 6th State Percentile#306 of 3,385 in U.S. · 9th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 19% below peer Fair BaseRate (0.81×)
Self-pay cash beats commercial insurance on 46% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (68/100 safety score) with 72% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
Captive ER (1.3×) & laboratory (1.8×) services average 1.56× higher multiples than routine shoppable care (0.9×)
Upper-quartile procedures (Q75 1.40×) jump +155% above the median procedure ratio (Q50 0.55×)
Unnegotiated chargemaster list prices average 5.3× Medicare (19¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.9× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.56× Divergence

1.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+155% Upper Tail

Q25 0.34× · Q50 0.55× · Q75 1.40×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.9× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.8× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.8× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

46% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 68/100Fair

Procedure Prices at Madison County Memorial Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 81 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Gallbladder removal (laparoscopic) CPT Code: `47562`	$3,975	$3,975	$6,109	0.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,348	$1,348	$303	unverified
Cataract surgery with lens implant CPT Code: `66984`	$1,885	$923	$2,540	0.4×
CT scan, head (with and without contrast) CPT Code: `70470`	$904	$904	$258	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$841	$841	$448	unverified
CT scan, pelvis CPT Code: `72192`	$452	$452	$163	unverified
Ultrasound, pelvis CPT Code: `76856`	$250	$250	$130	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$198	$198	$185	1.1×
X-ray, pelvis CPT Code: `72170`	$154	$154	$110	1.4×
MRI, brain (no contrast) CPT Code: `70551`	$418	$166	$343	0.5×
Blood transfusion CPT Code: `36430`	$163	$163	$498	0.3×
Screening mammogram (both breasts) CPT Code: `77067`	$172	$172	$123	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$355	$136	$272	0.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$793	$125	$981	0.1×
Colonoscopy with biopsy CPT Code: `45380`	$1,048	$135	$1,256	0.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$149	$149	$126	unverified
Physical therapy (gait training) CPT Code: `97116`	$49	$82	$33	2.5×
Physical therapy (manual therapy) CPT Code: `97140`	$59	$82	$34	2.4×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$55	$82	$35	2.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$53	$82	$38	2.2×
Occupational therapy (self-care training) CPT Code: `97535`	$52	$82	$38	2.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$50	$82	$40	2.0×
Prosthetic fitting and training CPT Code: `97761`	$57	$82	$45	1.8×
Orthotic fitting and training CPT Code: `97760`	$57	$82	$51	1.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$93	$92	$64	1.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$114	$86	$148	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$251	$94	$169	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$425	$93	$168	0.6×
CT scan, sinuses CPT Code: `70486`	$262	$83	$166	0.5×
Psychotherapy session (60 minutes) CPT Code: `90837`	$170	$85	$181	0.5×
CT scan, head (with contrast) CPT Code: `70460`	$897	$92	$242	0.4×
Upper endoscopy with biopsy CPT Code: `43239`	$711	$93	$987	0.1×
Typhoid vaccine HCPCS Code: `90675`	$397	$397	$347	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	$69	$85	$140	0.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$50	$50	$14	3.6×
Blood test, vitamin D CPT Code: `82306`	$50	$50	$31	1.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$33	$49	$35	1.4×
Ultrasound, abdomen (complete) CPT Code: `76700`	$317	$68	$134	0.5×
Ultrasound, thyroid and neck CPT Code: `76536`	$124	$64	$132	0.5×
Family therapy session CPT Code: `90847`	$130	$68	$173	0.4×
Breathing treatment (nebulizer) CPT Code: `94640`	$77	$77	$201	0.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$73	$73	$14	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$41	$41	$20	2.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$77	$15	$11	1.4×
Extended office visit (prolonged) HCPCS Code: `G2212`	$18	$33	$33	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$29	$29	$49	0.6×
New patient office visit (30-44 min) CPT Code: `99203`	$155	$51	$110	0.5×
X-ray, chest (single view) CPT Code: `71045`	$38	$38	$92	0.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$158	$46	$123	0.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$116	$57	$166	0.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$41	$41	$10	unverified
Blood test, calcium CPT Code: `82310`	$38	$7	$5	1.4×
Blood test, basic metabolic panel CPT Code: `80048`	$39	$12	$9	1.3×
Blood test, liver function panel CPT Code: `80076`	$39	$11	$9	1.2×
X-ray, lower back CPT Code: `72110`	$122	$27	$112	0.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$134	$19	$93	0.2×
X-ray, chest (two views) CPT Code: `71046`	$33	$17	$93	0.2×
X-ray, hand CPT Code: `73130`	$42	$17	$93	0.2×
X-ray, ankle CPT Code: `73610`	$42	$17	$93	0.2×
X-ray, shoulder CPT Code: `73030`	$69	$16	$92	0.2×
X-ray, foot CPT Code: `73630`	$149	$16	$92	0.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$41	$41	$14	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$8	$8	$3	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$15	$15	$5	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$20	$20	$4	unverified
Blood test, lipase CPT Code: `83690`	$29	$29	$7	unverified
Blood test, magnesium CPT Code: `83735`	$50	$50	$7	unverified
Blood test, thyroid (TSH) CPT Code: `84443`	$46	$46	$18	unverified
Culture, bacterial CPT Code: `87070`	$35	$35	$9	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$38	$6	$4	1.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$31	$9	$6	1.5×
Blood test, potassium CPT Code: `84132`	$28	$7	$5	1.4×
Blood test, sodium CPT Code: `84295`	$28	$7	$5	1.4×
Blood test, PSA (prostate screen) CPT Code: `84153`	$42	$26	$19	1.4×
Hepatitis C antibody test CPT Code: `86803`	$47	$20	$15	1.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$140	$30	$87	0.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$18	$18	$86	0.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	$10	$10	$49	0.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$31	$31	$5	unverified
Culture, blood CPT Code: `87040`	$26	$26	$11	unverified
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$179	$2	$25	unverified

Showing top 25 high-impact procedures of 81 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Madison County Memorial Hospital (Zero PHI Required)

CMS CCN: 101311

CPT 47562

Select Procedure to Audit:

Fair BaseRate™ $6,109

Medicare Rate $6,176

Self-Pay Cash $3,975

Insurer Median $3,975

1. Amount on Your Bill or Quote ($) Pre-filled with Madison County Memorial Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $3,975 Paying Cash

Self-Pay Cash Rate ($3,975) Beats Your Bill

Madison County Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $3,975 (vs. $3,975 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$1,841 Above Fair BaseRate

Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)

Your bill ($7,950) is $1,841 above the denoised Fair BaseRate ($6,109) and 1.3× the $6,176 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Madison County Memorial Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite68/100

Median ER Wait139 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Madison County Memorial Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2026-04-29·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Madison County Memorial Hospital.

Price Index: 0.65× regional baseline

Quality: 55/100 CMS composite

Median Household Income$48,176U.S. Census ACS

Local Uninsured Share12.1%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 67/100 · Caution CMS CCN 101311

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 101311) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-30

Validated Rate Rows763 (CMS v3.0.0)

File Integrity DigestVerified · CCN 101311

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy