How many shoppable procedure prices are published for Boone County Hospital?

Boone County Hospital in Boone, IA currently has 114 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Boone County Hospital's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Other 25 Beds · rural Updated: 2026-07-27

Boone County Hospital

1015 Union Street, Boone, IA 50036 · 114 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.44×vs. Fair Market Price

Typical commercial prices here are +44% above the fair benchmark (1.44×) even after accounting for local nurse/doctor wages and patient complexity.

75/100 · Corroborated

75/100Self-Pay Cash Beats Insurance 26% of the Time

File Completeness85

Price Logic52

Peer Alignment56

Clean Billing90

Real Cash Discount100

High-Markup · Check Safety

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

Behavioral Pricing FingerprintUpper-Quartile Spread · +96% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Boone County Hospital prices routine shoppable procedures at 1.9× Medicare (median 1.14× Fair BaseRate) while upper-quartile commercial rates jump +96% to 2.24× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#56 of 87 in IA · 63rd State Percentile#2,535 of 3,385 in U.S. · 74th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.72× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 26% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (69/100 safety score) with 69% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (43.3% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.44× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Commercial insurance median sits at 1.14× Fair BaseRate (1.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.24×) jump +96% above the median procedure ratio (Q50 1.14×)
Consolidated metro market (HHI 9,131) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.9× Medicare

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

Back-Door Captive & ER0.68× Divergence

1.3× Medicare

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

Quantile Tail Spread+96% Upper Tail

Q25 0.72× · Q50 1.14× · Q75 2.24×

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

1.9× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.6× MedicareFair

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

1.0× MedicareGood

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

26% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 69/100Fair

Procedure Prices at Boone County Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 114 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$12,964	$12,964	$19,087	0.7×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$10,010	$11,245	$8,223	1.4×
Total hip replacement CPT Code: `27130`	$2,644	$2,644	$13,413	0.2×
Total knee replacement CPT Code: `27447`	$2,640	$2,640	$13,523	0.2×
C-section delivery (full package) CPT Code: `59510`	$3,101	$2,586	$2,975	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,876	$2,533	$1,021	2.5×
Vaginal delivery (full package) CPT Code: `59400`	$2,789	$2,339	$2,680	0.9×
Rabies immune globulin HCPCS Code: `90375`	$1,810	$1,810	$322	5.6×
Trauma team activation HCPCS Code: `G0390`	$1,829	$1,829	$1,453	1.3×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,200	$1,200	$6,109	0.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,776	$1,142	$511	2.2×
CT scan, head (no contrast) CPT Code: `70450`	$1,368	$925	$160	5.8×
CT scan, head (with contrast) CPT Code: `70460`	$1,679	$925	$242	3.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,861	$925	$258	3.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,177	$925	$303	3.1×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,624	$925	$448	2.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,129	$887	$3,372	0.3×
MRI, lower back (no contrast) CPT Code: `72148`	$2,485	$827	$338	2.4×
MRI, brain (no contrast) CPT Code: `70551`	$2,460	$827	$343	2.4×
MRI, knee or other leg joint CPT Code: `73721`	$3,361	$827	$369	2.2×
Hepatitis B immune globulin HCPCS Code: `90371`	$744	$744	$151	4.9×
Inguinal hernia repair CPT Code: `49505`	$917	$629	$3,629	0.2×
Bunion correction surgery CPT Code: `28296`	$1,623	$542	$3,446	0.2×
Breast lump removal CPT Code: `19120`	$544	$484	$3,875	0.1×
CT scan, pelvis CPT Code: `72192`	$1,470	$426	$163	2.6×
CT scan, sinuses CPT Code: `70486`	$1,423	$426	$166	2.6×
CT scan, chest (no contrast) CPT Code: `71250`	$1,446	$426	$167	2.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,818	$426	$168	2.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,714	$426	$169	2.5×
Blood transfusion CPT Code: `36430`	$747	$431	$498	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,933	$427	$583	0.7×
Ultrasound, pelvis CPT Code: `76856`	$555	$311	$130	2.4×
Ultrasound, abdomen (complete) CPT Code: `76700`	$849	$311	$134	2.3×
Psychotherapy session (45 minutes) CPT Code: `90834`	$604	$294	$166	1.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$616	$294	$181	1.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,283	$311	$272	1.1×
Colonoscopy (diagnostic) CPT Code: `45378`	$400	$290	$981	0.3×
Colonoscopy with biopsy CPT Code: `45380`	$480	$314	$1,256	0.3×
Screening mammogram (both breasts) CPT Code: `77067`	$305	$211	$123	1.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$699	$197	$126	1.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$806	$197	$132	1.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$452	$211	$148	1.4×
Upper endoscopy with biopsy CPT Code: `43239`	$329	$219	$987	0.2×
Group therapy session CPT Code: `90853`	$588	$179	$100	1.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$204	$141	$123	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$122	$111	$34	3.3×
Prosthetic fitting and training CPT Code: `97761`	$91	$111	$45	2.5×
Orthotic fitting and training CPT Code: `97760`	$103	$111	$51	2.2×
Speech therapy (language evaluation) CPT Code: `92507`	$166	$132	$86	1.5×
New patient office visit (30-44 min) CPT Code: `99203`	$166	$121	$110	1.1×
Family therapy session CPT Code: `90847`	$676	$143	$173	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$96	$92	$38	2.4×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$108	$84	$64	1.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$128	$93	$87	1.1×
Breathing treatment (nebulizer) CPT Code: `94640`	$90	$90	$201	unverified
Typhoid vaccine HCPCS Code: `90675`	$564	$447	$347	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$174	$174	$203	0.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$198	$198	$11	unverified
Blood test, liver function panel CPT Code: `80076`	$174	$174	$9	unverified
Drug screening test HCPCS Code: `G0480`	$221	$113	$116	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$84	$84	$8	10.5×
Blood test, ferritin (iron stores) CPT Code: `82728`	$92	$92	$14	6.6×
Blood test, clotting time (PTT) CPT Code: `85730`	$58	$58	$6	9.7×
Culture, bacterial CPT Code: `87070`	$52	$52	$9	5.8×
Culture, blood CPT Code: `87040`	$45	$45	$11	4.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$67	$67	$18	3.7×
Blood test, PSA (prostate screen) CPT Code: `84153`	$63	$63	$19	3.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$64	$64	$20	3.2×
Blood test, vitamin D CPT Code: `82306`	$83	$83	$31	2.7×
Physical therapy (functional capacity test) CPT Code: `97750`	$62	$62	$38	1.6×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$90	$80	$111	0.7×
Blood test, vitamin B12 CPT Code: `82607`	$42	$42	$16	2.6×
X-ray, foot CPT Code: `73630`	$54	$61	$92	0.7×
X-ray, chest (two views) CPT Code: `71046`	$267	$61	$93	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$162	$61	$93	0.7×
X-ray, hand CPT Code: `73130`	$138	$61	$93	0.7×
X-ray, hip CPT Code: `73502`	$173	$61	$93	0.7×
X-ray, ankle CPT Code: `73610`	$164	$61	$93	0.7×
X-ray, lower back CPT Code: `72110`	$279	$61	$112	0.5×
Blood test, basic metabolic panel CPT Code: `80048`	$77	$77	$9	unverified
Blood test, calcium CPT Code: `82310`	$31	$31	$5	6.2×
Blood test, amylase CPT Code: `82150`	$29	$29	$7	4.1×
Blood test, magnesium CPT Code: `83735`	$28	$28	$7	4.0×
Blood test, lipase CPT Code: `83690`	$26	$26	$7	3.7×
Hepatitis C antibody test CPT Code: `86803`	$45	$45	$15	3.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$27	$27	$25	1.1×
Extended office visit (prolonged) HCPCS Code: `G2212`	$32	$32	$33	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$23	$23	$25	0.9×
Blood antibody screen CPT Code: `86850`	$63	$42	$46	0.9×
Physical therapy (gait training) CPT Code: `97116`	$90	$29	$33	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$96	$35	$40	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$104	$33	$38	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$48	$48	$56	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$50	$12	$14	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$33	$33	$39	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$104	$29	$35	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	$30	$30	$37	0.8×
Flu vaccine injection HCPCS Code: `G0008`	$31	$35	$48	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$34	$35	$49	0.7×
Colorectal cancer screening HCPCS Code: `G0010`	$34	$35	$49	0.7×
X-ray, shoulder CPT Code: `73030`	$47	$47	$92	0.5×
X-ray, chest (single view) CPT Code: `71045`	$27	$27	$92	0.3×
X-ray, pelvis CPT Code: `72170`	$32	$32	$110	0.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$50	$50	$14	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$55	$55	$10	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$6	$6	$5	1.2×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$20	$20	$3	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$16	$16	$4	unverified
Blood test, potassium CPT Code: `84132`	$6	$6	$5	unverified
Blood test, sodium CPT Code: `84295`	$16	$16	$5	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$24	$24	$4	unverified
Blood test, hemoglobin CPT Code: `85018`	$16	$16	$3	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$41	$41	$5	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$28	$28	$86	unverified

Showing top 25 high-impact procedures of 114 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 43.3%

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

CMS CCN: 161372

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $12,964

Insurer Median $12,964

1. Amount on Your Bill or Quote ($) Pre-filled with Boone County 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 501(r) AGB Cap: $7,015 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $7,015

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (43.3% of gross = $7,015).

Step 2 · Cash vs. Insurance Arbitrage Save $3,241 Paying Cash

Self-Pay Cash Rate ($12,964) Beats Your Bill

Boone County Hospital's published 45 CFR § 180 self-pay cash rate is $12,964 (vs. $12,964 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $19,087 Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($19,087).

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) 501(c)(3) Nonprofit Hospital

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

EIN: 426037625

Filing Period: 200803

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (43.3% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

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 Composite69/100

Would Recommend69%

Rated 9 or 10 (HCAHPS)77%

Median ER Wait120 min

Left ER Before Seen0%

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 Boone County Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2024-06-28·administrative_or_closure
Closure Notice
Recorded
2024-03-21·warning_notice
Warning Notice
Recorded
2023-08-09·administrative_or_closure
Closure Notice
Recorded
2023-04-27·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (71 completed HCAHPS patient surveys). 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 Boone County Hospital.

Price Index: 0.95× regional baseline

Quality: 57/100 CMS composite

Median Household Income$79,741U.S. Census ACS

Local Uninsured Share3.7%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 75/100 · Corroborated CMS CCN 161372 EIN 426037625

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 161372) ↗ Verify IRS Form 990 (EIN 426037625) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-07-27 · 72.38 MB

Validated Rate Rows2,697 (CMS v3.0.0)

File Integrity Digest75eda3222824e9539ed9…

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