Community Memorial Hospital Medical Center
909 West First Street, Sumner, IA 50674 · 66 Priced Procedures
Typical commercial prices here are +186% above the fair benchmark (2.86×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Community Memorial Hospital Medical Center prices routine shoppable procedures at 4.5× Medicare (median 2.71× Fair BaseRate) while upper-quartile commercial rates jump +41% to 3.82× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.53× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 30% of shoppable procedures (53/100 Cash Honesty)
- CMS clinical safety score (69/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (61.6% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
- Commercial insurance median sits at 2.71× Fair BaseRate (4.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 3.82×) jump +41% above the median procedure ratio (Q50 2.71×)
- Consolidated metro market (HHI 4,475) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Community Memorial Hospital Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 66 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| MRI, brain (with and without contrast) CPT Code: 70553 | $4,300 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $4,183 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,721 | 2.7× |
| MRI, brain (no contrast) CPT Code: 70551 | $2,645 | 7.7× |
| MRI, knee or other leg joint CPT Code: 73721 | $2,645 | 7.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,582 | 5.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $2,582 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $2,153 | 6.4× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,765 | 6.8× |
| CT scan, pelvis CPT Code: 72192 | $1,615 | 9.9× |
| CT scan, sinuses CPT Code: 70486 | $1,615 | 9.7× |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,615 | 9.7× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,615 | 9.6× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,615 | 9.6× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,615 | 6.7× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,400 | 2.4× |
| Trauma team activation HCPCS Code: G0390 | $1,378 | 0.9× |
| CT scan, head (no contrast) CPT Code: 70450 | $1,292 | 8.1× |
| Inguinal hernia repair CPT Code: 49505 | $1,160 | 0.3× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,038 | 3.8× |
| Blood transfusion CPT Code: 36430 | $871 | 1.7× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $740 | unverified |
| Ultrasound, thyroid and neck CPT Code: 76536 | $585 | 4.4× |
| Ultrasound, pelvis CPT Code: 76856 | $561 | unverified |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $496 | 3.9× |
Audit a Bill or Quote at Community Memorial Hospital Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $3,310
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (61.6% of gross = $3,310).
Self-Pay Cash Rate ($4,300) Beats Your Bill
Community Memorial Hospital Medical Center's published 45 CFR § 180 self-pay cash rate is $4,300 (vs. $4,300 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $511 Fair BaseRate ($356 Medicare)
Your bill ($5,375) is $4,864 above the denoised Fair BaseRate ($511) and 15.1× the $356 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (61.6% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Community Memorial Hospital Medical Center.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.