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

Decatur County Hospital in Leon, IA currently has 94 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Decatur County Hospital's median negotiated commercial rate is 2.7× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Local 11 Beds · rural Updated: 2026-03-04

Decatur County Hospital

1405 Nw Church Street, Leon, IA 50144 · 94 Priced Procedures · 74% Patient Recommendation

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

2.70×vs. Fair Market Price

Typical commercial prices here are +170% above the fair benchmark (2.70×) even after accounting for local nurse/doctor wages and patient complexity.

57/100 · Caution

57/100Self-Pay Cash Beats Insurance 52% of the Time

File Completeness45

Price Logic37

Peer Alignment56

Clean Billing60

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 · +156% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Decatur County Hospital prices routine shoppable procedures at 3.8× Medicare (median 1.87× Fair BaseRate) while upper-quartile commercial rates jump +156% to 4.79× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#83 of 87 in IA · 94th State Percentile#3,296 of 3,385 in U.S. · 97th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.90× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 52% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (71/100 safety score) with 74% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (79.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 4.8× markup over Medicare rates
Commercial insurance median sits at 1.87× Fair BaseRate (3.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 4.79×) jump +156% above the median procedure ratio (Q50 1.87×)
Unnegotiated chargemaster list prices average 6.7× Medicare (31¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

3.8× Medicare

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

Back-Door Captive & ER0.53× Divergence

2.0× Medicare

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

Quantile Tail Spread+156% Upper Tail

Q25 0.90× · Q50 1.87× · Q75 4.79×

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

3.8× MedicareElevated

Outpatient Surgery & ORBack-Door Captive

4.8× MedicareWatchout

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

4.0× MedicareElevated

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

1.4× MedicareGood

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

52% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 71/100Fair

Procedure Prices at Decatur County Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 94 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total knee replacement CPT Code: `27447`	$3,056	$3,056	$13,523	0.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,987	$2,987	$448	unverified
Total hip replacement CPT Code: `27130`	$2,922	$2,922	$13,413	0.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,255	$2,754	$511	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,312	$2,312	$303	unverified
MRI, brain (no contrast) CPT Code: `70551`	$2,324	$2,022	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$2,225	$1,959	$338	5.8×
MRI, knee or other leg joint CPT Code: `73721`	$1,924	$1,767	$369	4.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,556	$1,565	$258	6.1×
Rabies immune globulin HCPCS Code: `90375`	$1,583	$1,583	$322	4.9×
CT scan, chest (no contrast) CPT Code: `71250`	$1,298	$1,584	$167	unverified
CT scan, head (no contrast) CPT Code: `70450`	$1,441	$1,492	$160	9.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,398	$1,465	$242	6.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,541	$1,247	$169	7.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,390	$1,151	$168	6.9×
Trauma team activation HCPCS Code: `G0390`	$1,115	$1,115	$1,453	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,137	$1,048	$6,109	0.2×
CT scan, pelvis CPT Code: `72192`	$1,181	$1,017	$163	6.2×
CT scan, sinuses CPT Code: `70486`	$1,137	$989	$166	6.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,248	$859	$3,372	0.3×
Inguinal hernia repair CPT Code: `49505`	$910	$849	$3,629	0.2×
Breast lump removal CPT Code: `19120`	$680	$679	$3,875	0.2×
Blood transfusion CPT Code: `36430`	$627	$627	$498	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$659	$587	$134	4.4×
Group therapy session CPT Code: `90853`	$774	$583	$100	unverified
Ultrasound, pelvis CPT Code: `76856`	$459	$459	$130	3.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$536	$447	$126	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$411	$368	$132	2.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$307	$310	$166	1.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$328	$323	$181	1.8×
Colonoscopy with biopsy CPT Code: `45380`	$453	$328	$1,256	0.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$399	$279	$583	0.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$377	$302	$981	0.3×
X-ray, lower back CPT Code: `72110`	$307	$229	$112	2.0×
Family therapy session CPT Code: `90847`	$318	$247	$173	1.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,459	$239	$1,021	0.2×
Speech therapy (language evaluation) CPT Code: `92507`	$202	$199	$86	2.3×
Upper endoscopy with biopsy CPT Code: `43239`	$371	$218	$987	0.2×
X-ray, chest (single view) CPT Code: `71045`	$178	$221	$92	unverified
X-ray, hip CPT Code: `73502`	$240	$186	$93	2.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$153	$153	$40	3.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$162	$149	$64	2.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$214	$169	$93	1.8×
X-ray, shoulder CPT Code: `73030`	$198	$159	$92	1.7×
X-ray, chest (two views) CPT Code: `71046`	$198	$159	$93	1.7×
X-ray, hand CPT Code: `73130`	$183	$150	$93	1.6×
X-ray, foot CPT Code: `73630`	$175	$144	$92	1.6×
X-ray, ankle CPT Code: `73610`	$175	$144	$93	1.5×
X-ray, pelvis CPT Code: `72170`	$158	$133	$110	1.2×
Neurobehavioral status check CPT Code: `96116`	$142	$142	$231	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$170	$111	$123	0.9×
Physical therapy (gait training) CPT Code: `97116`	$82	$82	$33	2.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$82	$82	$35	2.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$82	$82	$38	2.2×
Occupational therapy (self-care training) CPT Code: `97535`	$82	$82	$38	2.2×
Physical therapy (functional capacity test) CPT Code: `97750`	$82	$82	$38	2.2×
New patient office visit (30-44 min) CPT Code: `99203`	$166	$98	$110	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$106	$106	$201	0.5×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$561	$81	$272	0.3×
Typhoid vaccine HCPCS Code: `90675`	$679	$679	$347	unverified
Culture, blood CPT Code: `87040`	$206	$206	$11	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$141	$141	$11	12.8×
Blood test, vitamin D CPT Code: `82306`	$133	$133	$31	4.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$158	$158	$56	unverified
Blood test, lipase CPT Code: `83690`	$78	$78	$7	11.1×
Blood test, liver function panel CPT Code: `80076`	$96	$96	$9	10.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$88	$88	$14	6.3×
Hepatitis C antibody test CPT Code: `86803`	$90	$90	$15	6.0×
Blood test, vitamin B12 CPT Code: `82607`	$92	$92	$16	5.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$106	$106	$19	5.6×
Blood test, basic metabolic panel CPT Code: `80048`	$108	$108	$9	unverified
Blood antibody screen CPT Code: `86850`	$88	$107	$46	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$46	$46	$3	15.3×
Blood test, amylase CPT Code: `82150`	$65	$65	$7	9.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$46	$46	$5	9.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$70	$70	$8	8.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$39	$39	$4	9.8×
Blood test, magnesium CPT Code: `83735`	$60	$60	$7	8.6×
Blood test, calcium CPT Code: `82310`	$42	$42	$5	8.4×
Physical therapy (manual therapy) CPT Code: `97140`	$62	$62	$34	1.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$103	$75	$87	0.9×
Blood test, glucose (blood sugar) CPT Code: `82947`	$34	$34	$4	8.5×
Blood test, sodium CPT Code: `84295`	$42	$42	$5	8.4×
Blood test, clotting time (PTT) CPT Code: `85730`	$49	$49	$6	8.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$40	$40	$5	8.0×
Blood test, potassium CPT Code: `84132`	$39	$39	$5	7.8×
Culture, bacterial CPT Code: `87070`	$46	$46	$9	5.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$60	$60	$14	4.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$39	$39	$10	3.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$58	$34	$18	1.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$60	$35	$20	1.8×
Orthotic fitting and training CPT Code: `97760`	$74	$50	$51	1.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$52	$52	$86	0.6×
Blood test, hemoglobin CPT Code: `85018`	$26	$26	$3	unverified

Showing top 25 high-impact procedures of 94 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 79.0%

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

CMS CCN: 161340

CPT 27447

Select Procedure to Audit:

Fair BaseRate™ $13,523

Medicare Rate $13,117

Self-Pay Cash $3,056

Insurer Median $3,056

1. Amount on Your Bill or Quote ($) Pre-filled with Decatur 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: $3,018 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,018

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (79.0% of gross = $3,018).

Step 2 · Cash vs. Insurance Arbitrage Save $764 Paying Cash

Self-Pay Cash Rate ($3,056) Beats Your Bill

Decatur County Hospital's published 45 CFR § 180 self-pay cash rate is $3,056 (vs. $3,056 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: $13,523 Fair BaseRate

Negotiate Toward $13,523 Fair BaseRate ($13,117 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($13,523).

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: 426007849

Filing Period: 197312

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 (79.0% 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 Composite71/100

Would Recommend74%

Rated 9 or 10 (HCAHPS)73%

Median ER Wait102 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 Decatur County Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-07-10·administrative_or_closure
Met Requirements
Recorded
2024-06-05·administrative_or_closure
Closure Notice
Recorded
2024-03-01·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (47 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 1.14× regional baseline

Quality: 58/100 CMS composite

Median Household Income$57,146U.S. Census ACS

Local Uninsured Share7.9%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 57/100 · Caution CMS CCN 161340 EIN 426007849

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 161340) ↗ Verify IRS Form 990 (EIN 426007849) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-03-04 · 68.36 MB

Validated Rate Rows2,001 (CMS v3.0.0)

File Integrity DigestVerified · CCN 161340

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