George C Grape Community Hospital
2959 Us Highway 275, Hamburg, IA 51640 · 92 Priced Procedures · 92% Patient Recommendation
Typical commercial prices here are +73% above the fair benchmark (1.73×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Cash-Arbitrage Bifurcated Pricer
George C Grape Community Hospital maintains elevated commercial insurance contracts (1.73× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 46% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.21× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 46% of shoppable procedures (44/100 Cash Honesty)
- CMS clinical safety score (75/100 safety score) with 92% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (63.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.73× 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 1.67× Fair BaseRate (2.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.11×) jump +26% above the median procedure ratio (Q50 1.67×)
- Unnegotiated chargemaster list prices average 9.4× Medicare (25¢ true HCRIS cost per $1 gross)
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 George C Grape Community Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 92 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Inguinal hernia repair CPT Code: 49505 | $5,838 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $4,451 | unverified |
| Breast lump removal CPT Code: 19120 | $2,815 | 0.7× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,711 | 2.7× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $2,735 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,655 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | $2,655 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,304 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,264 | 2.2× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $942 | 1.8× |
| CT scan, head (no contrast) CPT Code: 70450 | $791 | 4.9× |
| CT scan, head (with contrast) CPT Code: 70460 | $791 | 3.3× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $791 | 3.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $791 | 2.6× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $791 | 1.8× |
| MRI, lower back (no contrast) CPT Code: 72148 | $683 | 2.0× |
| MRI, brain (no contrast) CPT Code: 70551 | $683 | 2.0× |
| MRI, knee or other leg joint CPT Code: 73721 | $683 | 1.9× |
| Injection procedure for pain management HCPCS Code: G0260 | $554 | 0.6× |
| Ultrasound, pelvis CPT Code: 76856 | $374 | 2.9× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $374 | 2.8× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $393 | 1.4× |
| Blood transfusion CPT Code: 36430 | $376 | 0.8× |
| CT scan, pelvis CPT Code: 72192 | $297 | 1.8× |
| CT scan, sinuses CPT Code: 70486 | $297 | 1.8× |
Audit a Bill or Quote at George C Grape Community Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $4,114
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (63.4% of gross = $4,114).
Self-Pay Cash Rate ($5,838) Beats Your Bill
George C Grape Community Hospital's published 45 CFR § 180 self-pay cash rate is $5,838 (vs. $5,838 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $3,629 Fair BaseRate ($3,658 Medicare)
Your bill ($6,487) is $2,858 above the denoised Fair BaseRate ($3,629) and 1.8× the $3,658 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (63.4% 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 (27 completed HCAHPS patient surveys). 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 George C Grape Community Hospital.
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.