How many shoppable procedure prices are published for Iowa Specialty Hospital - Clarion?

Iowa Specialty Hospital - Clarion in Clarion, IA currently has 123 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Iowa Specialty Hospital - Clarion's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Iowa Specialty Hospital - Clarion's median negotiated commercial rate is 1.8× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Local 25 Beds · rural Updated: 2026-06-11

Iowa Specialty Hospital - Clarion

1316 South Main Street, Clarion, IA 50525 · 123 Priced Procedures · 84% Patient Recommendation

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

1.84×vs. Fair Market Price

Typical commercial prices here are +84% above the fair benchmark (1.84×) even after accounting for local nurse/doctor wages and patient complexity.

71/100 · Corroborated

71/100Self-Pay Cash Beats Insurance 51% of the Time

File Completeness50

Price Logic62

Peer Alignment66

Clean Billing90

Real Cash Discount100

High-Markup · Check Safety

4-Star CMS clinical quality rating paired with 1.84× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Iowa Specialty Hospital - Clarion prices routine shoppable procedures near 1.9× Medicare (p50 1.68×) while skewing captive emergency, lab, and upper-quartile codes to 5.8× Medicare (p75 2.47×, +47% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#73 of 87 in IA · 82nd State Percentile#2,977 of 3,385 in U.S. · 87th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.09× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 51% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 84% patient recommendation (74/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.84× 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.
Captive ER (1.5×) & laboratory (1.7×) services average 3.05× higher multiples than routine shoppable care (1.9×)
Upper-quartile procedures (Q75 2.47×) jump +47% above the median procedure ratio (Q50 1.68×)
Unnegotiated chargemaster list prices average 5.7× Medicare (24¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.9× Medicare

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

Back-Door Captive & ER3.05× Divergence

5.8× Medicare

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

Quantile Tail Spread+47% Upper Tail

Q25 1.09× · Q50 1.68× · Q75 2.47×

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

0.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.7× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.7× MedicareGood

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

1.3× MedicareGood

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

51% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 74/100Fair

Procedure Prices at Iowa Specialty Hospital - Clarion

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$30,816	$35,952	$19,432	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	—	$19,087	—
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	—	$17,936	—
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$11,030	$15,534	$8,223	unverified
Total knee replacement CPT Code: `27447`	—	—	$13,523	—
Trauma team activation HCPCS Code: `G0390`	$4,535	$5,857	$1,453	unverified
C-section delivery (full package) CPT Code: `59510`	$2,760	$3,377	$2,975	1.1×
Vaginal delivery (full package) CPT Code: `59400`	$3,360	$3,221	$2,680	1.2×
Total hip replacement CPT Code: `27130`	$2,443	$2,519	$13,413	0.2×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,407	$2,440	$1,021	unverified
Rabies immune globulin HCPCS Code: `90375`	$1,249	$1,458	$322	4.5×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,249	$1,344	$6,109	0.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,389	$997	$583	1.7×
Inguinal hernia repair CPT Code: `49505`	$1,191	$1,013	$3,629	0.3×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$2,418	$960	$3,372	0.3×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,321	$908	$511	1.8×
Bunion correction surgery CPT Code: `28296`	$1,255	$931	$3,446	0.3×
Blood transfusion CPT Code: `36430`	$963	$939	$498	unverified
Breast lump removal CPT Code: `19120`	$980	$786	$3,875	0.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,220	$774	$448	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,606	$644	$303	2.1×
MRI, lower back (no contrast) CPT Code: `72148`	$1,463	$605	$338	1.8×
MRI, brain (no contrast) CPT Code: `70551`	$2,177	$611	$343	1.8×
MRI, knee or other leg joint CPT Code: `73721`	$2,496	$616	$369	1.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,492	$581	$258	2.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,433	$537	$242	2.2×
CT scan, head (no contrast) CPT Code: `70450`	$696	$446	$160	2.8×
Colonoscopy with biopsy CPT Code: `45380`	$842	$418	$1,256	0.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$812	$390	$272	1.4×
Colonoscopy (diagnostic) CPT Code: `45378`	$771	$386	$981	0.4×
Ultrasound, abdomen (complete) CPT Code: `76700`	$803	$324	$134	2.4×
CT scan, chest (no contrast) CPT Code: `71250`	$1,405	$327	$167	2.0×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$779	$324	$168	1.9×
CT scan, pelvis CPT Code: `72192`	$761	$314	$163	1.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$836	$324	$169	1.9×
CT scan, sinuses CPT Code: `70486`	$1,320	$308	$166	1.9×
Upper endoscopy with biopsy CPT Code: `43239`	$771	$288	$987	0.3×
Ultrasound, pelvis CPT Code: `76856`	$334	$256	$130	2.0×
Speech therapy (language evaluation) CPT Code: `92507`	$238	$277	$86	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$373	$221	$126	1.8×
Hepatitis B immune globulin HCPCS Code: `90371`	$309	$246	$151	1.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$349	$209	$132	1.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$385	$206	$201	1.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$312	$168	$40	4.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$156	$190	$123	1.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$241	$210	$148	1.4×
Injection procedure for pain management HCPCS Code: `G0260`	$325	$177	$855	0.2×
Family therapy session CPT Code: `90847`	$128	$148	$173	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$239	$156	$185	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$94	$130	$38	3.4×
Psychotherapy session (60 minutes) CPT Code: `90837`	$145	$150	$181	0.8×
Neurobehavioral status check CPT Code: `96116`	$169	$148	$231	0.6×
Speech therapy (group session) CPT Code: `92508`	$86	$119	$27	4.4×
Orthotic fitting and training CPT Code: `97760`	$128	$137	$51	2.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$123	$92	$25	3.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$72	$99	$35	2.8×
New patient office visit (30-44 min) CPT Code: `99203`	$133	$120	$110	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$63	$89	$34	2.6×
Physical therapy (gait training) CPT Code: `97116`	$65	$84	$33	2.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$60	$83	$38	2.2×
Prosthetic fitting and training CPT Code: `97761`	$86	$98	$45	2.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$115	$93	$87	1.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$193	$89	$93	1.0×
X-ray, lower back CPT Code: `72110`	$291	$104	$112	0.9×
X-ray, shoulder CPT Code: `73030`	$196	$85	$92	0.9×
X-ray, ankle CPT Code: `73610`	$187	$84	$93	0.9×
X-ray, foot CPT Code: `73630`	$187	$82	$92	0.9×
X-ray, hand CPT Code: `73130`	$180	$82	$93	0.9×
Screening mammogram (both breasts) CPT Code: `77067`	$356	$104	$123	0.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$101	$107	$166	0.6×
Behavioral health assessment HCPCS Code: `H0001`	$75	$88	$157	0.6×
Typhoid vaccine HCPCS Code: `90675`	$781	$448	$347	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$344	$241	$203	1.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$223	$158	$111	1.4×
Drug screening test HCPCS Code: `G0480`	$224	$130	$116	1.1×
Culture, blood CPT Code: `87040`	$127	$148	$11	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$211	$122	$140	0.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$67	$78	$6	13.0×
Blood test, lipase CPT Code: `83690`	$74	$86	$7	12.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$81	$95	$14	6.8×
Blood test, vitamin D CPT Code: `82306`	$145	$101	$31	3.3×
Extended office visit (prolonged) HCPCS Code: `G2212`	$58	$74	$33	2.2×
Hepatitis B vaccine HCPCS Code: `90744`	$68	$78	$37	2.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$66	$79	$39	2.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$117	$103	$56	1.8×
Blood test, vitamin B12 CPT Code: `82607`	$94	$110	$16	unverified
Blood test, magnesium CPT Code: `83735`	$107	$125	$7	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$57	$77	$38	2.0×
Hepatitis C antibody test CPT Code: `86803`	$86	$100	$15	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$103	$120	$20	unverified
Blood test, calcium CPT Code: `82310`	$49	$53	$5	10.6×
Blood test, amylase CPT Code: `82150`	$63	$74	$7	10.6×
Blood test, liver function panel CPT Code: `80076`	$80	$58	$9	6.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$86	$64	$14	4.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$59	$60	$35	1.7×
Blood antibody screen CPT Code: `86850`	$63	$74	$46	1.6×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$20	$23	$3	7.7×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$18	$47	$11	4.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$136	$56	$64	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$75	$65	$86	0.8×
Group therapy session CPT Code: `90853`	$155	$70	$100	0.7×
X-ray, hip CPT Code: `73502`	$89	$62	$93	0.7×
X-ray, pelvis CPT Code: `72170`	$163	$71	$110	0.6×
Blood test, hemoglobin CPT Code: `85018`	$26	$26	$3	8.7×
Blood test, sodium CPT Code: `84295`	$58	$31	$5	6.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$40	$27	$5	5.4×
Blood test, complete blood count (CBC) CPT Code: `85025`	$58	$31	$8	3.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$79	$35	$10	3.5×
Blood test, basic metabolic panel CPT Code: `80048`	$55	$20	$9	2.2×
X-ray, chest (two views) CPT Code: `71046`	$200	$43	$93	0.5×
Blood test, glucose (blood sugar) CPT Code: `82947`	$37	$10	$4	2.5×
Blood test, potassium CPT Code: `84132`	$6	$10	$5	2.0×
Culture, bacterial CPT Code: `87070`	$12	$17	$9	1.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$53	$31	$18	1.7×
Flu vaccine (high dose) HCPCS Code: `90656`	$32	$34	$25	1.4×
X-ray, chest (single view) CPT Code: `71045`	$164	$34	$92	0.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$28	$8	$5	1.6×
Flu vaccine injection HCPCS Code: `G0008`	$46	$29	$48	0.6×
Pneumonia vaccine injection HCPCS Code: `G0009`	$46	$29	$49	0.6×
Colorectal cancer screening HCPCS Code: `G0010`	$46	$29	$49	0.6×
Psychological testing evaluation CPT Code: `96136`	$79	$43	$128	0.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$28	$6	$4	1.5×
Blood test, PSA (prostate screen) CPT Code: `84153`	$40	$22	$19	1.2×

Showing top 25 high-impact procedures of 123 total

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

Audit a Bill or Quote at Iowa Specialty Hospital - Clarion (Zero PHI Required)

CMS CCN: 161302

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $30,816

Insurer Median $35,952

1. Amount on Your Bill or Quote ($) Pre-filled with Iowa Specialty Hospital - Clarion’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 $20,544 Paying Cash

Self-Pay Cash Rate ($30,816) Beats Your Bill

Iowa Specialty Hospital - Clarion's published 45 CFR § 180 self-pay cash rate is $30,816 (vs. $35,952 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$31,928 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($51,360) is $31,928 above the denoised Fair BaseRate ($19,432) and 3.7× the $14,044 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 Iowa Specialty Hospital - Clarion 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

CMS Overall4/5 Stars (4/5)

Safety Composite74/100

Would Recommend84%

Rated 9 or 10 (HCAHPS)84%

Median ER Wait100 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3%

CMS Price Transparency Administrative Enforcement Log

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

2024-03-21·administrative_or_closure
Closure Notice
Recorded
2023-12-07·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (292 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

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Iowa Specialty Hospital - Clarion.

Price Index: 0.66× regional baseline

Quality: 72/100 CMS composite

Median Household Income$64,033U.S. Census ACS

Local Uninsured Share5.4%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 71/100 · Corroborated CMS CCN 161302

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 161302) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-06-11 · 43.30 MB

Validated Rate Rows2,189 (CMS v3.0.0)

File Integrity DigestVerified · CCN 161302

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