How many shoppable procedure prices are published for Knoxville Hospital & Clinics?

Knoxville Hospital & Clinics in Knoxville, IA currently has 63 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

What is Knoxville Hospital & Clinics's CMS Care Compare overall star rating?

CMS Care Compare assigns Knoxville Hospital & Clinics an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-01-24

Knoxville Hospital & Clinics

1002 South Lincoln Street, Knoxville, IA 50138 · 63 Priced Procedures · 86% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

51/100 · Caution

51/100Self-Pay Cash Beats Insurance 50% of the Time

File Completeness50

Price Logic1

Peer Alignment65

Clean Billing60

Real Cash Discount100

Regional Value Leader

2-Star CMS clinical quality rating paired with 1.00× fair market pricing.

Behavioral Pricing FingerprintHigh Infusion / OR Multiples

Specialty Drug & Surgical Margin Engine

Knoxville Hospital & Clinics concentrates commercial margin in outpatient surgical suites (1.8× Medicare) and specialty drug infusions (3.2× Medicare) relative to routine diagnostics (2.4×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.

Regional Benchmark in IAU.S. National Reference Pool

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 50% of shoppable procedures (99/100 Cash Honesty)
2-Star CMS clinical rating with 86% patient recommendation (72/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (44.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.8× markup over Medicare rates
Commercial insurance median sits at 1.00× Fair BaseRate (6.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
Consolidated metro market (HHI 5,931) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

6.8× Medicare

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

Back-Door Captive & ER0.76× Divergence

5.2× Medicare

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

Quantile Tail Spread+28% Upper Tail

Q25 0.78× · Q50 1.00× · Q75 1.28×

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

6.8× MedicareWatchout

Outpatient Surgery & ORBack-Door Captive

1.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.4× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.4× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

2.8× MedicareFair

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

3.2× MedicareElevated

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

50% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 72/100Fair

Procedure Prices at Knoxville Hospital & Clinics

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 63 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Vaginal delivery (full package) CPT Code: `59400`	$2,995	$2,995	$2,680	1.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,528	$1,528	$583	2.6×
Rabies immune globulin HCPCS Code: `90375`	$928	$928	$322	2.9×
Colonoscopy (diagnostic) CPT Code: `45378`	$775	$775	$981	0.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$558	$558	$272	2.1×
Blood transfusion CPT Code: `36430`	$315	$315	$498	0.6×
Hospital observation (per hour) HCPCS Code: `G0378`	$328	$328	$86	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$125	$125	$123	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$140	$140	$185	0.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$116	$116	$181	0.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$86	$86	$64	1.3×
Typhoid vaccine HCPCS Code: `90675`	$483	$483	$347	1.4×
Pneumococcal vaccine HCPCS Code: `90732`	$156	$156	$140	1.1×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$160	$160	$203	0.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$118	$118	$11	10.7×
Blood test, PSA (prostate screen) CPT Code: `84153`	$97	$97	$19	5.1×
Blood test, vitamin D CPT Code: `82306`	$121	$121	$31	3.9×
Blood test, basic metabolic panel CPT Code: `80048`	$94	$94	$9	10.4×
Blood test, liver function panel CPT Code: `80076`	$83	$83	$9	9.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$97	$97	$20	4.8×
Drug screening test HCPCS Code: `G0480`	$120	$120	$116	1.0×
Culture, bacterial CPT Code: `87070`	$69	$69	$9	7.7×
Culture, blood CPT Code: `87040`	$72	$72	$11	6.5×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$97	$97	$111	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$66	$66	$14	4.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$66	$66	$14	4.7×
Hepatitis C antibody test CPT Code: `86803`	$66	$66	$15	4.4×
Blood test, vitamin B12 CPT Code: `82607`	$68	$68	$16	4.3×
Blood antibody screen CPT Code: `86850`	$86	$86	$46	1.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$77	$77	$56	1.4×
New patient office visit (30-44 min) CPT Code: `99203`	$79	$79	$110	0.7×
Extended office visit (prolonged) HCPCS Code: `G2212`	$29	$29	$33	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$43	$43	$49	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$59	$59	$87	0.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$72	$72	$35	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$72	$72	$38	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$72	$72	$34	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$72	$72	$40	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$72	$72	$38	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$72	$72	$38	unverified
Orthotic fitting and training CPT Code: `97760`	$72	$72	$51	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$35	$35	$3	11.7×
Blood test, sodium CPT Code: `84295`	$35	$35	$5	7.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$38	$38	$6	6.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$54	$54	$18	3.0×
Hepatitis B vaccine HCPCS Code: `90744`	$61	$61	$37	1.6×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$56	$56	$39	1.4×
Blood test, calcium CPT Code: `82310`	$28	$28	$5	5.6×
Blood test, potassium CPT Code: `84132`	$28	$28	$5	5.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$27	$27	$5	5.4×
Blood test, complete blood count (CBC) CPT Code: `85025`	$33	$33	$8	4.1×
Flu vaccine injection HCPCS Code: `G0008`	$43	$43	$48	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$43	$43	$49	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$21	$21	$25	0.8×
Blood test, amylase CPT Code: `82150`	$41	$41	$7	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$29	$29	$5	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$29	$29	$4	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$48	$48	$10	unverified
Blood test, lipase CPT Code: `83690`	$44	$44	$7	unverified
Blood test, magnesium CPT Code: `83735`	$34	$34	$7	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$25	$25	$4	unverified
Blood test, hemoglobin CPT Code: `85018`	$17	$17	$3	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$39	$39	$14	unverified

Showing top 25 high-impact procedures of 63 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 44.0%

Audit a Bill or Quote at Knoxville Hospital & Clinics (Zero PHI Required)

CMS CCN: 161355

CPT 59400

Select Procedure to Audit:

Fair BaseRate™ $2,680

Medicare Rate $2,214

Self-Pay Cash $2,995

Insurer Median $2,995

1. Amount on Your Bill or Quote ($) Pre-filled with Knoxville Hospital & Clinics’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: $2,196 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $2,196

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (44.0% of gross = $2,196).

Step 2 · Cash vs. Insurance Arbitrage Save $1,996 Paying Cash

Self-Pay Cash Rate ($2,995) Beats Your Bill

Knoxville Hospital & Clinics's published 45 CFR § 180 self-pay cash rate is $2,995 (vs. $2,995 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$2,311 Above Fair BaseRate

Negotiate Toward $2,680 Fair BaseRate ($2,214 Medicare)

Your bill ($4,991) is $2,311 above the denoised Fair BaseRate ($2,680) and 2.3× the $2,214 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) 501(c)(3) Nonprofit Hospital

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

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 (44.0% 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

CMS Overall2/5 Stars (2/5)

Safety Composite72/100

Would Recommend86%

Rated 9 or 10 (HCAHPS)85%

Median ER Wait145 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

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

2025-07-10·administrative_or_closure
Met Requirements
Recorded
2024-02-27·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (91 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 Knoxville Hospital & Clinics.

Price Index: 1.00× regional baseline

Quality: 48/100 CMS composite

Median Household Income$78,059U.S. Census ACS

Local Uninsured Share2.5%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 51/100 · Caution CMS CCN 161355

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 161355) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-01-24 · 15.45 MB

Validated Rate Rows17 (CMS v3.0.0)

File Integrity DigestVerified · CCN 161355

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