How many shoppable procedure prices are published for Spencer Municipal Hospital?

Spencer Municipal Hospital in Spencer, IA currently has 92 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Spencer Municipal Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Spencer Municipal Hospital's median negotiated commercial rate is 1.5× the regionally adjusted fair BaseRate benchmark.

What is Spencer Municipal Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Spencer Municipal Hospital an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Government - Local 49 Beds · rural Updated: 7/1/2024

Spencer Municipal Hospital

1200 1St Avenue East, Spencer, IA 51301 · 92 Priced Procedures · 79% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.47×vs. Fair Market Price

Typical commercial prices here are +47% above the fair benchmark (1.47×) even after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 78% of the Time

File Completeness88

Price Logic71

Peer Alignment80

Clean Billing57

Real Cash Discount100

High-Markup · Check Safety

4-Star CMS clinical quality rating paired with 1.47× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +36% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Spencer Municipal Hospital prices routine shoppable procedures at 1.9× Medicare (median 1.41× Fair BaseRate) while upper-quartile commercial rates jump +36% to 1.92× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#57 of 87 in IA · 64th State Percentile#2,583 of 3,385 in U.S. · 76th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.83× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 78% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 79% patient recommendation (73/100 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 (1.47× 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 1.41× Fair BaseRate (1.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.92×) jump +36% above the median procedure ratio (Q50 1.41×)
Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.9× Medicare

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

Back-Door Captive & ER0.95× Divergence

1.8× Medicare

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

Quantile Tail Spread+36% Upper Tail

Q25 0.83× · Q50 1.41× · Q75 1.92×

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

0.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.8× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.3× MedicareFair

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

0.5× MedicareGood

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

78% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 73/100Fair

Procedure Prices at Spencer Municipal 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.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$20,024	$15,325	$19,087	0.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$32,475	$14,970	$19,432	0.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$10,992	$6,167	$8,223	0.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,214	$1,709	$1,021	1.7×
Injection procedure for pain management HCPCS Code: `G0260`	$1,307	$1,145	$855	1.3×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,702	$719	$511	1.4×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,635	$617	$448	1.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,635	$557	$303	1.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,824	$516	$583	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$931	$534	$242	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$704	$534	$258	unverified
CT scan, head (no contrast) CPT Code: `70450`	$628	$502	$160	3.1×
MRI, lower back (no contrast) CPT Code: `72148`	$1,235	$506	$338	1.5×
MRI, brain (no contrast) CPT Code: `70551`	$1,702	$506	$343	1.5×
MRI, knee or other leg joint CPT Code: `73721`	$1,386	$506	$369	1.4×
Blood transfusion CPT Code: `36430`	$319	$405	$498	0.8×
Trauma team activation HCPCS Code: `G0390`	$389	$389	$1,453	0.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$898	$294	$272	1.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$612	$238	$134	1.8×
CT scan, pelvis CPT Code: `72192`	$1,052	$239	$163	1.5×
CT scan, sinuses CPT Code: `70486`	$913	$239	$166	1.4×
CT scan, chest (no contrast) CPT Code: `71250`	$913	$239	$167	1.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$844	$239	$168	1.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$844	$239	$169	1.4×
Ultrasound, pelvis CPT Code: `76856`	$493	$238	$130	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$169	$169	$123	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$389	$171	$126	1.4×
Ultrasound, thyroid and neck CPT Code: `76536`	$418	$171	$132	1.3×
Breathing treatment (nebulizer) CPT Code: `94640`	$297	$177	$201	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$197	$179	$86	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$124	$127	$34	3.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$125	$127	$35	3.6×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$125	$127	$38	3.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$125	$127	$40	3.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$135	$135	$87	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$152	$152	$110	1.4×
Screening mammogram (both breasts) CPT Code: `77067`	$235	$144	$123	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$290	$153	$148	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$150	$127	$185	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$113	$113	$35	unverified
X-ray, pelvis CPT Code: `72170`	$223	$87	$110	0.8×
X-ray, lower back CPT Code: `72110`	$223	$87	$112	0.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$134	$134	$20	6.7×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$105	$105	$11	9.5×
Blood test, vitamin B12 CPT Code: `82607`	$112	$112	$16	7.0×
Blood test, liver function panel CPT Code: `80076`	$80	$80	$9	8.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$90	$90	$14	6.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$89	$89	$14	6.4×
Drug screening test HCPCS Code: `G0480`	$97	$97	$116	0.8×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$52	$52	$3	17.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$63	$63	$4	15.8×
Blood test, lipase CPT Code: `83690`	$63	$63	$7	9.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$109	$62	$14	4.4×
Blood test, vitamin D CPT Code: `82306`	$124	$62	$31	2.0×
Physical therapy (gait training) CPT Code: `97116`	$125	$62	$33	1.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$72	$79	$56	1.4×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$207	$62	$64	1.0×
X-ray, chest (single view) CPT Code: `71045`	$150	$76	$92	0.8×
X-ray, shoulder CPT Code: `73030`	$150	$76	$92	0.8×
X-ray, foot CPT Code: `73630`	$185	$76	$92	0.8×
X-ray, chest (two views) CPT Code: `71046`	$150	$76	$93	0.8×
X-ray, neck (cervical spine) CPT Code: `72040`	$359	$76	$93	0.8×
X-ray, hand CPT Code: `73130`	$150	$76	$93	0.8×
X-ray, hip CPT Code: `73502`	$150	$76	$93	0.8×
X-ray, ankle CPT Code: `73610`	$209	$76	$93	0.8×
Pneumococcal vaccine HCPCS Code: `90732`	$72	$79	$140	0.6×
Blood test, basic metabolic panel CPT Code: `80048`	$83	$83	$9	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$39	$39	$5	7.8×
Blood test, amylase CPT Code: `82150`	$44	$44	$7	6.3×
Blood test, magnesium CPT Code: `83735`	$39	$39	$7	5.6×
Occupational therapy (self-care training) CPT Code: `97535`	$134	$62	$38	1.6×
Extended office visit (prolonged) HCPCS Code: `G2212`	$50	$50	$33	1.5×
Flu vaccine injection HCPCS Code: `G0008`	$108	$47	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$108	$47	$49	1.0×
Blood antibody screen CPT Code: `86850`	$52	$42	$46	0.9×
Blood test, calcium CPT Code: `82310`	$63	$63	$5	unverified
Blood test, potassium CPT Code: `84132`	$63	$63	$5	unverified
Blood test, sodium CPT Code: `84295`	$63	$63	$5	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$63	$63	$4	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$29	$29	$5	5.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$26	$16	$6	2.7×
Culture, bacterial CPT Code: `87070`	$35	$21	$9	2.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$44	$18	$8	2.3×
Culture, blood CPT Code: `87040`	$168	$22	$11	2.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$73	$37	$19	1.9×
Hepatitis C antibody test CPT Code: `86803`	$68	$29	$15	1.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$112	$33	$18	1.8×
Hepatitis B vaccine HCPCS Code: `90744`	$49	$49	$37	1.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$39	$39	$86	0.5×
Group therapy session CPT Code: `90853`	$29	$29	$100	0.3×
Blood test, hemoglobin CPT Code: `85018`	$46	$46	$3	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$73	$19	$10	1.9×

Showing top 25 high-impact procedures of 92 total

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

Audit a Bill or Quote at Spencer Municipal Hospital (Zero PHI Required)

CMS CCN: 160112

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $20,024

Insurer Median $15,325

1. Amount on Your Bill or Quote ($) Pre-filled with Spencer Municipal 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 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 $6,675 Paying Cash

Self-Pay Cash Rate ($20,024) Beats Your Bill

Spencer Municipal Hospital's published 45 CFR § 180 self-pay cash rate is $20,024 (vs. $15,325 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$7,612 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($26,699) is $7,612 above the denoised Fair BaseRate ($19,087) and 1.9× the $14,117 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)

EIN: 426005883

Public IRS & CMS ownership records classify Spencer Municipal Hospital 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 Composite73/100

Would Recommend79%

Rated 9 or 10 (HCAHPS)81%

Median ER Wait118 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.4%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare (285 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 Spencer Municipal Hospital.

Price Index: 1.00× regional baseline

Quality: 71/100 CMS composite

Median Household Income$64,082U.S. Census ACS

Local Uninsured Share4.6%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 79/100 · Corroborated CMS CCN 160112 EIN 426005883

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 160112) ↗ Verify IRS Form 990 (EIN 426005883) ↗ CMS HCRIS Cost Reports ↗

Published MRF File426005883_Spencer-Municipal-Hospital_standard_charges.csv

Publication / Vintage7/1/2024 · 3.87 MB

Validated Rate Rows1,308 (CMS v2.0.0)

File Integrity Digest8cf620d91351094ab9bb…

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