How many shoppable procedure prices are published for St Anthony Regional Hospital & Nursing Home?

St Anthony Regional Hospital & Nursing Home in Carroll, IA currently has 113 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do St Anthony Regional Hospital & Nursing Home's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, St Anthony Regional Hospital & Nursing Home's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is St Anthony Regional Hospital & Nursing Home's CMS Care Compare overall star rating?

CMS Care Compare assigns St Anthony Regional Hospital & Nursing Home 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 Updated: 2026-07-14

St Anthony Regional Hospital & Nursing Home

311 South Clark Street, Carroll, IA 51401 · 113 Priced Procedures · 78% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Above Fair Market · Negotiate

1.13×vs. Fair Market Price

Typical commercial prices here are +13% above the fair benchmark (1.13×) even after accounting for local nurse/doctor wages and patient complexity.

63/100 · Caution

63/100Self-Pay Cash Beats Insurance 14% of the Time

File Completeness100

Price Logic54

Peer Alignment57

Clean Billing87

Real Cash Discount6

High Quality · Fair Price

5-Star CMS clinical quality rating paired with 1.13× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

St Anthony Regional Hospital & Nursing Home prices routine shoppable procedures near 1.6× Medicare (p50 0.98×) while skewing captive emergency, lab, and upper-quartile codes to 1.9× Medicare (p75 1.60×, +63% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#44 of 87 in IA · 49th State Percentile#1,786 of 3,385 in U.S. · 52nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.68× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 14% of shoppable procedures (25/100 Cash Honesty)
2-Star CMS clinical rating with 78% 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 (41.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.13× 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 (1.3×) & laboratory (2.7×) services average 1.19× higher multiples than routine shoppable care (1.6×)
Upper-quartile procedures (Q75 1.60×) jump +63% above the median procedure ratio (Q50 0.98×)
Consolidated metro market (HHI 9,321) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.6× Medicare

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

Back-Door Captive & ER1.19× Divergence

1.9× Medicare

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

Quantile Tail Spread+63% Upper Tail

Q25 0.68× · Q50 0.98× · Q75 1.60×

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

1.6× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.7× MedicareFair

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

1.4× MedicareGood

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

14% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 72/100Fair

Procedure Prices at St Anthony Regional Hospital & Nursing Home

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 113 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`	$71,063	$27,043	$19,432	1.4×
MRI, lower back (no contrast) CPT Code: `72148`	$3,963	$3,963	$338	11.7×
Total hip replacement CPT Code: `27130`	$3,674	$3,674	$13,413	0.3×
Total knee replacement CPT Code: `27447`	$3,670	$3,670	$13,523	0.3×
Trauma team activation HCPCS Code: `G0390`	$3,160	$3,160	$1,453	2.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,667	$2,667	$169	15.8×
C-section delivery (full package) CPT Code: `59510`	$4,955	$2,573	$2,975	0.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,458	$2,458	$168	14.6×
Vaginal delivery (full package) CPT Code: `59400`	$5,620	$2,402	$2,680	0.9×
Blood transfusion CPT Code: `36430`	$1,488	$1,379	$498	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$5,405	$1,094	$448	2.4×
CT scan, pelvis CPT Code: `72192`	$2,106	$1,094	$163	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$4,337	$1,094	$303	unverified
MRI, knee or other leg joint CPT Code: `73721`	$3,545	$1,032	$369	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,894	$892	$6,109	0.1×
MRI, brain (no contrast) CPT Code: `70551`	$4,139	$725	$343	2.1×
MRI, brain (with and without contrast) CPT Code: `70553`	$6,896	$725	$511	1.4×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,571	$743	$3,372	0.2×
Inguinal hernia repair CPT Code: `49505`	$1,505	$629	$3,629	0.2×
Breast lump removal CPT Code: `19120`	$1,181	$573	$3,875	0.1×
CT scan, head (no contrast) CPT Code: `70450`	$2,120	$505	$160	3.2×
CT scan, head (with contrast) CPT Code: `70460`	$3,176	$505	$242	2.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,754	$505	$258	2.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,470	$436	$583	0.7×
Rabies immune globulin HCPCS Code: `90375`	$2,310	$348	$322	1.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,692	$318	$272	1.2×
Speech therapy (group session) CPT Code: `92508`	$288	$288	$27	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	$1,065	$243	$981	0.2×
Colonoscopy with biopsy CPT Code: `45380`	$1,380	$263	$1,256	0.2×
Screening mammogram (both breasts) CPT Code: `77067`	$480	$232	$123	1.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$533	$232	$148	1.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$216	$202	$123	1.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$257	$201	$126	1.6×
Ultrasound, pelvis CPT Code: `76856`	$592	$201	$130	1.5×
Ultrasound, thyroid and neck CPT Code: `76536`	$541	$201	$132	1.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$345	$201	$134	1.5×
Breathing treatment (nebulizer) CPT Code: `94640`	$211	$211	$201	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	$1,127	$183	$987	0.2×
Physical therapy (gait training) CPT Code: `97116`	$139	$139	$33	4.2×
Electrical stimulation therapy HCPCS Code: `G0283`	$112	$112	$14	8.0×
Physical therapy (manual therapy) CPT Code: `97140`	$136	$136	$34	4.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$134	$134	$35	3.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$135	$135	$38	3.6×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$135	$135	$40	3.4×
Occupational therapy (self-care training) CPT Code: `97535`	$146	$127	$38	3.3×
Orthotic fitting and training CPT Code: `97760`	$156	$143	$51	2.8×
Speech therapy (language evaluation) CPT Code: `92507`	$314	$135	$86	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$176	$129	$110	1.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$154	$154	$185	0.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$145	$145	$181	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$114	$114	$38	3.0×
CT scan, sinuses CPT Code: `70486`	$2,078	$124	$166	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$2,262	$124	$167	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$131	$131	$35	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$116	$116	$86	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$147	$87	$64	1.4×
Office visit, established patient (20-29 min) CPT Code: `99213`	$153	$95	$87	1.1×
Family therapy session CPT Code: `90847`	$149	$112	$173	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$98	$98	$166	0.6×
Typhoid vaccine HCPCS Code: `90675`	$450	$292	$347	0.8×
Drug screening test HCPCS Code: `G0480`	$164	$150	$116	1.3×
Pneumococcal vaccine HCPCS Code: `90732`	$173	$122	$140	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$229	$146	$203	0.7×
Blood test, vitamin D CPT Code: `82306`	$89	$89	$31	2.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$300	$83	$111	0.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$41	$41	$14	2.9×
Blood test, vitamin B12 CPT Code: `82607`	$45	$45	$16	2.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$55	$55	$20	2.8×
X-ray, chest (single view) CPT Code: `71045`	$76	$62	$92	0.7×
X-ray, shoulder CPT Code: `73030`	$394	$62	$92	0.7×
X-ray, foot CPT Code: `73630`	$100	$62	$92	0.7×
X-ray, chest (two views) CPT Code: `71046`	$368	$62	$93	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$113	$62	$93	0.7×
X-ray, hand CPT Code: `73130`	$105	$62	$93	0.7×
X-ray, hip CPT Code: `73502`	$135	$62	$93	0.7×
X-ray, ankle CPT Code: `73610`	$105	$62	$93	0.7×
X-ray, pelvis CPT Code: `72170`	$81	$62	$110	0.6×
X-ray, lower back CPT Code: `72110`	$144	$62	$112	0.6×
Blood test, calcium CPT Code: `82310`	$15	$15	$5	3.0×
Blood test, lipase CPT Code: `83690`	$21	$21	$7	3.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$32	$32	$11	2.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	$69	$34	$33	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$56	$40	$49	0.8×
Flu vaccine injection HCPCS Code: `G0008`	$71	$39	$48	0.8×
Group therapy session CPT Code: `90853`	$92	$38	$100	0.4×
Hepatitis C antibody test CPT Code: `86803`	$43	$43	$15	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$12	$12	$4	3.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$8	$8	$3	2.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$10	$10	$4	2.5×
Blood test, creatinine (kidney) CPT Code: `82565`	$12	$11	$5	2.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$22	$22	$10	2.2×
Blood test, potassium CPT Code: `84132`	$14	$11	$5	2.2×
Blood test, sodium CPT Code: `84295`	$11	$11	$5	2.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$11	$11	$5	2.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$23	$17	$8	2.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$20	$20	$14	1.4×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$37	$32	$39	0.8×
Blood test, hemoglobin CPT Code: `85018`	$6	$6	$3	2.0×
Culture, bacterial CPT Code: `87070`	$20	$17	$9	1.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$42	$28	$19	1.5×
Blood test, thyroid (TSH) CPT Code: `84443`	$25	$25	$18	1.4×
Hepatitis B vaccine HCPCS Code: `90744`	$92	$34	$37	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$43	$22	$25	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$28	$21	$25	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$127	$34	$56	0.6×
Colorectal cancer screening HCPCS Code: `G0010`	$27	$27	$49	0.6×
Blood antibody screen CPT Code: `86850`	$15	$15	$46	0.3×
Blood test, basic metabolic panel CPT Code: `80048`	$25	$25	$9	unverified
Blood test, liver function panel CPT Code: `80076`	$13	$13	$9	unverified
Blood test, amylase CPT Code: `82150`	$15	$15	$7	unverified
Blood test, magnesium CPT Code: `83735`	$11	$11	$7	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$10	$10	$6	unverified
Culture, blood CPT Code: `87040`	$31	$31	$11	unverified

Showing top 25 high-impact procedures of 113 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 41.0%

Audit a Bill or Quote at St Anthony Regional Hospital & Nursing Home (Zero PHI Required)

CMS CCN: 161382

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $71,063

Insurer Median $27,043

1. Amount on Your Bill or Quote ($) Pre-filled with St Anthony Regional Hospital & Nursing Home’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: $29,136 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $29,136

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (41.0% of gross = $29,136).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $71,063

Compare Prompt-Pay Cash Rate Against Remaining Deductible

St Anthony Regional Hospital & Nursing Home's published 45 CFR § 180 self-pay cash rate is $71,063 (vs. $27,043 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$51,631 Above Fair BaseRate

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

Your bill ($71,063) is $51,631 above the denoised Fair BaseRate ($19,432) and 5.1× 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) 501(c)(3) Nonprofit Hospital

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

EIN: 420733472

Filing Period: 194603

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 (41.0% 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 Overall5/5 Stars (5/5)

Safety Composite72/100

Would Recommend78%

Rated 9 or 10 (HCAHPS)81%

Median ER Wait132 min

30-Day Mortality vs U.S.worse

Unplanned Readmissionsame

Hip/Knee Complication Rate4.3%

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 (258 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 St Anthony Regional Hospital & Nursing Home.

Price Index: 0.76× regional baseline

Quality: 64/100 CMS composite

Median Household Income$68,528U.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 63/100 · Caution CMS CCN 161382 EIN 420733472

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 161382) ↗ Verify IRS Form 990 (EIN 420733472) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-07-14 · 48.48 MB

Validated Rate Rows1,916 (CMS v3.0.0)

File Integrity Digest8887265b708ef17b7d5a…

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