How many shoppable procedure prices are published for Waverly Health Center?

Waverly Health Center in Waverly, IA currently has 118 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Waverly Health Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Waverly Health Center's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is Waverly Health Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Waverly Health Center an overall hospital quality rating of 5 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Government - Local 21 Beds · rural Updated: 2026-03-03

Waverly Health Center

312 9Th Street Sw, Waverly, IA 50677 · 118 Priced Procedures · 81% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

Above Fair Market · Negotiate

1.15×vs. Fair Market Price

Typical commercial prices here are +15% above the fair benchmark (1.15×) even after accounting for local nurse/doctor wages and patient complexity.

74/100 · Corroborated

74/100Self-Pay Cash Beats Insurance 59% of the Time

File Completeness51

Price Logic66

Peer Alignment67

Clean Billing94

Real Cash Discount100

High Quality · Fair Price

5-Star CMS clinical quality rating paired with 1.15× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 4,475), Waverly Health Center commands a 1.15× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#45 of 87 in IA · 50th State Percentile#1,863 of 3,385 in U.S. · 55th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.79× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 59% of shoppable procedures (99/100 Cash Honesty)
5-Star CMS clinical rating with 81% patient recommendation (80/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (50.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.15× 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 1.07× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.46×) jump +36% above the median procedure ratio (Q50 1.07×)
Consolidated metro market (HHI 4,475) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.7× Medicare

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

Back-Door Captive & ER0.59× Divergence

1.0× Medicare

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

Quantile Tail Spread+36% Upper Tail

Q25 0.79× · Q50 1.07× · Q75 1.46×

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

1.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.5× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.5× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

3.0× MedicareFair

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

0.8× MedicareGood

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

59% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 80/100Good

Procedure Prices at Waverly Health Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 118 published procedures.

Sort:

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`	$19,067	$19,067	$19,432	1.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$15,323	$15,323	$19,087	0.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$4,842	$4,842	$8,223	0.6×
Total knee replacement CPT Code: `27447`	$3,208	$3,208	$13,523	0.2×
Total hip replacement CPT Code: `27130`	$2,998	$2,998	$13,413	0.2×
C-section delivery (full package) CPT Code: `59510`	$4,181	$2,155	$2,975	0.7×
Vaginal delivery (full package) CPT Code: `59400`	$3,692	$1,949	$2,680	0.7×
Bunion correction surgery CPT Code: `28296`	$1,444	$1,444	$3,446	0.4×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,102	$1,102	$6,109	0.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,903	$1,041	$511	2.0×
Rabies immune globulin HCPCS Code: `90375`	$931	$931	$322	2.9×
CT scan, head (no contrast) CPT Code: `70450`	$945	$875	$160	5.5×
CT scan, head (with contrast) CPT Code: `70460`	$1,117	$875	$242	3.6×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,239	$875	$258	3.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,914	$875	$303	2.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,471	$875	$448	2.0×
MRI, lower back (no contrast) CPT Code: `72148`	$1,776	$756	$338	2.2×
MRI, brain (no contrast) CPT Code: `70551`	$1,776	$756	$343	2.2×
MRI, knee or other leg joint CPT Code: `73721`	$1,631	$756	$369	2.0×
Breast lump removal CPT Code: `19120`	$623	$769	$3,875	0.2×
Trauma team activation HCPCS Code: `G0390`	$599	$599	$1,453	0.4×
Cataract surgery with lens implant CPT Code: `66984`	$562	$562	$2,540	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,303	$467	$3,372	0.1×
Inguinal hernia repair CPT Code: `49505`	$1,036	$451	$3,629	0.1×
Ultrasound, pelvis CPT Code: `76856`	$512	$413	$130	3.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$609	$413	$134	3.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$672	$413	$272	1.5×
Blood transfusion CPT Code: `36430`	$490	$396	$498	0.8×
CT scan, pelvis CPT Code: `72192`	$963	$328	$163	2.0×
CT scan, sinuses CPT Code: `70486`	$996	$328	$166	2.0×
CT scan, chest (no contrast) CPT Code: `71250`	$1,144	$328	$167	2.0×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,057	$328	$168	2.0×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,032	$328	$169	1.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$492	$270	$126	2.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$421	$270	$132	2.0×
Screening mammogram (both breasts) CPT Code: `77067`	$232	$216	$123	1.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$329	$216	$148	1.5×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,196	$211	$1,021	0.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$251	$172	$185	0.9×
X-ray, shoulder CPT Code: `73030`	$210	$134	$92	1.5×
X-ray, foot CPT Code: `73630`	$152	$134	$92	1.5×
X-ray, hand CPT Code: `73130`	$152	$134	$93	1.4×
X-ray, hip CPT Code: `73502`	$268	$134	$93	1.4×
X-ray, pelvis CPT Code: `72170`	$120	$134	$110	1.2×
X-ray, lower back CPT Code: `72110`	$262	$134	$112	1.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$112	$138	$123	1.1×
Colonoscopy (diagnostic) CPT Code: `45378`	$524	$153	$981	0.2×
Colonoscopy with biopsy CPT Code: `45380`	$701	$165	$1,256	0.1×
X-ray, chest (single view) CPT Code: `71045`	$119	$134	$92	1.5×
X-ray, chest (two views) CPT Code: `71046`	$158	$134	$93	1.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$152	$134	$93	1.4×
X-ray, ankle CPT Code: `73610`	$162	$134	$93	1.4×
Speech therapy (language evaluation) CPT Code: `92507`	$137	$111	$86	1.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$82	$93	$87	1.1×
New patient office visit (30-44 min) CPT Code: `99203`	$97	$116	$110	1.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$253	$134	$181	0.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$157	$130	$583	0.2×
Family therapy session CPT Code: `90847`	$257	$102	$173	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$222	$91	$166	0.5×
Upper endoscopy with biopsy CPT Code: `43239`	$612	$115	$987	0.1×
Typhoid vaccine HCPCS Code: `90675`	$356	$326	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$176	$174	$203	0.9×
Blood test, vitamin D CPT Code: `82306`	$154	$154	$31	unverified
Culture, blood CPT Code: `87040`	$82	$82	$11	7.5×
Blood test, PSA (prostate screen) CPT Code: `84153`	$86	$86	$19	4.5×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$86	$86	$20	4.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$103	$92	$111	0.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$54	$54	$6	9.0×
Hepatitis C antibody test CPT Code: `86803`	$68	$68	$15	4.5×
Blood test, vitamin B12 CPT Code: `82607`	$66	$66	$16	4.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$70	$70	$18	3.9×
Neurobehavioral status check CPT Code: `96116`	$219	$70	$231	0.3×
Electrical stimulation therapy HCPCS Code: `G0283`	$72	$72	$14	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$30	$30	$3	10.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$28	$28	$4	7.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$32	$32	$5	6.4×
Blood test, magnesium CPT Code: `83735`	$42	$42	$7	6.0×
Blood test, calcium CPT Code: `82310`	$29	$29	$5	5.8×
Blood test, lipase CPT Code: `83690`	$37	$37	$7	5.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$42	$42	$8	5.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$54	$54	$11	4.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$49	$49	$10	4.9×
Blood test, liver function panel CPT Code: `80076`	$43	$43	$9	4.8×
Speech therapy (group session) CPT Code: `92508`	$63	$35	$27	1.3×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$74	$44	$40	1.1×
Orthotic fitting and training CPT Code: `97760`	$74	$56	$51	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$58	$55	$56	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$16	$28	$25	1.1×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$36	$28	$25	1.1×
Blood antibody screen CPT Code: `86850`	$35	$49	$46	1.1×
Prosthetic fitting and training CPT Code: `97761`	$70	$47	$45	1.0×
Physical therapy (gait training) CPT Code: `97116`	$68	$34	$33	1.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$74	$39	$38	1.0×
Occupational therapy (self-care training) CPT Code: `97535`	$74	$38	$38	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$71	$38	$38	1.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$71	$34	$35	1.0×
Physical therapy (manual therapy) CPT Code: `97140`	$68	$31	$34	0.9×
Flu vaccine injection HCPCS Code: `G0008`	$43	$39	$48	0.8×
Pneumonia vaccine injection HCPCS Code: `G0009`	$50	$39	$49	0.8×
Pneumococcal vaccine HCPCS Code: `90732`	$50	$50	$140	0.4×
Breathing treatment (nebulizer) CPT Code: `94640`	$36	$36	$201	0.2×
Blood test, basic metabolic panel CPT Code: `80048`	$43	$43	$9	unverified
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$68	$68	$14	unverified
Blood test, amylase CPT Code: `82150`	$32	$32	$7	4.6×
Blood test, ferritin (iron stores) CPT Code: `82728`	$49	$49	$14	unverified
Culture, bacterial CPT Code: `87070`	$60	$10	$9	1.1×
Hepatitis B vaccine HCPCS Code: `90744`	$20	$32	$37	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$37	$32	$39	0.8×
Extended office visit (prolonged) HCPCS Code: `G2212`	$33	$26	$33	0.8×
Colorectal cancer screening HCPCS Code: `G0010`	$42	$34	$49	0.7×
Group therapy session CPT Code: `90853`	$76	$24	$100	0.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$38	$12	$64	0.2×
Blood test, potassium CPT Code: `84132`	$35	$35	$5	unverified
Blood test, sodium CPT Code: `84295`	$33	$33	$5	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	$39	$39	$35	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$14	$4	$5	0.8×
Blood test, hemoglobin CPT Code: `85018`	$9	$2	$3	0.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$25	$25	$4	unverified

Showing top 25 high-impact procedures of 118 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 50.6%

Audit a Bill or Quote at Waverly Health Center (Zero PHI Required)

CMS CCN: 161339

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $19,067

Insurer Median $19,067

1. Amount on Your Bill or Quote ($) Pre-filled with Waverly Health Center’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: $18,550 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $18,550

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (50.6% of gross = $18,550).

Step 2 · Cash vs. Insurance Arbitrage Save $17,600 Paying Cash

Self-Pay Cash Rate ($19,067) Beats Your Bill

Waverly Health Center's published 45 CFR § 180 self-pay cash rate is $19,067 (vs. $19,067 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$17,235 Above Fair BaseRate

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

Your bill ($36,667) is $17,235 above the denoised Fair BaseRate ($19,432) and 2.6× 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: 421029188

Filing Period: 199010

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 (50.6% 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 Composite80/100

Would Recommend81%

Rated 9 or 10 (HCAHPS)84%

Median ER Wait155 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

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

2024-11-14·administrative_or_closure
Closure Notice
Recorded
2024-08-12·warning_notice
Warning Notice
Recorded
2023-03-09·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (118 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 Waverly Health Center.

Price Index: 1.00× regional baseline

Quality: 81/100 CMS composite

Median Household Income$83,343U.S. Census ACS

Local Uninsured Share2.2%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 74/100 · Corroborated CMS CCN 161339 EIN 421029188

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 161339) ↗ Verify IRS Form 990 (EIN 421029188) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-03

Validated Rate Rows1,990 (CMS v3.0.0)

File Integrity DigestVerified · CCN 161339

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