How many shoppable procedure prices are published for Anderson Hospital?

Anderson Hospital in Maryville, IL currently has 110 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Anderson Hospital's median negotiated commercial rate is 1.3× the regionally adjusted fair BaseRate benchmark.

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

CMS Care Compare assigns Anderson Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 144 Beds · urban Updated: 4/1/2026

Anderson Hospital

6800 State Route 162, Maryville, IL 62062 · 110 Priced Procedures · 67% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.31×vs. Fair Market Price

Typical commercial prices here are +31% above the fair benchmark (1.31×) even after accounting for local nurse/doctor wages and patient complexity.

75/100 · Corroborated

75/100Self-Pay Cash Beats Insurance 49% of the Time

File Completeness51

Price Logic77

Peer Alignment71

Clean Billing81

Real Cash Discount100

Regional Benchmark Tier

4-Star CMS clinical quality rating paired with 1.31× fair market pricing.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Anderson Hospital maintains elevated commercial insurance contracts (1.31× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 49% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#87 of 126 in IL · 68th State Percentile#2,269 of 3,385 in U.S. · 67th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.93× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 49% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (67/100 safety score) with 67% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (14.9% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.9× markup over Medicare rates
Commercial insurance median sits at 1.41× Fair BaseRate (2.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.7× Medicare — verify per-unit billing on itemized statements
Unnegotiated chargemaster list prices average 13.6× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

2.2× Medicare

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

Back-Door Captive & ER0.68× Divergence

1.5× Medicare

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

Quantile Tail Spread+9% Upper Tail

Q25 0.93× · Q50 1.41× · Q75 1.54×

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

2.2× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.4× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

3.2× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

3.6× MedicareElevated

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

1.7× MedicareGood

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

49% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 67/100Fair

Procedure Prices at Anderson Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 110 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`	—	$15,868	$19,087	0.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$15,757	$19,432	0.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$14,400	$17,936	0.8×
Total knee replacement CPT Code: `27447`	$43,692	$12,637	$13,523	0.9×
Total hip replacement CPT Code: `27130`	$47,002	$12,512	$13,413	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$6,803	$8,223	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$25,293	$6,479	$6,109	1.1×
Cataract surgery with lens implant CPT Code: `66984`	—	$5,163	$2,540	unverified
Breast lump removal CPT Code: `19120`	$12,211	$4,129	$3,875	1.1×
Inguinal hernia repair CPT Code: `49505`	$24,042	$3,775	$3,629	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,513	$3,446	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$16,613	$3,351	$3,372	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$2,822	$2,975	0.9×
Colonoscopy with biopsy CPT Code: `45380`	$7,778	$2,705	$1,256	unverified
Vaginal delivery (full package) CPT Code: `59400`	—	$2,480	$2,680	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,524	$1,838	$1,021	1.8×
Colonoscopy (diagnostic) CPT Code: `45378`	$4,637	$1,693	$981	1.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,434	$1,423	$511	unverified
MRI, brain (no contrast) CPT Code: `70551`	$2,394	$1,310	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$2,344	$1,262	$338	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$5,392	$1,225	$987	1.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,443	$1,156	$583	2.0×
CT scan, head (with contrast) CPT Code: `70460`	$1,253	$1,126	$242	unverified
MRI, knee or other leg joint CPT Code: `73721`	$2,427	$1,082	$369	2.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,629	$1,073	$258	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,933	$935	$448	2.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,463	$838	$169	unverified
Blood transfusion CPT Code: `36430`	$658	$812	$498	1.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,508	$796	$168	unverified
CT scan, chest (no contrast) CPT Code: `71250`	$1,131	$756	$167	unverified
CT scan, pelvis CPT Code: `72192`	$1,302	$739	$163	unverified
Injection procedure for pain management HCPCS Code: `G0260`	$3,468	$688	$855	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,517	$639	$303	2.1×
CT scan, head (no contrast) CPT Code: `70450`	$1,066	$658	$160	unverified
CT scan, sinuses CPT Code: `70486`	$1,307	$682	$166	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,291	$371	$272	1.4×
Rabies immune globulin HCPCS Code: `90375`	$1,318	$331	$322	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$996	$221	$134	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$172	$185	$110	1.7×
Ultrasound, pelvis CPT Code: `76856`	$770	$204	$130	1.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$185	$187	$123	1.5×
Ultrasound, thyroid and neck CPT Code: `76536`	$652	$199	$132	1.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$692	$188	$126	1.5×
Office visit, established patient (20-29 min) CPT Code: `99213`	$164	$151	$87	1.7×
X-ray, lower back CPT Code: `72110`	$437	$148	$112	1.3×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,133	$142	$151	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$165	$165	$201	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$120	$120	$14	8.6×
X-ray, ankle CPT Code: `73610`	$336	$118	$93	1.3×
X-ray, pelvis CPT Code: `72170`	$273	$139	$110	1.3×
X-ray, shoulder CPT Code: `73030`	$307	$116	$92	1.3×
X-ray, foot CPT Code: `73630`	$298	$116	$92	1.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$405	$116	$93	1.2×
X-ray, hand CPT Code: `73130`	$305	$116	$93	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$375	$115	$148	0.8×
X-ray, chest (single view) CPT Code: `71045`	$250	$135	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$286	$135	$93	unverified
X-ray, hip CPT Code: `73502`	$369	$135	$93	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$235	$92	$64	1.4×
Screening mammogram (both breasts) CPT Code: `77067`	$260	$95	$123	0.8×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$408	$408	$203	unverified
Typhoid vaccine HCPCS Code: `90675`	$314	$320	$347	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$208	$208	$111	unverified
Drug screening test HCPCS Code: `G0480`	$154	$154	$116	1.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$99	$99	$20	5.0×
Blood antibody screen CPT Code: `86850`	$75	$66	$46	1.4×
Diagnostic procedure preparation HCPCS Code: `G0279`	$44	$44	$35	1.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$54	$49	$56	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$238	$73	$86	0.8×
Pneumococcal vaccine HCPCS Code: `90732`	$37	$72	$140	0.5×
Blood test, vitamin D CPT Code: `82306`	$170	$44	$31	1.4×
Prosthetic fitting and training CPT Code: `97761`	$92	$39	$45	0.9×
Orthotic fitting and training CPT Code: `97760`	$71	$44	$51	0.9×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$68	$5	$3	1.7×
Blood test, calcium CPT Code: `82310`	$67	$8	$5	1.6×
Blood test, creatinine (kidney) CPT Code: `82565`	$68	$8	$5	1.6×
Blood test, glucose (blood sugar) CPT Code: `82947`	$58	$6	$4	1.5×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$86	$15	$10	1.5×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$65	$6	$4	1.5×
Blood test, complete blood count (CBC) CPT Code: `85025`	$77	$12	$8	1.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$62	$9	$6	1.5×
Blood test, PSA (prostate screen) CPT Code: `84153`	$133	$28	$19	1.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$140	$16	$11	1.5×
Blood test, basic metabolic panel CPT Code: `80048`	$190	$13	$9	1.4×
Culture, bacterial CPT Code: `87070`	$86	$13	$9	1.4×
Blood test, vitamin B12 CPT Code: `82607`	$108	$23	$16	1.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$85	$20	$14	1.4×
Blood test, amylase CPT Code: `82150`	$78	$10	$7	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$112	$20	$14	1.4×
Blood test, lipase CPT Code: `83690`	$93	$10	$7	1.4×
Blood test, magnesium CPT Code: `83735`	$60	$10	$7	1.4×
Blood test, potassium CPT Code: `84132`	$50	$7	$5	1.4×
Blood test, sodium CPT Code: `84295`	$56	$7	$5	1.4×
Hepatitis C antibody test CPT Code: `86803`	$89	$21	$15	1.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$121	$25	$18	1.4×
Culture, blood CPT Code: `87040`	$160	$15	$11	1.4×
Blood test, liver function panel CPT Code: `80076`	$184	$12	$9	1.3×
Hepatitis B vaccine HCPCS Code: `90744`	$31	$33	$37	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$34	$34	$39	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$94	$33	$38	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$65	$31	$38	0.8×
Blood test, hemoglobin CPT Code: `85018`	$39	$4	$3	1.3×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$46	$6	$5	1.2×
Flu vaccine (high dose) HCPCS Code: `90656`	$22	$23	$25	0.9×
Speech therapy (group session) CPT Code: `92508`	$189	$23	$27	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$83	$34	$40	0.8×
Physical therapy (gait training) CPT Code: `97116`	$75	$28	$33	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$83	$31	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$63	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$65	$27	$34	0.8×

Showing top 25 high-impact procedures of 110 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 14.9%

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

CMS CCN: 140289

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash Request Quote

Insurer Median $15,868

1. Amount on Your Bill or Quote ($) Pre-filled with Anderson 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 501(r) AGB Cap: $5,678 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $5,678

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (14.9% of gross = $5,678).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Anderson Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$18,996 Above Fair BaseRate

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

Your bill ($38,083) is $18,996 above the denoised Fair BaseRate ($19,087) and 2.7× 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) 501(c)(3) Nonprofit Hospital

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

EIN: 370662561

Filing Period: 194808

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 (14.9% 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 Overall4/5 Stars (4/5)

Safety Composite67/100

Would Recommend67%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait223 min

Left ER Before Seen1%

30-Day Mortality vs U.S.worse

Unplanned Readmissionsame

Hip/Knee Complication Rate3.2%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

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

2026-04-08·warning_notice
Warning Notice
Recorded
2026-03-25·administrative_or_closure
Met Requirements
Recorded
2025-01-21·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (326 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 Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Anderson Hospital.

Price Index: 1.17× regional baseline

Quality: 57/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Aetna

-43.7%

Median Household Income$74,800U.S. Census ACS

Local Uninsured Share4.8%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 75/100 · Corroborated CMS CCN 140289 EIN 370662561

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 140289) ↗ Verify IRS Form 990 (EIN 370662561) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage4/1/2026

Validated Rate Rows4,948 (CMS v3.0.0)

File Integrity DigestVerified · CCN 140289

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