How many shoppable procedure prices are published for Clay County Hospital?

Clay County Hospital in Flora, IL currently has 117 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Clay County Hospital's median negotiated commercial rate is 0.7× the regionally adjusted fair BaseRate benchmark.

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

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

Hospital Profile Critical Access Hospital Government - Local 20 Beds · rural Updated: 2026-05-07

Clay County Hospital

911 Stacy Burk Dr, Flora, IL 62839 · 117 Priced Procedures · 78% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.69×vs. Fair Market Price

Typical commercial prices here are 31% below the fair benchmark (0.69×) after accounting for local nurse/doctor wages and patient complexity.

66/100 · Caution

66/100Self-Pay Cash Beats Insurance 6% of the Time

File Completeness85

Price Logic82

Peer Alignment60

Clean Billing82

Real Cash Discount6

Regional Value Leader

3-Star CMS clinical quality rating paired with 0.69× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Clay County Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.7× Medicare, p50 0.70× Fair BaseRate) and emergency/ancillary services (0.8× Medicare, p75 0.88× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#8 of 126 in IL · 5th State Percentile#125 of 3,385 in U.S. · 3rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 31% below peer Fair BaseRate (0.69×)
Self-pay cash beats commercial insurance on 6% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (72/100 safety score) with 78% patient recommendation
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 (0.69× 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 (0.4×) & laboratory (0.5×) services average 1.14× higher multiples than routine shoppable care (0.7×)
Upper-quartile procedures (Q75 0.88×) jump +26% above the median procedure ratio (Q50 0.70×)
Unnegotiated chargemaster list prices average 12.6× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.7× Medicare

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

Back-Door Captive & ER1.14× Divergence

0.8× Medicare

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

Quantile Tail Spread+26% Upper Tail

Q25 0.35× · Q50 0.70× · Q75 0.88×

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

0.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.6× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.5× MedicareGood

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

0.5× MedicareGood

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

6% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 72/100Fair

Procedure Prices at Clay County Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Gallbladder removal (laparoscopic) CPT Code: `47562`	$6,224	$6,224	$6,109	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$3,350	$2,975	1.1×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,994	$2,680	1.1×
Total knee replacement CPT Code: `27447`	—	$2,130	$13,523	0.2×
Breast lump removal CPT Code: `19120`	$1,747	$1,747	$3,875	0.5×
Bunion correction surgery CPT Code: `28296`	—	$1,047	$3,446	0.3×
Blood transfusion CPT Code: `36430`	$961	$961	$498	1.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$896	$2,540	0.4×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$849	$3,372	0.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$5,132	$730	$1,021	0.7×
Rabies immune globulin HCPCS Code: `90375`	$7,908	$683	$322	2.1×
X-ray, pelvis CPT Code: `72170`	$549	$549	$110	5.0×
Inguinal hernia repair CPT Code: `49505`	$5,351	$531	$3,629	0.1×
Psychiatric evaluation (first visit) CPT Code: `90791`	$478	$224	$185	1.2×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$182	$151	1.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$437	$185	$181	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$195	$195	$201	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$6,701	$198	$448	0.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$5,256	$194	$511	0.4×
Colonoscopy with biopsy CPT Code: `45380`	$3,890	$194	$1,256	0.2×
Family therapy session CPT Code: `90847`	$376	$166	$173	1.0×
Neurobehavioral status check CPT Code: `96116`	—	$177	$231	0.8×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,276	$168	$981	0.2×
Care planning with family CPT Code: `90887`	—	$130	$107	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$590	$110	$148	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$3,942	$119	$343	0.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$3,362	$127	$583	0.2×
Upper endoscopy with biopsy CPT Code: `43239`	$2,809	$134	$987	0.1×
Speech therapy (language evaluation) CPT Code: `92507`	$420	$101	$86	1.2×
Psychotherapy session (45 minutes) CPT Code: `90834`	$371	$126	$166	0.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,283	$130	$272	0.5×
New patient office visit (30-44 min) CPT Code: `99203`	$254	$94	$110	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$243	$102	$123	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$426	$85	$123	0.7×
CT scan, sinuses CPT Code: `70486`	$2,508	$85	$166	0.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,379	$105	$258	0.4×
MRI, knee or other leg joint CPT Code: `73721`	$3,747	$130	$369	0.4×
CT scan, head (with contrast) CPT Code: `70460`	$2,672	$89	$242	0.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$5,366	$103	$303	0.3×
MRI, lower back (no contrast) CPT Code: `72148`	$4,181	$114	$338	0.3×
Typhoid vaccine HCPCS Code: `90675`	$1,303	$459	$347	1.3×
Hepatitis C antibody test CPT Code: `86803`	$360	$360	$15	24.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$349	$349	$11	unverified
Blood test, basic metabolic panel CPT Code: `80048`	$240	$240	$9	26.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$263	$263	$14	18.8×
Blood test, vitamin B12 CPT Code: `82607`	$228	$228	$16	14.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$222	$203	1.1×
Blood test, lipase CPT Code: `83690`	$180	$180	$7	25.7×
Blood test, liver function panel CPT Code: `80076`	$157	$157	$9	17.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$149	$149	$14	10.6×
Blood test, complete blood count (CBC) CPT Code: `85025`	$120	$120	$8	15.0×
Pneumococcal vaccine HCPCS Code: `90732`	$334	$142	$140	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$381	$115	$111	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$72	$72	$48	1.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$72	$72	$49	1.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$302	$57	$56	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$157	$70	$87	0.8×
Review of medical records for care CPT Code: `90889`	—	$78	$114	0.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,060	$75	$132	0.6×
Ultrasound, pelvis CPT Code: `76856`	$1,360	$72	$130	0.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,711	$71	$134	0.5×
CT scan, pelvis CPT Code: `72192`	$2,725	$76	$163	0.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$3,097	$77	$169	0.5×
CT scan, chest (no contrast) CPT Code: `71250`	$2,812	$76	$167	0.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$3,096	$76	$168	0.5×
Speech therapy (group session) CPT Code: `92508`	—	$38	$27	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,293	$54	$126	0.4×
CT scan, head (no contrast) CPT Code: `70450`	$2,420	$62	$160	0.4×
Flu vaccine (high dose) HCPCS Code: `90656`	$63	$63	$25	unverified
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$30	$25	1.2×
Hepatitis B vaccine HCPCS Code: `90744`	—	$34	$37	0.9×
Orthotic fitting and training CPT Code: `97760`	$209	$46	$51	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$35	$39	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$187	$34	$38	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$164	$34	$38	0.9×
Prosthetic fitting and training CPT Code: `97761`	$124	$40	$45	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$167	$35	$40	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$164	$33	$38	0.9×
Psychological testing evaluation CPT Code: `96136`	—	$57	$128	0.4×
Psychological testing by technician CPT Code: `96138`	—	$57	$395	0.1×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$30	$33	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$210	$30	$35	0.9×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$118	$4	$4	1.0×
Physical therapy (gait training) CPT Code: `97116`	$108	$29	$33	0.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$30	$35	0.9×
Blood test, potassium CPT Code: `84132`	$104	$4	$5	0.8×
Blood test, sodium CPT Code: `84295`	$138	$4	$5	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$130	$4	$5	0.8×
Electrical stimulation therapy HCPCS Code: `G0283`	$179	$11	$14	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$180	$26	$34	0.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$264	$15	$20	0.8×
Blood test, PSA (prostate screen) CPT Code: `84153`	$185	$14	$19	0.7×
Culture, blood CPT Code: `87040`	$319	$8	$11	0.7×
Blood test, hemoglobin CPT Code: `85018`	$73	$2	$3	0.7×
Blood test, clotting time (PTT) CPT Code: `85730`	$152	$4	$6	0.7×
Culture, bacterial CPT Code: `87070`	$276	$5	$9	0.6×
Blood test, thyroid (TSH) CPT Code: `84443`	$228	$9	$18	0.5×
X-ray, hip CPT Code: `73502`	$750	$33	$93	0.4×
X-ray, lower back CPT Code: `72110`	$548	$37	$112	0.3×
Group therapy session CPT Code: `90853`	$498	$29	$100	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$113	$3	$3	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$92	$4	$4	1.0×
Blood test, magnesium CPT Code: `83735`	$131	$6	$7	0.9×
Blood test, calcium CPT Code: `82310`	$74	$4	$5	0.8×
Blood test, creatinine (kidney) CPT Code: `82565`	$87	$4	$5	0.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$210	$8	$10	0.8×
Blood test, vitamin D CPT Code: `82306`	$283	$23	$31	0.7×
Blood test, amylase CPT Code: `82150`	$80	$4	$7	0.6×
X-ray, neck (cervical spine) CPT Code: `72040`	$619	$27	$93	0.3×
X-ray, hand CPT Code: `73130`	$289	$27	$93	0.3×
X-ray, ankle CPT Code: `73610`	$289	$26	$93	0.3×
X-ray, shoulder CPT Code: `73030`	$555	$25	$92	0.3×
X-ray, foot CPT Code: `73630`	$289	$24	$92	0.3×
X-ray, chest (two views) CPT Code: `71046`	$432	$21	$93	0.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$385	$13	$64	0.2×
X-ray, chest (single view) CPT Code: `71045`	$262	$16	$92	0.2×
Blood antibody screen CPT Code: `86850`	—	$5	$46	0.1×

Showing top 25 high-impact procedures of 117 total

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

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

CMS CCN: 141351

CPT 47562

Select Procedure to Audit:

Fair BaseRate™ $6,109

Medicare Rate $6,176

Self-Pay Cash $6,224

Insurer Median $6,224

1. Amount on Your Bill or Quote ($) Pre-filled with Clay County 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 Published Cash: $6,224

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Clay County Hospital's published 45 CFR § 180 self-pay cash rate is $6,224 (vs. $6,224 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$115 Above Fair BaseRate

Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)

Your bill ($6,224) is $115 above the denoised Fair BaseRate ($6,109) and 1.0× the $6,176 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: 376000605

Public IRS & CMS ownership records classify Clay County 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 Overall3/5 Stars (3/5)

Safety Composite72/100

Would Recommend78%

Rated 9 or 10 (HCAHPS)86%

Median ER Wait88 min

Left ER Before Seen0%

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 Clay County Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-12-08·administrative_or_closure
Closure Notice
Recorded
2025-11-12·cap_corrective_action
CAP Request
Recorded
2025-08-06·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (65 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

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

Price Index: 0.97× regional baseline

Quality: 60/100 CMS composite

Median Household Income$57,266U.S. Census ACS

Local Uninsured Share5.6%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 66/100 · Caution CMS CCN 141351 EIN 376000605

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 141351) ↗ Verify IRS Form 990 (EIN 376000605) ↗ CMS HCRIS Cost Reports ↗

Published MRF File376000605_county-of-clay_standardcharges.csv

Publication / Vintage2026-05-07 · 46.04 MB

Validated Rate Rows3,951 (CMS v3.0.0)

File Integrity Digestdc2fd789458947df05c7…

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

Clay County Hospital

Uniform Value Leader · Low-Cost Across Departments

Where They're Good (Patient & Payer Edge)

Where You Can Get Burned (Markup Traps)

REA Pricing Decompiler · 5-Layer Cost-to-Charge Reverse Engineering

Insurer Bargaining Power & Cash-Vulnerability Matrix

Procedure Prices at Clay County Hospital

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

Above Standard 400% FPL Financial-Assistance Ceiling

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)

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

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Price Transparency Administrative Enforcement Log

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

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