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Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-06-08

Illini Community Hospital

640 W Washington, Pittsfield, IL 62363 · 84 Priced Procedures · 81% Patient Recommendation

CMS Overall Rating 3 / 5 Stars
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Good Deal · Below Fair Market
0.63×vs. Fair Market Price
Position vs. 1.00× Fair Price37% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 37% below the fair benchmark (0.63×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).80/100 · Corroborated
80/100Self-Pay Cash Beats Insurance 71% of the Time
File Completeness66Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic96Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment60Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing75Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star Rating3/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score72/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait114 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

3-Star CMS clinical quality rating paired with 0.63× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Illini Community Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.6× Medicare, p50 0.62× Fair BaseRate) and emergency/ancillary services (0.9× Medicare, p75 0.87× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#2 of 126 in IL · 1st State Percentile#93 of 3,385 in U.S. · 2nd National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 37% below peer Fair BaseRate (0.63×)
  • Self-pay cash beats commercial insurance on 71% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (72/100 safety score) with 81% patient recommendation
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (80.9% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (0.63× 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 (0.9×) & laboratory (4.3×) services average 1.50× higher multiples than routine shoppable care (0.6×)
  • Upper-quartile procedures (Q75 0.87×) jump +40% above the median procedure ratio (Q50 0.62×)
  • Unnegotiated chargemaster list prices average 18.1× Medicare (25¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
0.6× Medicare

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

Back-Door Captive & ER1.50× Divergence
0.9× Medicare

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

Quantile Tail Spread+40% Upper Tail
Q25 0.23× · Q50 0.62× · Q75 0.87×

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
0.6× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.8× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.4× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
0.9× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
4.3× MedicareElevated
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.5× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
71% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 72/100Fair

Procedure Prices at Illini Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 84 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
MRI, brain (with and without contrast)
CPT Code: 70553
 $5,886 11.5×
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $5,552 12.4×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $4,899 16.2×
MRI, brain (no contrast)
CPT Code: 70551
 $4,724 13.8×
Sleep study (overnight, in lab)
CPT Code: 95810
 $4,695 4.6×
MRI, lower back (no contrast)
CPT Code: 72148
 $4,028 11.9×
MRI, knee or other leg joint
CPT Code: 73721
 $3,689 10.0×
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $3,273 19.5×
CT scan, neck (cervical spine)
CPT Code: 72125
 $3,218 19.0×
CT scan, head (with and without contrast)
CPT Code: 70470
 $3,165 12.3×
Colonoscopy with biopsy
CPT Code: 45380
 $2,977 2.4×
CT scan, pelvis
CPT Code: 72192
 $2,752 16.9×
CT scan, sinuses
CPT Code: 70486
 $2,552 15.4×
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $2,557 4.4×
CT scan, chest (no contrast)
CPT Code: 71250
 $2,464 14.8×
CT scan, head (no contrast)
CPT Code: 70450
 $2,184 13.7×
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $1,665 6.1×
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $1,418 0.2×
Ultrasound, abdomen (complete)
CPT Code: 76700
 $1,162 8.7×
Ultrasound, pelvis
CPT Code: 76856
 $1,084 8.3×
Ultrasound, thyroid and neck
CPT Code: 76536
 $772 5.8×
X-ray, lower back
CPT Code: 72110
 $624 5.6×
X-ray, hip
CPT Code: 73502
 $454 4.9×
X-ray, neck (cervical spine)
CPT Code: 72040
 $453 4.9×
Breathing treatment (nebulizer)
CPT Code: 94640
 $459 2.3×
Showing top 25 high-impact procedures of 84 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 80.9%

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

CMS CCN: 141315
CPT 70553
Fair BaseRate™ $511
Medicare Rate $356
Self-Pay Cash $5,886
Insurer Median $5,886
Pre-filled with Illini Community Hospital’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $7,937 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $7,937

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (80.9% of gross = $7,937).

Step 2 · Cash vs. Insurance Arbitrage Save $3,924 Paying Cash

Self-Pay Cash Rate ($5,886) Beats Your Bill

Illini Community Hospital's published 45 CFR § 180 self-pay cash rate is $5,886 (vs. $5,886 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$9,299 Above Fair BaseRate

Negotiate Toward $511 Fair BaseRate ($356 Medicare)

Your bill ($9,810) is $9,299 above the denoised Fair BaseRate ($511) and 27.6× the $356 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)

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 (80.9% 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 Overall3/5 Stars (3/5)
Safety Composite72/100
Would Recommend81%
Rated 9 or 10 (HCAHPS)85%
Median ER Wait114 min
Left ER Before Seen0%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

Source: CMS Hospital Care Compare (76 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

Higher-Quality, Above-Median Price Tier

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

Price Index: 3.44× regional baseline
Quality: 61/100 CMS composite
Median Household Income$58,029U.S. Census ACS
Local Uninsured Share5.9%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 80/100 · Corroborated CMS CCN 141315

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 141315) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2026-06-08
Validated Rate Rows2,539 (CMS v3.0.0)
File Integrity DigestVerified · CCN 141315

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