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Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural

Iroquois Memorial Hospital

200 Fairman Street, Watseka, IL 60970 · 27 Priced Procedures

CMS Overall Rating No CMS Rating
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.High Markup · Shop Alternatives
1.49×vs. Fair Market Price
Position vs. 1.00× Fair Price+49% Above 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 +49% above the fair benchmark (1.49×) even 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).82/100 · Corroborated
82/100Self-Pay Cash Beats Insurance 0% of the Time
File Completeness78Provenance (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 Logic100Coherence (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 Alignment75Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing54Regularity (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.High-Markup · Check Safety
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score67/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait149 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Iroquois Memorial Hospital prices shoppable and inpatient services (2.0× to 1.5× Medicare, divergence 0.75×) in alignment with regional hospital peers (1.49× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#96 of 126 in IL · 75th State Percentile#2,614 of 3,385 in U.S. · 77th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.73× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (67/100 safety score) with 72% patient recommendation
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (12.4% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (1.49× 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 1.50× Fair BaseRate (2.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 1.92×) jump +28% above the median procedure ratio (Q50 1.50×)
  • Unnegotiated chargemaster list prices average 19.4× Medicare (14¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
2.0× Medicare

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

Back-Door Captive & ER0.75× Divergence
1.5× Medicare

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

Quantile Tail Spread+28% Upper Tail
Q25 0.73× · Q50 1.50× · Q75 1.92×

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
2.0× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.9× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.1× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.9× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
0.9× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.8× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 67/100Fair

Procedure Prices at Iroquois Memorial Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 27 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Rabies immune globulin
HCPCS Code: 90375
 $2,351 7.3×
Ultrasound, abdomen (complete)
CPT Code: 76700
 $829 6.2×
Ultrasound, thyroid and neck
CPT Code: 76536
 $597 4.5×
X-ray, lower back
CPT Code: 72110
 $510 4.6×
Psychotherapy session (60 minutes)
CPT Code: 90837
 $443 2.4×
Psychiatric evaluation (first visit)
CPT Code: 90791
 $443 2.4×
CT scan, pelvis
CPT Code: 72192
 $325 2.0×
CT scan, neck (cervical spine)
CPT Code: 72125
 $325 1.9×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $325 1.1×
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $325 0.7×
Screening mammogram (both breasts)
CPT Code: 77067
 $286 2.3×
Office visit, established patient (30-39 min)
CPT Code: 99214
 $282 2.3×
Psychotherapy session (45 minutes)
CPT Code: 90834
 $295 1.8×
New patient office visit (30-44 min)
CPT Code: 99203
 $227 2.1×
Breathing treatment (nebulizer)
CPT Code: 94640
 $164 0.8×
Office visit, established patient (20-29 min)
CPT Code: 99213
 $123 1.4×
Group therapy session
CPT Code: 90853
 $76 0.8×
Hospital observation (per hour)
HCPCS Code: G0378
 $61 0.7×
Blood test, average blood sugar (A1c)
CPT Code: 83036
 $14 1.4×
Blood test, comprehensive metabolic panel
CPT Code: 80053
 $11 1.0×
Blood test, complete blood count (CBC)
CPT Code: 85025
 $8 1.0×
Blood test, PSA (prostate screen)
CPT Code: 84153
 $18 0.9×
Blood test, cholesterol (lipid panel)
CPT Code: 80061
 $13 0.9×
Blood test, vitamin D
CPT Code: 82306
 $28 0.9×
Blood test, thyroid (TSH)
CPT Code: 84443
 $15 0.8×
Showing top 25 high-impact procedures of 27 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 12.4%

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

CMS CCN: 141353
CPT 90375
Fair BaseRate™ $322
Medicare Rate $275
Self-Pay Cash $2,351
Insurer Median $2,351
Pre-filled with Iroquois Memorial 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: $418 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $418

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (12.4% of gross = $418).

Step 2 · Cash vs. Insurance Arbitrage Save $1,008 Paying Cash

Self-Pay Cash Rate ($2,351) Beats Your Bill

Iroquois Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $2,351 (vs. $2,351 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$3,037 Above Fair BaseRate

Negotiate Toward $322 Fair BaseRate ($275 Medicare)

Your bill ($3,359) is $3,037 above the denoised Fair BaseRate ($322) and 12.2× the $275 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: 370673512
Filing Period: 192306
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 (12.4% 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

Safety Composite67/100
Median ER Wait149 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 Iroquois Memorial Hospital. Prior administrative notices do not necessarily reflect current compliance status.

  • 2024-12-10·administrative_or_closure

    Closure Notice

    Recorded
  • 2024-09-04·cap_corrective_action

    CAP Request

    Recorded

Source: CMS Hospital Care Compare. 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 Iroquois Memorial Hospital.

Price Index: 0.58× regional baseline
Quality: 57/100 CMS composite
Median Household Income$62,439U.S. Census ACS
Local Uninsured Share6.3%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 82/100 · Corroborated CMS CCN 141353 EIN 370673512

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 141353) ↗ Verify IRS Form 990 (EIN 370673512) ↗ CMS HCRIS Cost Reports ↗
Published MRF File37-0673512_IroquoisMemorialHospital_standardcharges.CSV
Publication / Vintage2026-10 · 15.93 MB
Validated Rate Rows4 (CMS v2)
File Integrity Digest77685c0752def31dcf25…

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