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Hospital Profile Critical Access Hospitals Voluntary non-profit - Private

Jacksonville Memorial Hospital

1600 W WALNUT ST, Jacksonville, IL 62650

CMS Overall Rating No CMS Rating
Factual Overview

Jacksonville Memorial Hospital is a Critical Access Hospitals (Voluntary non-profit - Private) operating in Jacksonville, IL. Mapped commercial insurance prices across 82 procedures average 9.23x the Medicare baseline. CMS has not published a quality star rating for this facility.

Facility Overview

Setting: rural Bed Count: 25 Beds Teaching Status: Non-Teaching Annual Discharges: 2,277

Patient Experience

Recommendation Rate: N/A High Patient Rating: N/A ER Wait Time (Med): 182 min Readmission Rate: N/A

Pricing & Transparency

Procedures Mapped: 82 codes Avg Markup vs Medicare: 9.23x Price File In Index: Yes MRF Version: 3.0.0
Procedure & Code Cash Price Actions
Heart stent placement (inpatient stay)
MS-DRG Code: 322
 Contact Desk Calc
Blood transfusion
CPT Code: 36430
 $1,751 Calc
Digestive disorders treatment (inpatient stay)
MS-DRG Code: 392
 Contact Desk Calc
Upper endoscopy with biopsy
CPT Code: 43239
 $1,900 Calc
Hip or knee replacement (inpatient stay)
MS-DRG Code: 470
 Contact Desk Calc
CT scan, head (no contrast)
CPT Code: 70450
 $3,422 Calc
CT scan, head (with contrast)
CPT Code: 70460
 $3,848 Calc
CT scan, head (with and without contrast)
CPT Code: 70470
 $4,688 Calc
CT scan, sinuses
CPT Code: 70486
 $3,678 Calc
MRI, brain (no contrast)
CPT Code: 70551
 $4,899 Calc
MRI, brain (with and without contrast)
CPT Code: 70553
 $7,396 Calc
X-ray, chest (single view)
CPT Code: 71045
 $487 Calc
X-ray, chest (two views)
CPT Code: 71046
 $667 Calc
CT scan, chest (no contrast)
CPT Code: 71250
 $3,754 Calc
X-ray, neck (cervical spine)
CPT Code: 72040
 $782 Calc
X-ray, lower back
CPT Code: 72110
 $1,163 Calc
CT scan, neck (cervical spine)
CPT Code: 72125
 $4,514 Calc
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $3,847 Calc
MRI, lower back (no contrast)
CPT Code: 72148
 $5,540 Calc
X-ray, pelvis
CPT Code: 72170
 $737 Calc
CT scan, pelvis
CPT Code: 72192
 $2,804 Calc
X-ray, shoulder
CPT Code: 73030
 $620 Calc
X-ray, hand
CPT Code: 73130
 $602 Calc
X-ray, hip
CPT Code: 73502
 $653 Calc
X-ray, ankle
CPT Code: 73610
 $744 Calc
X-ray, foot
CPT Code: 73630
 $611 Calc
MRI, knee or other leg joint
CPT Code: 73721
 $4,800 Calc
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $6,499 Calc
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $7,583 Calc
Ultrasound, thyroid and neck
CPT Code: 76536
 $1,378 Calc
Ultrasound, abdomen (complete)
CPT Code: 76700
 $1,947 Calc
Ultrasound, abdomen (limited)
CPT Code: 76705
 $1,592 Calc
Ultrasound, pelvis
CPT Code: 76856
 $1,684 Calc
Diagnostic mammogram (both breasts)
CPT Code: 77066
 $719 Calc
Screening mammogram (both breasts)
CPT Code: 77067
 $558 Calc
Blood test, basic metabolic panel
CPT Code: 80048
 $272 Calc
Blood test, comprehensive metabolic panel
CPT Code: 80053
 $380 Calc
Blood test, cholesterol (lipid panel)
CPT Code: 80061
 $315 Calc
Blood test, liver function panel
CPT Code: 80076
 $332 Calc
Urinalysis (automated, with microscopy)
CPT Code: 81001
 $161 Calc
Blood test, amylase
CPT Code: 82150
 $220 Calc
Blood test, vitamin D
CPT Code: 82306
 $493 Calc
Blood test, calcium
CPT Code: 82310
 $150 Calc
Blood test, creatinine (kidney)
CPT Code: 82565
 $100 Calc
Blood test, vitamin B12
CPT Code: 82607
 $320 Calc
Blood test, ferritin (iron stores)
CPT Code: 82728
 $321 Calc
Blood test, glucose (blood sugar)
CPT Code: 82947
 $144 Calc
Blood test, average blood sugar (A1c)
CPT Code: 83036
 $239 Calc
Blood test, lipase
CPT Code: 83690
 $287 Calc
Blood test, magnesium
CPT Code: 83735
 $207 Calc
Blood test, potassium
CPT Code: 84132
 $57 Calc
Blood test, PSA (prostate screen)
CPT Code: 84153
 $375 Calc
Blood test, sodium
CPT Code: 84295
 $58 Calc
Blood test, thyroid (TSH)
CPT Code: 84443
 $324 Calc
Blood test, urea nitrogen (BUN, kidney)
CPT Code: 84520
 $78 Calc
Blood test, hemoglobin
CPT Code: 85018
 $65 Calc
Blood test, complete blood count (CBC)
CPT Code: 85025
 $163 Calc
Blood test, clotting time (PT/INR)
CPT Code: 85610
 $106 Calc
Blood test, clotting time (PTT)
CPT Code: 85730
 $202 Calc
Hepatitis C antibody test
CPT Code: 86803
 $303 Calc
Blood antibody screen
CPT Code: 86850
 $206 Calc
Culture, blood
CPT Code: 87040
 $283 Calc
Culture, bacterial
CPT Code: 87070
 $310 Calc
Sepsis treatment (inpatient stay)
MS-DRG Code: 871
 Contact Desk Calc
Speech therapy (language evaluation)
CPT Code: 92507
 $348 Calc
Speech therapy (group session)
CPT Code: 92508
 $100 Calc
Electrocardiogram (EKG, tracing only)
CPT Code: 93005
 $500 Calc
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $4,465 Calc
Breathing treatment (nebulizer)
CPT Code: 94640
 $630 Calc
Sleep study (overnight, in lab)
CPT Code: 95810
 $8,669 Calc
Physical therapy (therapeutic exercise)
CPT Code: 97110
 $251 Calc
Physical therapy (neuromuscular re-education)
CPT Code: 97112
 $280 Calc
Physical therapy (gait training)
CPT Code: 97116
 $206 Calc
Physical therapy (manual therapy)
CPT Code: 97140
 $230 Calc
Occupational therapy (therapeutic activities)
CPT Code: 97530
 $198 Calc
Occupational therapy (self-care training)
CPT Code: 97535
 $247 Calc
Physical therapy (functional capacity test)
CPT Code: 97750
 $165 Calc
Orthotic fitting and training
CPT Code: 97760
 $254 Calc
Prosthetic fitting and training
CPT Code: 97761
 $113 Calc
New patient office visit (30-44 min)
CPT Code: 99203
 $416 Calc
Office visit, established patient (20-29 min)
CPT Code: 99213
 $384 Calc
Office visit, established patient (30-39 min)
CPT Code: 99214
 $481 Calc