How many shoppable procedure prices are published for Kirby Medical Center?

Kirby Medical Center in Monticello, IL currently has 133 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Kirby Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Kirby Medical Center's median negotiated commercial rate is 0.7× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 16 Beds · urban Updated: 2026-06-11

Kirby Medical Center

1000 Medical Center Drive, Monticello, IL 61856 · 133 Priced Procedures · 91% Patient Recommendation

CMS Overall Rating No CMS Rating

Good Deal · Below Fair Market

0.68×vs. Fair Market Price

Typical commercial prices here are 32% below the fair benchmark (0.68×) after accounting for local nurse/doctor wages and patient complexity.

87/100 · Verified

87/100Self-Pay Cash Beats Insurance 65% of the Time

File Completeness100

Price Logic88

Peer Alignment49

Clean Billing94

Real Cash Discount100

Regional Value Leader

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

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Kirby Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.6× Medicare, p50 0.67× Fair BaseRate) and emergency/ancillary services (1.2× Medicare, p75 0.86× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#7 of 126 in IL · 4th State Percentile#121 of 3,385 in U.S. · 3rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 32% below peer Fair BaseRate (0.68×)
Self-pay cash beats commercial insurance on 65% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (75/100 safety score) with 91% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (31.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.68× 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 2.00× higher multiples than routine shoppable care (0.6×)
Upper-quartile procedures (Q75 0.86×) jump +28% above the median procedure ratio (Q50 0.67×)
Consolidated metro market (HHI 6,686) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.6× Medicare

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

Back-Door Captive & ER2.00× Divergence

1.2× Medicare

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

Quantile Tail Spread+28% Upper Tail

Q25 0.40× · Q50 0.67× · Q75 0.86×

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

0.7× 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

1.1× MedicareGood

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

65% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 75/100Fair

Procedure Prices at Kirby Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 133 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	$4,590	$4,590	$13,413	0.3×
Total knee replacement CPT Code: `27447`	$4,590	$4,590	$13,523	0.3×
C-section delivery (full package) CPT Code: `59510`	—	$2,660	$2,975	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$2,625	$2,625	$6,109	0.4×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,358	$2,680	unverified
Breast lump removal CPT Code: `19120`	$2,295	$2,295	$3,875	0.6×
Blood transfusion CPT Code: `36430`	$1,027	$1,027	$498	2.1×
Rabies immune globulin HCPCS Code: `90375`	$1,002	$1,002	$322	unverified
Residential mental health treatment HCPCS Code: `H2036`	—	$609	$406	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$3,983	$509	$1,021	0.5×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$2,295	$521	$3,372	0.2×
Inguinal hernia repair CPT Code: `49505`	$2,625	$531	$3,629	0.1×
Cataract surgery with lens implant CPT Code: `66984`	—	$483	$2,540	0.2×
Bunion correction surgery CPT Code: `28296`	$2,295	$483	$3,446	0.1×
X-ray, pelvis CPT Code: `72170`	$450	$450	$110	4.1×
Behavioral health residential care HCPCS Code: `H0011`	—	$384	$364	1.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$276	$276	$64	4.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$4,200	$198	$448	0.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$4,200	$206	$511	0.4×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$144	$151	1.0×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$168	$257	0.7×
Behavioral health day treatment HCPCS Code: `H0010`	—	$181	$343	0.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,641	$168	$981	0.2×
Colonoscopy with biopsy CPT Code: `45380`	$1,641	$188	$1,256	0.1×
Hospital observation (per hour) HCPCS Code: `G0378`	$83	$120	$86	1.4×
Psychotherapy session (60 minutes) CPT Code: `90837`	$312	$137	$181	0.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	$384	$137	$185	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,140	$139	$272	0.5×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$90	$88	1.0×
Care planning with family CPT Code: `90887`	—	$95	$107	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,000	$113	$258	0.4×
MRI, lower back (no contrast) CPT Code: `72148`	$3,300	$134	$338	0.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,000	$120	$303	0.4×
MRI, brain (no contrast) CPT Code: `70551`	$3,300	$133	$343	0.4×
MRI, knee or other leg joint CPT Code: `73721`	$3,300	$132	$369	0.4×
Upper endoscopy with biopsy CPT Code: `43239`	$1,314	$130	$987	0.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	$264	$86	$123	0.7×
Family therapy session CPT Code: `90847`	—	$103	$173	0.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,220	$120	$583	0.2×
Psychotherapy session (45 minutes) CPT Code: `90834`	$269	$93	$166	0.6×
CT scan, pelvis CPT Code: `72192`	$2,220	$84	$163	0.5×
CT scan, chest (no contrast) CPT Code: `71250`	$2,220	$85	$167	0.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,220	$83	$168	0.5×
CT scan, sinuses CPT Code: `70486`	$2,220	$82	$166	0.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,220	$83	$169	0.5×
CT scan, head (with contrast) CPT Code: `70460`	$3,000	$98	$242	0.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$459	$103	$148	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$444	$85	$123	unverified
Typhoid vaccine HCPCS Code: `90675`	$837	$330	$347	1.0×
Blood test, amylase CPT Code: `82150`	$198	$198	$7	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$162	$203	0.8×
Blood test, magnesium CPT Code: `83735`	$176	$176	$7	unverified
Pneumococcal vaccine HCPCS Code: `90732`	—	$136	$140	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$333	$74	$86	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$86	$111	0.8×
Drug screening test HCPCS Code: `G0480`	$219	$78	$116	0.7×
New patient office visit (30-44 min) CPT Code: `99203`	$256	$73	$110	0.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$414	$75	$132	0.6×
Review of medical records for care CPT Code: `90889`	—	$63	$114	0.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$660	$73	$134	0.5×
Ultrasound, pelvis CPT Code: `76856`	$660	$68	$130	0.5×
CT scan, head (no contrast) CPT Code: `70450`	$2,220	$71	$160	0.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$420	$55	$126	0.4×
Neurobehavioral status check CPT Code: `96116`	—	$73	$231	0.3×
Blood test, potassium CPT Code: `84132`	$63	$63	$5	unverified
Culture, bacterial CPT Code: `87070`	$160	$18	$9	2.0×
Hepatitis C antibody test CPT Code: `86803`	—	$28	$15	1.9×
Culture, blood CPT Code: `87040`	$221	$20	$11	1.8×
X-ray, hip CPT Code: `73502`	$360	$35	$93	0.4×
X-ray, lower back CPT Code: `72110`	$450	$37	$112	0.3×
Blood test, sodium CPT Code: `84295`	$60	$60	$5	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$75	$75	$4	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$114	$6	$3	2.0×
Blood test, lipase CPT Code: `83690`	$141	$13	$7	1.9×
Blood test, calcium CPT Code: `82310`	$80	$9	$5	1.8×
Blood test, creatinine (kidney) CPT Code: `82565`	$83	$9	$5	1.8×
Blood test, hemoglobin CPT Code: `85018`	$41	$5	$3	1.7×
Blood test, complete blood count (CBC) CPT Code: `85025`	$112	$11	$8	1.4×
Blood test, glucose (blood sugar) CPT Code: `82947`	$59	$4	$4	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$103	$6	$6	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$18	$25	$25	1.0×
Behavioral health outpatient services HCPCS Code: `H2015`	—	$15	$16	0.9×
Prosthetic fitting and training CPT Code: `97761`	—	$39	$45	0.9×
Orthotic fitting and training CPT Code: `97760`	$111	$44	$51	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$12	$14	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$23	$27	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$128	$34	$40	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$172	$40	$56	0.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$223	$58	$87	0.7×
Behavioral health day program HCPCS Code: `H2012`	—	$59	$100	0.6×
Behavioral health assessment HCPCS Code: `H0001`	—	$55	$157	0.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$223	$10	$11	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$161	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$199	$8	$9	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$184	$16	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$161	$12	$16	0.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$177	$10	$14	0.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$184	$10	$14	0.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$99	$7	$10	0.7×
Blood test, PSA (prostate screen) CPT Code: `84153`	$189	$13	$19	0.7×
Blood test, vitamin D CPT Code: `82306`	$272	$21	$31	0.7×
Behavioral health living support HCPCS Code: `H2019`	—	$21	$34	0.6×
Mental health services (assessment) HCPCS Code: `H0031`	—	$44	$140	0.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$194	$17	$20	0.8×
Physical therapy (gait training) CPT Code: `97116`	—	$28	$33	0.8×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$28	$33	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$32	$38	0.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$381	$29	$35	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$141	$31	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$128	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$164	$27	$34	0.8×
Flu vaccine injection HCPCS Code: `G0008`	$114	$23	$48	0.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$114	$23	$49	0.5×
Colorectal cancer screening HCPCS Code: `G0010`	$210	$23	$49	0.5×
X-ray, neck (cervical spine) CPT Code: `72040`	$360	$27	$93	0.3×
X-ray, hand CPT Code: `73130`	$360	$27	$93	0.3×
X-ray, ankle CPT Code: `73610`	$360	$27	$93	0.3×
Mental health services (therapy) HCPCS Code: `H0032`	—	$18	$65	0.3×
X-ray, shoulder CPT Code: `73030`	$360	$25	$92	0.3×
X-ray, foot CPT Code: `73630`	$360	$24	$92	0.3×
X-ray, chest (two views) CPT Code: `71046`	$206	$22	$93	0.2×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$39	$269	0.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$42	$39	unverified
Hepatitis B vaccine HCPCS Code: `90744`	—	$42	$37	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$78	$4	$5	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$17	$25	0.7×
Blood antibody screen CPT Code: `86850`	$127	$20	$46	0.4×
Group therapy session CPT Code: `90853`	$318	$26	$100	0.3×
Psychological testing evaluation CPT Code: `96136`	—	$22	$128	0.2×
Psychological testing by technician CPT Code: `96138`	—	$35	$395	0.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$136	$32	$38	unverified
Community mental health services HCPCS Code: `H0038`	—	$3	$16	0.2×
X-ray, chest (single view) CPT Code: `71045`	$360	$16	$92	0.2×

Showing top 25 high-impact procedures of 133 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 31.0%

Audit a Bill or Quote at Kirby Medical Center (Zero PHI Required)

CMS CCN: 141301

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash $4,590

Insurer Median $4,590

1. Amount on Your Bill or Quote ($) Pre-filled with Kirby Medical Center’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: $2,372 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $2,372

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (31.0% of gross = $2,372).

Step 2 · Cash vs. Insurance Arbitrage Save $3,060 Paying Cash

Self-Pay Cash Rate ($4,590) Beats Your Bill

Kirby Medical Center's published 45 CFR § 180 self-pay cash rate is $4,590 (vs. $4,590 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $13,413 Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($13,413).

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: 370661215

Filing Period: 199305

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 (31.0% 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 Composite75/100

Would Recommend91%

Rated 9 or 10 (HCAHPS)89%

Median ER Wait126 min

Left ER Before Seen0%

Unplanned Readmissionsame

Source: CMS Hospital Care Compare (90 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 Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Kirby Medical Center.

Price Index: 0.88× regional baseline

Quality: 61/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Cigna

+83.7%

Blue Cross Blue Shield

+176.8%

Median Household Income$87,516U.S. Census ACS

Local Uninsured Share3.0%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 87/100 · Verified CMS CCN 141301 EIN 370661215

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 141301) ↗ Verify IRS Form 990 (EIN 370661215) ↗ CMS HCRIS Cost Reports ↗

Published MRF File370661215_kirby-medical-center_standardcharges.csv

Publication / Vintage2026-06-11 · 100.83 MB

Validated Rate Rows4,997 (CMS v3.0.0)

File Integrity Digest38c33b1a7defea5c9a02…

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