How many shoppable procedure prices are published for Mc Donough District Hospital?

Mc Donough District Hospital in Macomb, IL currently has 132 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Mc Donough District Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Mc Donough District Hospital's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

What is Mc Donough District Hospital's CMS Care Compare overall star rating?

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

Hospital Profile Acute Care Hospital Government - Hospital District or Authority 45 Beds · rural Updated: 3/25/2026

Mc Donough District Hospital

525 East Grant Street, Macomb, IL 61455 · 132 Priced Procedures · 58% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.79×vs. Fair Market Price

Typical commercial prices here are 21% below the fair benchmark (0.79×) after accounting for local nurse/doctor wages and patient complexity.

76/100 · Corroborated

76/100Self-Pay Cash Beats Insurance 62% of the Time

File Completeness61

Price Logic79

Peer Alignment60

Clean Billing85

Real Cash Discount100

Regional Value Leader

4-Star CMS clinical quality rating paired with 0.79× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Mc Donough District Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.6× Medicare, p50 0.82× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.96× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#16 of 126 in IL · 11th State Percentile#247 of 3,385 in U.S. · 7th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 21% below peer Fair BaseRate (0.79×)
Self-pay cash beats commercial insurance on 62% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (70/100 safety score) with 58% 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 (0.79× 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 (1.3×) services average 1.67× higher multiples than routine shoppable care (0.6×)
Upper-quartile procedures (Q75 0.96×) jump +17% above the median procedure ratio (Q50 0.82×)
Consolidated metro market (HHI 10,000) 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 & ER1.67× Divergence

1.0× Medicare

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

Quantile Tail Spread+17% Upper Tail

Q25 0.44× · Q50 0.82× · Q75 0.96×

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

1.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.9× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.3× MedicareGood

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

1.1× MedicareGood

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

62% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 70/100Fair

Procedure Prices at Mc Donough District Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 132 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
C-section delivery (full package) CPT Code: `59510`	—	$2,690	$2,975	0.9×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,406	$2,680	0.9×
Trauma team activation HCPCS Code: `G0390`	—	$1,477	$1,453	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	—	$878	$86	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$798	$3,372	0.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$758	$2,540	0.3×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$652	$257	2.5×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$652	$269	2.4×
Behavioral health residential care HCPCS Code: `H0011`	—	$652	$364	1.8×
Injection procedure for pain management HCPCS Code: `G0260`	—	$675	$855	0.8×
Behavioral health day treatment HCPCS Code: `H0010`	—	$652	$343	unverified
Breast lump removal CPT Code: `19120`	—	$623	$3,875	0.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,139	$588	$981	0.6×
Behavioral health day program HCPCS Code: `H2012`	—	$587	$100	unverified
Bunion correction surgery CPT Code: `28296`	—	$560	$3,446	0.2×
Residential mental health treatment HCPCS Code: `H2036`	—	$446	$406	1.1×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,616	$455	$1,021	0.4×
Inguinal hernia repair CPT Code: `49505`	—	$424	$3,629	0.1×
Colonoscopy with biopsy CPT Code: `45380`	$1,426	$395	$1,256	0.3×
Mental health services (assessment) HCPCS Code: `H0031`	—	$312	$140	2.2×
Upper endoscopy with biopsy CPT Code: `43239`	$1,244	$337	$987	0.3×
Behavioral health assessment HCPCS Code: `H0001`	—	$312	$157	unverified
Rabies immune globulin HCPCS Code: `90375`	—	$280	$322	0.9×
Psychological testing by technician CPT Code: `96138`	—	$238	$395	0.6×
Blood transfusion CPT Code: `36430`	$805	$263	$498	0.5×
Care planning with family CPT Code: `90887`	—	$212	$107	2.0×
X-ray, pelvis CPT Code: `72170`	$213	$213	$110	1.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,169	$195	$448	0.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,177	$191	$511	0.4×
Behavioral health living support HCPCS Code: `H2019`	—	$162	$34	4.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$151	$151	$64	2.4×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$162	$88	1.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	$193	$165	$185	unverified
Mental health services (therapy) HCPCS Code: `H0032`	—	$124	$65	1.9×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$134	$151	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$1,319	$127	$369	0.3×
Psychotherapy session (60 minutes) CPT Code: `90837`	$191	$152	$181	unverified
Review of medical records for care CPT Code: `90889`	—	$124	$114	1.1×
Breathing treatment (nebulizer) CPT Code: `94640`	$127	$127	$201	0.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$661	$135	$272	0.5×
Office visit, established patient (30-39 min) CPT Code: `99214`	$119	$93	$123	0.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$191	$103	$166	0.6×
Family therapy session CPT Code: `90847`	$191	$103	$173	0.6×
MRI, brain (no contrast) CPT Code: `70551`	$1,405	$115	$343	0.3×
CT scan, sinuses CPT Code: `70486`	$1,159	$80	$166	0.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$945	$103	$258	0.4×
Neurobehavioral status check CPT Code: `96116`	—	$87	$231	0.4×
CT scan, head (with contrast) CPT Code: `70460`	$1,053	$87	$242	0.4×
MRI, lower back (no contrast) CPT Code: `72148`	$1,316	$110	$338	0.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$411	$93	$303	0.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,114	$112	$583	0.2×
Typhoid vaccine HCPCS Code: `90675`	—	$314	$347	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	—	$133	$140	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$141	$203	0.7×
Drug screening test HCPCS Code: `G0480`	$194	$114	$116	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$238	$73	$86	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$172	$79	$110	0.7×
Colorectal cancer screening HCPCS Code: `G0010`	—	$52	$49	1.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$392	$73	$132	0.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$413	$69	$134	0.5×
Ultrasound, pelvis CPT Code: `76856`	$402	$64	$130	0.5×
Screening mammogram (both breasts) CPT Code: `77067`	$111	$60	$123	0.5×
CT scan, pelvis CPT Code: `72192`	$600	$74	$163	0.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$634	$76	$169	0.4×
CT scan, chest (no contrast) CPT Code: `71250`	$175	$75	$167	0.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$722	$75	$168	0.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$175	$52	$126	0.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$248	$60	$148	0.4×
CT scan, head (no contrast) CPT Code: `70450`	$592	$61	$160	0.4×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$25	$27	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$29	$33	0.9×
Physical therapy (gait training) CPT Code: `97116`	—	$28	$33	0.8×
Prosthetic fitting and training CPT Code: `97761`	—	$38	$45	0.8×
Orthotic fitting and training CPT Code: `97760`	—	$43	$51	0.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$101	$63	$87	0.7×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$185	$18	$20	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$12	$14	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$48	$32	$38	0.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	—	$33	$40	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	—	$31	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$94	$28	$35	0.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$101	$27	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	—	$26	$34	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$40	$56	0.7×
Culture, bacterial CPT Code: `87070`	$37	$9	$9	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	—	$32	$37	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$23	$27	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$27	$39	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$25	$25	$49	0.5×
X-ray, hip CPT Code: `73502`	$276	$33	$93	0.4×
Psychological testing evaluation CPT Code: `96136`	—	$39	$128	0.3×
Flu vaccine injection HCPCS Code: `G0008`	—	—	$48	—
Blood test, creatinine (kidney) CPT Code: `82565`	$25	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$68	$14	$14	1.0×
Blood test, lipase CPT Code: `83690`	$35	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$20	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$18	$5	$5	1.0×
Blood test, vitamin D CPT Code: `82306`	$106	$30	$31	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$13	$25	0.5×
Flu vaccine (high dose) HCPCS Code: `90656`	$12	$12	$25	0.5×
X-ray, chest (single view) CPT Code: `71045`	$29	$29	$92	0.3×
X-ray, lower back CPT Code: `72110`	$226	$35	$112	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$20	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$22	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$17	$4	$4	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$17	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$30	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$27	$6	$6	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$65	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$56	$17	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$59	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	$62	$14	$15	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$15	$13	$14	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$30	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$40	$8	$9	0.9×
Blood test, amylase CPT Code: `82150`	$33	$6	$7	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$27	$4	$5	0.8×
Group therapy session CPT Code: `90853`	$99	$28	$100	0.3×
Blood test, hemoglobin CPT Code: `85018`	$11	$2	$3	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$180	$26	$93	0.3×
X-ray, hand CPT Code: `73130`	$178	$26	$93	0.3×
X-ray, ankle CPT Code: `73610`	$176	$25	$93	0.3×
X-ray, shoulder CPT Code: `73030`	$177	$23	$92	0.3×
X-ray, foot CPT Code: `73630`	$175	$23	$92	0.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$27	$111	0.2×
X-ray, chest (two views) CPT Code: `71046`	$280	$21	$93	0.2×
Blood antibody screen CPT Code: `86850`	$239	$10	$46	0.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$50	$11	$11	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$35	$10	$10	unverified
Blood test, magnesium CPT Code: `83735`	$29	$7	$7	unverified
Culture, blood CPT Code: `87040`	$46	$10	$11	unverified

Showing top 25 high-impact procedures of 132 total

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

Audit a Bill or Quote at Mc Donough District Hospital (Zero PHI Required)

CMS CCN: 140089

CPT 59510

Select Procedure to Audit:

Fair BaseRate™ $2,975

Medicare Rate $2,473

Self-Pay Cash Request Quote

Insurer Median $2,690

1. Amount on Your Bill or Quote ($) Pre-filled with Mc Donough District 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 Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Mc Donough District Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$3,481 Above Fair BaseRate

Negotiate Toward $2,975 Fair BaseRate ($2,473 Medicare)

Your bill ($6,456) is $3,481 above the denoised Fair BaseRate ($2,975) and 2.6× the $2,473 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)

Public IRS & CMS ownership records classify Mc Donough District 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 Overall4/5 Stars (4/5)

Safety Composite70/100

Would Recommend58%

Rated 9 or 10 (HCAHPS)68%

Median ER Wait152 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Mc Donough District Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2026-03-11·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (154 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 Mc Donough District Hospital.

Price Index: 1.00× regional baseline

Quality: 65/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Health Alliance

-51.4%

Humana

+73.7%

Blue Choice

+86.7%

Blue Cross Blue Shield

+89.4%

Median Household Income$50,434U.S. Census ACS

Local Uninsured Share6.5%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 76/100 · Corroborated CMS CCN 140089

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 140089) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage3/25/2026

Validated Rate Rows8,791 (CMS v3.0.0)

File Integrity DigestVerified · CCN 140089

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