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Hospital Profile Critical Access Hospital Government - Hospital District or Authority 25 Beds · rural Updated: 2026-01-08

Sparta Community Hospital

818 E Broadway, Sparta, IL 62286 · 40 Priced Procedures · 64% 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.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 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 match the fair market benchmark (1.00×) 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).8/100 · Quarantined
8/100Self-Pay Cash Beats Insurance 0% of the Time
File Completeness30Provenance (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 Logic0Coherence (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 Alignment0Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing0Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount9Cash 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 Benchmark Tier
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 Score65/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian 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 1.00× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Sparta Community Hospital prices routine shoppable procedures near 16.2× Medicare (p50 1.00×) while skewing captive emergency, lab, and upper-quartile codes to 29.2× Medicare (p75 1.28×, +28% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

Regional Benchmark in ILU.S. National Reference Pool
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (25/100 Cash Honesty)
  • CMS clinical safety score (65/100 safety score) with 64% 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)

  • Outpatient surgery & OR suites carry a 20.2× markup over Medicare rates
  • Captive ER (23.5×) & laboratory (21.3×) services average 1.80× higher multiples than routine shoppable care (16.2×)
  • Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
  • Unnegotiated chargemaster list prices average 18.4× Medicare (14¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
16.2× Medicare

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

Back-Door Captive & ER1.80× Divergence
29.2× Medicare

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

Quantile Tail Spread+28% Upper Tail
Q25 0.78× · Q50 1.00× · Q75 1.28×

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
16.2× MedicareWatchout
Outpatient Surgery & ORBack-Door Captive
20.2× MedicareWatchout
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
7.4× MedicareWatchout
Back-Door Captive ER VisitsBack-Door Captive
23.5× MedicareWatchout
Inpatient Lab & PathologyBack-Door Captive
21.3× MedicareWatchout
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
18.6× MedicareWatchout
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 65/100Fair

Procedure Prices at Sparta Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 40 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Sepsis treatment (inpatient stay)
MS-DRG Code: 871
 $11,012 0.6×
Sleep study (overnight, in lab)
CPT Code: 95810
 $5,902 5.8×
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $4,925 8.4×
MRI, lower back (no contrast)
CPT Code: 72148
 $4,339 unverified
Blood transfusion
CPT Code: 36430
 $2,760 5.5×
X-ray, foot
CPT Code: 73630
 $570 6.2×
X-ray, hand
CPT Code: 73130
 $573 6.2×
X-ray, lower back
CPT Code: 72110
 $587 5.2×
X-ray, chest (two views)
CPT Code: 71046
 $488 5.2×
Electrocardiogram (EKG, tracing only)
CPT Code: 93005
 $390 6.1×
Hospital observation (per hour)
HCPCS Code: G0378
 $324 unverified
Blood test, comprehensive metabolic panel
CPT Code: 80053
 $371 unverified
Blood test, liver function panel
CPT Code: 80076
 $373 unverified
Blood test, vitamin B12
CPT Code: 82607
 $306 unverified
Blood test, cholesterol (lipid panel)
CPT Code: 80061
 $280 unverified
Culture, blood
CPT Code: 87040
 $300 unverified
Blood test, ferritin (iron stores)
CPT Code: 82728
 $274 unverified
Blood test, thyroid (TSH)
CPT Code: 84443
 $263 unverified
Culture, bacterial
CPT Code: 87070
 $206 22.9×
Blood test, PSA (prostate screen)
CPT Code: 84153
 $216 11.4×
Prostate cancer screening (blood test)
HCPCS Code: G0103
 $226 11.3×
Blood test, vitamin D
CPT Code: 82306
 $229 7.4×
Blood test, basic metabolic panel
CPT Code: 80048
 $248 unverified
Blood antibody screen
CPT Code: 86850
 $212 4.6×
Blood test, amylase
CPT Code: 82150
 $160 22.9×
Showing top 25 high-impact procedures of 40 total
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

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

CMS CCN: 141349
CPT 871
Fair BaseRate™ $19,087
Medicare Rate $14,117
Self-Pay Cash $11,012
Insurer Median $11,012
Pre-filled with Sparta 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 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 Published Cash: $11,012

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Sparta Community Hospital's published 45 CFR § 180 self-pay cash rate is $11,012 (vs. $11,012 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: $19,087 Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($19,087).

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 Sparta Community 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 Overall3/5 Stars (3/5)
Safety Composite65/100
Would Recommend64%
Rated 9 or 10 (HCAHPS)61%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

Source: CMS Hospital Care Compare (35 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 Quality & Price Benchmark

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

Price Index: 0.92× regional baseline
Quality: 54/100 CMS composite
Median Household Income$68,870U.S. Census ACS
Local Uninsured Share5.3%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 8/100 · Quarantined CMS CCN 141349

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 141349) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2026-01-08
Validated Rate Rows0 (CMS v3.0.0)
File Integrity DigestVerified · CCN 141349

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