How many shoppable procedure prices are published for St Joseph's Hospital?

St Joseph's Hospital in Highland, IL currently has 93 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do St Joseph's Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, St Joseph's Hospital's median negotiated commercial rate is 2.0× the regionally adjusted fair BaseRate benchmark.

What is St Joseph's Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns St Joseph's Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Church 25 Beds · urban Updated: 3/24/2026

St Joseph's Hospital

12866 Troxler Avenue, Highland, IL 62249 · 93 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

2.03×vs. Fair Market Price

Typical commercial prices here are +103% above the fair benchmark (2.03×) even after accounting for local nurse/doctor wages and patient complexity.

77/100 · Corroborated

77/100Self-Pay Cash Beats Insurance 56% of the Time

File Completeness51

Price Logic86

Peer Alignment62

Clean Billing90

Real Cash Discount100

High-Markup · Check Safety

5-Star CMS clinical quality rating paired with 2.03× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +60% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

St Joseph's Hospital prices routine shoppable procedures at 4.0× Medicare (median 1.90× Fair BaseRate) while upper-quartile commercial rates jump +60% to 3.04× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#120 of 126 in IL · 94th State Percentile#3,090 of 3,385 in U.S. · 91st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.61× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 56% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (80/100 safety score) with 75% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (73.9% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 5.0× markup over Medicare rates
Commercial insurance median sits at 1.90× Fair BaseRate (4.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 3.04×) jump +60% above the median procedure ratio (Q50 1.90×)
Unnegotiated chargemaster list prices average 13.7× Medicare (26¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

4.0× Medicare

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

Back-Door Captive & ER0.45× Divergence

1.8× Medicare

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

Quantile Tail Spread+60% Upper Tail

Q25 1.61× · Q50 1.90× · Q75 3.04×

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

4.0× MedicareElevated

Outpatient Surgery & ORBack-Door Captive

5.0× MedicareWatchout

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

5.7× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

5.8× MedicareWatchout

Inpatient Lab & PathologyBack-Door Captive

7.8× MedicareWatchout

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

1.9× MedicareGood

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

56% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 80/100Good

Procedure Prices at St Joseph's Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 93 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
MRI, brain (with and without contrast) CPT Code: `70553`	$4,523	$2,144	$511	4.2×
MRI, brain (no contrast) CPT Code: `70551`	$3,221	$2,144	$343	unverified
MRI, knee or other leg joint CPT Code: `73721`	$2,946	$2,144	$369	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$4,028	$1,670	$1,021	1.6×
CT scan, head (no contrast) CPT Code: `70450`	$1,835	$1,253	$160	7.8×
CT scan, pelvis CPT Code: `72192`	$2,088	$1,253	$163	7.7×
CT scan, sinuses CPT Code: `70486`	$1,817	$1,253	$166	7.5×
CT scan, chest (no contrast) CPT Code: `71250`	$2,139	$1,253	$167	7.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,537	$1,253	$168	7.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,484	$1,253	$169	7.4×
CT scan, head (with contrast) CPT Code: `70460`	$1,889	$1,253	$242	5.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,588	$1,253	$258	4.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$4,477	$1,253	$303	4.1×
MRI, lower back (no contrast) CPT Code: `72148`	$3,208	$1,219	$338	3.6×
Rabies immune globulin HCPCS Code: `90375`	$1,176	$1,176	$322	3.7×
Injection procedure for pain management HCPCS Code: `G0260`	$1,619	$1,142	$855	1.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,834	$953	$583	1.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$5,075	$916	$448	2.0×
Blood transfusion CPT Code: `36430`	$750	$815	$498	1.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,392	$549	$134	4.1×
Neurobehavioral status check CPT Code: `96116`	$397	$552	$231	2.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,210	$486	$126	3.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$327	$454	$64	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,998	$402	$272	1.5×
X-ray, neck (cervical spine) CPT Code: `72040`	$488	$398	$93	unverified
X-ray, lower back CPT Code: `72110`	$827	$413	$112	unverified
Ultrasound, pelvis CPT Code: `76856`	$1,236	$348	$130	2.7×
Family therapy session CPT Code: `90847`	$248	$345	$173	2.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$228	$316	$181	1.7×
X-ray, pelvis CPT Code: `72170`	$404	$340	$110	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$300	$286	$201	1.4×
Ultrasound, thyroid and neck CPT Code: `76536`	$985	$238	$132	1.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$529	$213	$148	1.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$154	$214	$166	1.3×
Speech therapy (language evaluation) CPT Code: `92507`	$186	$186	$86	2.2×
Orthotic fitting and training CPT Code: `97760`	$112	$155	$51	3.0×
X-ray, shoulder CPT Code: `73030`	$447	$174	$92	1.9×
X-ray, foot CPT Code: `73630`	$446	$174	$92	1.9×
X-ray, hand CPT Code: `73130`	$436	$174	$93	1.9×
X-ray, hip CPT Code: `73502`	$221	$174	$93	1.9×
X-ray, ankle CPT Code: `73610`	$426	$174	$93	1.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$237	$146	$87	1.7×
Group therapy session CPT Code: `90853`	$116	$161	$100	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$310	$146	$110	1.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$162	$162	$38	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$181	$181	$34	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$91	$127	$35	3.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$336	$146	$123	1.2×
Physical therapy (gait training) CPT Code: `97116`	$110	$110	$33	3.3×
Occupational therapy (self-care training) CPT Code: `97535`	$85	$118	$38	3.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$85	$118	$40	3.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	$99	$99	$35	2.8×
Prosthetic fitting and training CPT Code: `97761`	$76	$105	$45	2.3×
X-ray, chest (single view) CPT Code: `71045`	$342	$116	$92	1.3×
X-ray, chest (two views) CPT Code: `71046`	$396	$116	$93	1.2×
Screening mammogram (both breasts) CPT Code: `77067`	$280	$84	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$1,502	$528	$347	1.5×
Drug screening test HCPCS Code: `G0480`	$174	$174	$116	1.5×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$141	$141	$20	7.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$34	$47	$14	3.4×
Blood test, vitamin D CPT Code: `82306`	$84	$59	$31	1.9×
Flu vaccine injection HCPCS Code: `G0008`	$87	$71	$48	1.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$87	$71	$49	1.4×
Colorectal cancer screening HCPCS Code: `G0010`	$87	$71	$49	1.4×
Hospital observation (per hour) HCPCS Code: `G0378`	$56	$78	$86	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$145	$37	$19	1.9×
Blood test, glucose (blood sugar) CPT Code: `82947`	$79	$9	$4	2.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$104	$6	$3	2.0×
Blood test, calcium CPT Code: `82310`	$89	$10	$5	2.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$79	$10	$5	2.0×
Blood test, lipase CPT Code: `83690`	$135	$14	$7	2.0×
Blood test, potassium CPT Code: `84132`	$79	$10	$5	2.0×
Blood test, sodium CPT Code: `84295`	$79	$10	$5	2.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$86	$8	$4	2.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$165	$12	$6	2.0×
Culture, bacterial CPT Code: `87070`	$150	$18	$9	2.0×
Hepatitis C antibody test CPT Code: `86803`	$439	$29	$15	1.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$156	$27	$14	1.9×
Culture, blood CPT Code: `87040`	$241	$21	$11	1.9×
Blood test, vitamin B12 CPT Code: `82607`	$163	$30	$16	1.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$72	$43	$25	1.7×
Blood test, amylase CPT Code: `82150`	$106	$13	$7	1.9×
Blood test, magnesium CPT Code: `83735`	$102	$13	$7	1.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$109	$9	$5	1.8×
Blood test, basic metabolic panel CPT Code: `80048`	$234	$16	$9	1.8×
Blood test, liver function panel CPT Code: `80076`	$288	$16	$9	1.8×
Blood test, hemoglobin CPT Code: `85018`	$374	$5	$3	1.7×
Blood test, complete blood count (CBC) CPT Code: `85025`	$122	$13	$8	1.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$11	$15	$10	1.5×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$122	$20	$14	1.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$72	$22	$18	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$152	$11	$11	1.0×
Blood antibody screen CPT Code: `86850`	$142	$20	$46	0.4×

Showing top 25 high-impact procedures of 93 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 73.9%

Audit a Bill or Quote at St Joseph's Hospital (Zero PHI Required)

CMS CCN: 141336

CPT 70553

Select Procedure to Audit:

Fair BaseRate™ $511

Medicare Rate $356

Self-Pay Cash $4,523

Insurer Median $2,144

1. Amount on Your Bill or Quote ($) Pre-filled with St Joseph's 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 501(r) AGB Cap: $4,642 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $4,642

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (73.9% of gross = $4,642).

Step 2 · Cash vs. Insurance Arbitrage Save $1,759 Paying Cash

Self-Pay Cash Rate ($4,523) Beats Your Bill

St Joseph's Hospital's published 45 CFR § 180 self-pay cash rate is $4,523 (vs. $2,144 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$5,771 Above Fair BaseRate

Negotiate Toward $511 Fair BaseRate ($356 Medicare)

Your bill ($6,282) is $5,771 above the denoised Fair BaseRate ($511) and 17.6× the $356 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)

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 (73.9% 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

CMS Overall5/5 Stars (5/5)

Safety Composite80/100

Would Recommend75%

Rated 9 or 10 (HCAHPS)82%

Left ER Before Seen0%

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 St Joseph's Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2022-01-19·administrative_or_closure
Closure Notice
Recorded
2021-12-01·cap_corrective_action
CAP Request
Recorded
2021-06-23·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (132 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

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for St Joseph's Hospital.

Price Index: 1.39× regional baseline

Quality: 82/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Cigna

-44.7%

Caterpillar, Inc.

-42.0%

Median Household Income$74,800U.S. Census ACS

Local Uninsured Share4.8%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 77/100 · Corroborated CMS CCN 141336

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 141336) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage3/24/2026

Validated Rate Rows4,211 (CMS v3.0.0)

File Integrity DigestVerified · CCN 141336

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