How many shoppable procedure prices are published for Valley West Community Hospital?

Valley West Community Hospital in Sandwich, IL currently has 101 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Valley West Community Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Valley West Community Hospital's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

What is Valley West Community Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Valley West Community Hospital an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 19 Beds · rural Updated: 2026-04-01

Valley West Community Hospital

11 East Pleasant Avenue, Sandwich, IL 60548 · 101 Priced Procedures · 79% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Good Deal · Below Fair Market

0.80×vs. Fair Market Price

Typical commercial prices here are 20% below the fair benchmark (0.80×) after accounting for local nurse/doctor wages and patient complexity.

83/100 · Corroborated

83/100Self-Pay Cash Beats Insurance 42% of the Time

File Completeness66

Price Logic91

Peer Alignment69

Clean Billing91

Real Cash Discount100

Regional Value Leader

5-Star CMS clinical quality rating paired with 0.80× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Valley West Community Hospital prices routine shoppable procedures near 0.5× Medicare (p50 0.29×) while skewing captive emergency, lab, and upper-quartile codes to 2.9× Medicare (p75 0.31×, +7% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#20 of 126 in IL · 15th State Percentile#275 of 3,385 in U.S. · 8th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 20% below peer Fair BaseRate (0.80×)
Self-pay cash beats commercial insurance on 42% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 79% patient recommendation (81/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (60.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
Captive ER (0.7×) & laboratory (2.7×) services average 5.80× higher multiples than routine shoppable care (0.5×)
Even at low-cost facilities (0.80× 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.
Unnegotiated chargemaster list prices average 14.7× Medicare (22¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.5× Medicare

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

Back-Door Captive & ER5.80× Divergence

2.9× Medicare

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

Quantile Tail Spread+7% Upper Tail

Q25 0.22× · Q50 0.29× · Q75 0.31×

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

0.5× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.0× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

0.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.7× MedicareFair

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

0.9× MedicareGood

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

42% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 81/100Good

Procedure Prices at Valley West Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 101 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$22,048	$22,048	$19,087	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$16,161	$16,684	$8,223	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	$15,823	$15,823	$6,109	2.6×
Rabies immune globulin HCPCS Code: `90375`	$9,389	$9,389	$322	29.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$6,049	$6,049	$448	13.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$5,385	$5,385	$511	10.5×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$4,802	$4,802	$303	15.8×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,582	$4,582	$1,021	4.5×
MRI, brain (no contrast) CPT Code: `70551`	$3,887	$3,887	$343	11.3×
MRI, lower back (no contrast) CPT Code: `72148`	$3,837	$3,837	$338	11.4×
MRI, knee or other leg joint CPT Code: `73721`	$3,835	$3,835	$369	10.4×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,757	$3,757	$258	14.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$3,168	$3,168	$169	18.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$3,084	$3,084	$168	18.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,951	$2,951	$583	5.1×
CT scan, head (with contrast) CPT Code: `70460`	$2,922	$2,922	$242	12.1×
CT scan, sinuses CPT Code: `70486`	$2,606	$2,606	$166	15.7×
CT scan, chest (no contrast) CPT Code: `71250`	$2,611	$2,611	$167	15.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$2,626	$2,626	$272	9.7×
CT scan, head (no contrast) CPT Code: `70450`	$2,475	$2,475	$160	15.5×
CT scan, pelvis CPT Code: `72192`	$2,157	$2,157	$163	13.2×
Blood transfusion CPT Code: `36430`	$1,944	$1,944	$498	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,772	$1,772	$134	13.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,604	$1,604	$126	12.7×
Ultrasound, pelvis CPT Code: `76856`	$1,510	$1,510	$130	11.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,343	$1,343	$132	10.2×
X-ray, lower back CPT Code: `72110`	$909	$909	$112	8.1×
Psychological testing by technician CPT Code: `96138`	$921	$921	$395	2.3×
Neurobehavioral status check CPT Code: `96116`	$805	$805	$231	3.5×
X-ray, chest (two views) CPT Code: `71046`	$674	$674	$93	7.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$666	$666	$93	7.2×
X-ray, shoulder CPT Code: `73030`	$623	$623	$92	6.8×
X-ray, foot CPT Code: `73630`	$594	$594	$92	6.5×
X-ray, pelvis CPT Code: `72170`	$576	$576	$110	5.2×
X-ray, hand CPT Code: `73130`	$547	$547	$93	5.9×
X-ray, chest (single view) CPT Code: `71045`	$538	$538	$92	5.8×
X-ray, ankle CPT Code: `73610`	$542	$542	$93	5.8×
X-ray, hip CPT Code: `73502`	$523	$523	$93	5.6×
Screening mammogram (both breasts) CPT Code: `77067`	$524	$524	$123	4.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$514	$514	$148	3.5×
Speech therapy (language evaluation) CPT Code: `92507`	$356	$356	$86	4.1×
New patient office visit (30-44 min) CPT Code: `99203`	$380	$380	$110	3.5×
Office visit, established patient (30-39 min) CPT Code: `99214`	$281	$281	$123	2.3×
Upper endoscopy with biopsy CPT Code: `43239`	$6,777	$306	$987	0.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,409	$271	$981	0.3×
Colonoscopy with biopsy CPT Code: `45380`	$8,178	$271	$1,256	0.2×
Physical therapy (manual therapy) CPT Code: `97140`	$214	$214	$34	6.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$216	$216	$64	3.4×
Office visit, established patient (20-29 min) CPT Code: `99213`	$221	$221	$87	2.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$224	$224	$185	1.2×
Speech therapy (group session) CPT Code: `92508`	$167	$167	$27	6.2×
Physical therapy (gait training) CPT Code: `97116`	$170	$170	$33	5.2×
Occupational therapy (self-care training) CPT Code: `97535`	$188	$188	$38	4.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$186	$186	$38	4.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$165	$165	$35	4.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$169	$169	$38	4.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$169	$169	$40	4.2×
Prosthetic fitting and training CPT Code: `97761`	$179	$179	$45	4.0×
Orthotic fitting and training CPT Code: `97760`	$181	$181	$51	3.5×
Breathing treatment (nebulizer) CPT Code: `94640`	$158	$158	$201	0.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$96	$96	$35	2.7×
Group therapy session CPT Code: `90853`	$84	$84	$100	0.8×
Pneumococcal vaccine HCPCS Code: `90732`	$701	$701	$140	5.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$459	$459	$111	4.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$307	$307	$11	27.9×
Hepatitis B vaccine HCPCS Code: `90744`	$301	$301	$37	8.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$324	$324	$56	5.8×
Blood test, basic metabolic panel CPT Code: `80048`	$220	$220	$9	24.4×
Culture, blood CPT Code: `87040`	$181	$181	$11	16.5×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$192	$192	$20	9.6×
Drug screening test HCPCS Code: `G0480`	$212	$212	$116	1.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$184	$184	$14	13.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$172	$172	$19	9.1×
Blood test, vitamin D CPT Code: `82306`	$191	$191	$31	6.2×
Blood test, liver function panel CPT Code: `80076`	$139	$139	$9	15.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$162	$162	$18	9.0×
Culture, bacterial CPT Code: `87070`	$132	$132	$9	14.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$144	$144	$14	10.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$117	$117	$10	11.7×
Blood test, vitamin B12 CPT Code: `82607`	$135	$135	$16	8.4×
Blood antibody screen CPT Code: `86850`	$146	$146	$46	3.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$103	$103	$8	12.9×
Hepatitis C antibody test CPT Code: `86803`	$117	$117	$15	7.8×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$62	$62	$3	20.7×
Blood test, calcium CPT Code: `82310`	$65	$65	$5	13.0×
Blood test, magnesium CPT Code: `83735`	$81	$81	$7	11.6×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$52	$52	$4	13.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$75	$75	$6	12.5×
Blood test, amylase CPT Code: `82150`	$86	$86	$7	12.3×
Blood test, lipase CPT Code: `83690`	$85	$85	$7	12.1×
Blood test, glucose (blood sugar) CPT Code: `82947`	$43	$43	$4	10.8×
Blood test, creatinine (kidney) CPT Code: `82565`	$53	$53	$5	10.6×
Blood test, sodium CPT Code: `84295`	$53	$53	$5	10.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$52	$52	$5	10.4×
Blood test, hemoglobin CPT Code: `85018`	$31	$31	$3	10.3×
Blood test, potassium CPT Code: `84132`	$48	$48	$5	9.6×
Behavioral health outpatient services HCPCS Code: `H2015`	$50	$50	$16	3.1×
Flu vaccine injection HCPCS Code: `G0008`	$72	$72	$48	1.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$62	$62	$49	1.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$62	$62	$86	0.7×
Flu vaccine (high dose) HCPCS Code: `90656`	$27	$27	$25	1.1×

Showing top 25 high-impact procedures of 101 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 60.4%

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

CMS CCN: 141340

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $22,048

Insurer Median $22,048

1. Amount on Your Bill or Quote ($) Pre-filled with Valley West Community 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: $19,021 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $19,021

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (60.4% of gross = $19,021).

Step 2 · Cash vs. Insurance Arbitrage Save $9,449 Paying Cash

Self-Pay Cash Rate ($22,048) Beats Your Bill

Valley West Community Hospital's published 45 CFR § 180 self-pay cash rate is $22,048 (vs. $22,048 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$12,410 Above Fair BaseRate

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

Your bill ($31,497) is $12,410 above the denoised Fair BaseRate ($19,087) and 2.2× the $14,117 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 (60.4% 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 Composite81/100

Would Recommend79%

Rated 9 or 10 (HCAHPS)80%

Median ER Wait128 min

Left ER Before Seen1%

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

Source: CMS Hospital Care Compare (107 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 Valley West Community Hospital.

Price Index: 2.34× regional baseline

Quality: 82/100 CMS composite

Median Household Income$69,022U.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 83/100 · Corroborated CMS CCN 141340

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 141340) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows3,898 (CMS v3.0.0)

File Integrity DigestVerified · CCN 141340

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