How many shoppable procedure prices are published for Holton Community Hospital?

Holton Community Hospital in Holton, KS currently has 106 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Holton Community Hospital's median negotiated commercial rate is 2.2× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 14 Beds · urban Updated: 2026-04-23

Holton Community Hospital

1110 Columbine Drive, Holton, KS 66436 · 106 Priced Procedures · 93% Patient Recommendation

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

2.18×vs. Fair Market Price

Typical commercial prices here are +118% above the fair benchmark (2.18×) even after accounting for local nurse/doctor wages and patient complexity.

65/100 · Caution

65/100Self-Pay Cash Beats Insurance 47% of the Time

File Completeness51

Price Logic36

Peer Alignment70

Clean Billing87

Real Cash Discount100

High-Markup · Check Safety

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

Behavioral Pricing FingerprintUpper-Quartile Spread · +84% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Holton Community Hospital prices routine shoppable procedures at 3.5× Medicare (median 1.79× Fair BaseRate) while upper-quartile commercial rates jump +84% to 3.29× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#91 of 103 in KS · 87th State Percentile#3,159 of 3,385 in U.S. · 93rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.14× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 47% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (74/100 safety score) with 93% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (60.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Commercial insurance median sits at 1.79× Fair BaseRate (3.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 3.29×) jump +84% above the median procedure ratio (Q50 1.79×)
Consolidated metro market (HHI 6,016) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

3.5× Medicare

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

Back-Door Captive & ER0.29× Divergence

1.0× Medicare

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

Quantile Tail Spread+84% Upper Tail

Q25 1.14× · Q50 1.79× · Q75 3.29×

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

3.5× MedicareElevated

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.9× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

5.1× MedicareWatchout

Inpatient Lab & PathologyBack-Door Captive

5.9× MedicareWatchout

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

1.5× MedicareGood

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

47% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 74/100Fair

Procedure Prices at Holton Community Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 106 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`	$11,648	$11,648	$13,413	0.9×
Total knee replacement CPT Code: `27447`	$11,648	$11,648	$13,523	0.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$16,610	$11,434	$19,432	0.6×
Bunion correction surgery CPT Code: `28296`	$3,740	$4,189	$3,446	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$2,725	$3,633	$511	unverified
C-section delivery (full package) CPT Code: `59510`	$2,703	$3,604	$2,975	1.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,724	$2,298	$583	3.9×
MRI, lower back (no contrast) CPT Code: `72148`	$1,552	$2,069	$338	6.1×
MRI, brain (no contrast) CPT Code: `70551`	$1,552	$2,069	$343	6.0×
Vaginal delivery (full package) CPT Code: `59400`	$2,453	$1,980	$2,680	0.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,976	$1,976	$303	unverified
CT scan, pelvis CPT Code: `72192`	$1,641	$1,641	$163	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,129	$1,505	$168	9.0×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,129	$1,505	$258	5.8×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,129	$1,505	$448	3.4×
CT scan, chest (no contrast) CPT Code: `71250`	$1,104	$1,473	$167	8.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,425	$1,425	$6,109	0.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$982	$1,309	$169	7.7×
Trauma team activation HCPCS Code: `G0390`	$993	$1,324	$1,453	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$1,232	$1,232	$160	7.7×
Blood transfusion CPT Code: `36430`	$919	$1,225	$498	2.5×
CT scan, sinuses CPT Code: `70486`	$884	$1,178	$166	7.1×
CT scan, head (with contrast) CPT Code: `70460`	$884	$1,178	$242	4.9×
MRI, knee or other leg joint CPT Code: `73721`	$1,219	$1,182	$369	3.2×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$1,030	$1,030	$19,087	0.1×
Breast lump removal CPT Code: `19120`	$888	$888	$3,875	0.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$677	$721	$272	2.7×
Ultrasound, abdomen (complete) CPT Code: `76700`	$717	$717	$134	unverified
Ultrasound, pelvis CPT Code: `76856`	$609	$609	$130	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$581	$581	$132	4.4×
X-ray, lower back CPT Code: `72110`	$572	$572	$112	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$572	$572	$126	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	$2,742	$494	$3,372	0.1×
Inguinal hernia repair CPT Code: `49505`	$2,705	$461	$3,629	0.1×
X-ray, ankle CPT Code: `73610`	$364	$430	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$401	$401	$93	unverified
X-ray, foot CPT Code: `73630`	$346	$382	$92	unverified
X-ray, hand CPT Code: `73130`	$246	$328	$93	3.5×
X-ray, hip CPT Code: `73502`	$353	$353	$93	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$263	$351	$201	unverified
X-ray, shoulder CPT Code: `73030`	$341	$303	$92	3.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$243	$324	$148	2.2×
Upper endoscopy with biopsy CPT Code: `43239`	$887	$285	$987	0.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$186	$248	$64	3.9×
X-ray, chest (two views) CPT Code: `71046`	$186	$248	$93	2.7×
Family therapy session CPT Code: `90847`	$311	$270	$173	1.6×
X-ray, pelvis CPT Code: `72170`	$181	$242	$110	2.2×
X-ray, chest (single view) CPT Code: `71045`	$155	$207	$92	2.3×
Screening mammogram (both breasts) CPT Code: `77067`	$167	$223	$123	1.8×
Psychotherapy session (60 minutes) CPT Code: `90837`	$238	$220	$181	1.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$191	$211	$185	1.1×
Colonoscopy with biopsy CPT Code: `45380`	$1,094	$225	$1,256	0.2×
Speech therapy (language evaluation) CPT Code: `92507`	$152	$152	$86	1.8×
Group therapy session CPT Code: `90853`	$221	$162	$100	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$164	$143	$110	1.3×
Psychotherapy session (45 minutes) CPT Code: `90834`	$197	$150	$166	0.9×
Colonoscopy (diagnostic) CPT Code: `45378`	$603	$155	$981	0.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$152	$116	$123	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$62	$83	$38	2.2×
Physical therapy (functional capacity test) CPT Code: `97750`	$62	$83	$38	2.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$60	$80	$86	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$262	$350	$203	1.7×
Blood test, vitamin D CPT Code: `82306`	$287	$287	$31	unverified
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$135	$180	$111	1.6×
Drug screening test HCPCS Code: `G0480`	$108	$109	$116	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$66	$66	$9	7.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$72	$72	$11	6.5×
Blood test, ferritin (iron stores) CPT Code: `82728`	$72	$72	$14	5.1×
Blood test, vitamin B12 CPT Code: `82607`	$80	$80	$16	5.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$92	$92	$19	4.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$92	$92	$20	4.6×
Culture, bacterial CPT Code: `87070`	$56	$56	$9	6.2×
Blood test, liver function panel CPT Code: `80076`	$43	$43	$9	4.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$63	$63	$14	4.5×
Electrical stimulation therapy HCPCS Code: `G0283`	$47	$63	$14	4.5×
Hepatitis C antibody test CPT Code: `86803`	$58	$58	$15	3.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$59	$79	$35	2.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$61	$81	$56	1.4×
Blood test, amylase CPT Code: `82150`	$56	$56	$7	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$30	$30	$5	6.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$47	$47	$8	5.9×
Culture, blood CPT Code: `87040`	$49	$49	$11	4.5×
Physical therapy (gait training) CPT Code: `97116`	$55	$73	$33	2.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$59	$79	$40	2.0×
Physical therapy (manual therapy) CPT Code: `97140`	$55	$65	$34	1.9×
Occupational therapy (self-care training) CPT Code: `97535`	$42	$56	$38	1.5×
Blood test, glucose (blood sugar) CPT Code: `82947`	$23	$23	$4	5.8×
Blood test, lipase CPT Code: `83690`	$38	$38	$7	5.4×
Extended office visit (prolonged) HCPCS Code: `G2212`	$30	$40	$33	1.2×
Orthotic fitting and training CPT Code: `97760`	$52	$44	$51	0.9×
Blood test, hemoglobin CPT Code: `85018`	$14	$14	$3	4.7×
Blood test, potassium CPT Code: `84132`	$23	$23	$5	4.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$44	$44	$10	4.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$60	$60	$18	3.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$30	$30	$6	5.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$33	$44	$25	1.8×
Flu vaccine (high dose) HCPCS Code: `90656`	$26	$35	$25	1.4×
Blood antibody screen CPT Code: `86850`	$39	$52	$46	1.1×
Office visit, established patient (20-29 min) CPT Code: `99213`	$83	$47	$87	0.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$26	$26	$3	unverified
Blood test, calcium CPT Code: `82310`	$34	$34	$5	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$34	$34	$5	unverified
Blood test, magnesium CPT Code: `83735`	$48	$48	$7	unverified
Flu vaccine injection HCPCS Code: `G0008`	$9	$9	$48	0.2×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$34	$34	$4	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$8	$8	$49	0.2×

Showing top 25 high-impact procedures of 106 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 60.0%

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

CMS CCN: 171319

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash $11,648

Insurer Median $11,648

1. Amount on Your Bill or Quote ($) Pre-filled with Holton 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: $9,315 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $9,315

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (60.0% of gross = $9,315).

Step 2 · Cash vs. Insurance Arbitrage Save $3,882 Paying Cash

Self-Pay Cash Rate ($11,648) Beats Your Bill

Holton Community Hospital's published 45 CFR § 180 self-pay cash rate is $11,648 (vs. $11,648 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$2,117 Above Fair BaseRate

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

Your bill ($15,530) is $2,117 above the denoised Fair BaseRate ($13,413) and 1.2× the $13,117 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)

EIN: 742826278

Filing Period: 199707

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 (60.0% 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 Composite74/100

Would Recommend93%

Rated 9 or 10 (HCAHPS)91%

Median ER Wait142 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

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

2026-04-21·warning_notice
Warning Notice
Recorded
2024-08-09·administrative_or_closure
Closure Notice
Recorded
2024-06-21·cap_corrective_action
CAP Request
Recorded
2024-03-11·warning_notice
Warning Notice
Recorded
2023-12-07·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (62 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 Holton Community Hospital.

Price Index: 0.78× regional baseline

Quality: 62/100 CMS composite

Median Household Income$72,703U.S. Census ACS

Local Uninsured Share8.1%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 65/100 · Caution CMS CCN 171319 EIN 742826278

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 171319) ↗ Verify IRS Form 990 (EIN 742826278) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-23

Validated Rate Rows1,605 (CMS v3.0.0)

File Integrity DigestVerified · CCN 171319

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