Madelia Health
121 Drew Avenue Southeast, Madelia, MN 56062 · 80 Priced Procedures · 89% Patient Recommendation
Typical commercial prices here are +108% above the fair benchmark (2.08×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Madelia Health prices routine shoppable procedures at 3.2× Medicare (median 1.93× Fair BaseRate) while upper-quartile commercial rates jump +42% to 2.74× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.24× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 19% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (74/100 safety score) with 89% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (56.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 4.0× markup over Medicare rates
- Commercial insurance median sits at 1.93× Fair BaseRate (3.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.74×) jump +42% above the median procedure ratio (Q50 1.93×)
- Unnegotiated chargemaster list prices average 13.3× Medicare (21¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Madelia Health
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 80 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,964 | 3.9× |
| Total hip replacement CPT Code: 27130 | $2,163 | 0.2× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,619 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,059 | 3.9× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $890 | 6.6× |
| MRI, lower back (no contrast) CPT Code: 72148 | $820 | 2.4× |
| MRI, brain (no contrast) CPT Code: 70551 | $820 | 2.4× |
| MRI, knee or other leg joint CPT Code: 73721 | $820 | 2.2× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $820 | 1.6× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $744 | 5.9× |
| Blood transfusion CPT Code: 36430 | $758 | 1.5× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $730 | 5.5× |
| Ultrasound, pelvis CPT Code: 76856 | $675 | 5.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $627 | 1.4× |
| Screening mammogram (both breasts) CPT Code: 77067 | $565 | unverified |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $539 | 3.6× |
| CT scan, head (with contrast) CPT Code: 70460 | $529 | 2.2× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $529 | 2.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $529 | 1.7× |
| X-ray, lower back CPT Code: 72110 | $491 | 4.4× |
| X-ray, shoulder CPT Code: 73030 | $464 | 5.0× |
| CT scan, head (no contrast) CPT Code: 70450 | $461 | 2.9× |
| CT scan, pelvis CPT Code: 72192 | $461 | 2.8× |
| CT scan, sinuses CPT Code: 70486 | $461 | 2.8× |
| CT scan, chest (no contrast) CPT Code: 71250 | $461 | 2.8× |
Audit a Bill or Quote at Madelia Health (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $2,999
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (56.3% of gross = $2,999).
Self-Pay Cash Rate ($3,964) Beats Your Bill
Madelia Health's published 45 CFR § 180 self-pay cash rate is $3,964 (vs. $3,964 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,021 Fair BaseRate ($877 Medicare)
Your bill ($5,331) is $4,310 above the denoised Fair BaseRate ($1,021) and 6.1× the $877 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (56.3% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Madelia Health. Prior administrative notices do not necessarily reflect current compliance status.
- 2024-03-18·administrative_or_closure
Met Requirements
Recorded - 2023-06-15·administrative_or_closure
Closure Notice
Recorded - 2023-03-03·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (48 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Madelia Health.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.