Hannibal Regional Hospital
6000 Hospital Dr, Hannibal, MO 63401 · 117 Priced Procedures · 68% Patient Recommendation
Typical commercial prices here are +9% above the fair benchmark (1.09×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.09× fair market pricing.
Cash-Arbitrage Bifurcated Pricer
Hannibal Regional Hospital maintains elevated commercial insurance contracts (1.09× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 86% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.97× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 86% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 68% patient recommendation (58/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (78.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
- Commercial insurance median sits at 1.08× Fair BaseRate (1.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (1.09× 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.
- Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
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 Hannibal Regional Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $26,010 | 0.8× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $16,537 | 0.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $15,892 | 0.8× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $15,248 | 0.9× |
| Total hip replacement CPT Code: 27130 | $14,677 | 1.1× |
| Total knee replacement CPT Code: 27447 | $14,677 | 1.1× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $9,500 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $6,577 | 0.8× |
| Breast lump removal CPT Code: 19120 | $4,251 | 1.1× |
| Inguinal hernia repair CPT Code: 49505 | $3,858 | 1.1× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,610 | 1.1× |
| Bunion correction surgery CPT Code: 28296 | $3,610 | 1.0× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,599 | 1.0× |
| Trauma team activation HCPCS Code: G0390 | $1,368 | 0.9× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,316 | 1.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,166 | 1.1× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,019 | 1.0× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,011 | 1.0× |
| Injection procedure for pain management HCPCS Code: G0260 | $771 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $615 | 1.1× |
| Blood transfusion CPT Code: 36430 | $484 | 1.0× |
| Psychological testing by technician CPT Code: 96138 | $413 | 1.0× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $429 | 1.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $429 | 0.8× |
| Neurobehavioral status check CPT Code: 96116 | $350 | unverified |
Audit a Bill or Quote at Hannibal Regional Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $48,691
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (78.0% of gross = $48,691).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Hannibal Regional Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($62,424) is $31,649 above the denoised Fair BaseRate ($30,775) and 2.7× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (78.0% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Hannibal Regional Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2023-08-30·administrative_or_closure
Closure Notice
Recorded - 2023-06-27·cap_corrective_action
CAP Request
Recorded
Source: CMS Hospital Care Compare (865 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 Hannibal Regional Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
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.