How many shoppable procedure prices are published for Hermann Area District Hospital?

Hermann Area District Hospital in Hermann, MO currently has 104 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Hermann Area District Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Hermann Area District Hospital's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Hospital District or Authority 24 Beds · rural Updated: 2026-10-01

Hermann Area District Hospital

509 W 18Th St, Hermann, MO 65041 · 104 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.08×vs. Fair Market Price

Typical commercial prices here are +8% above the fair benchmark (1.08×) even after accounting for local nurse/doctor wages and patient complexity.

85/100 · Verified

85/100Self-Pay Cash Beats Insurance 46% of the Time

File Completeness90

Price Logic80

Peer Alignment68

Clean Billing90

Real Cash Discount100

Premium Quality Tier

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

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Hermann Area District Hospital maintains elevated commercial insurance contracts (1.08× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 46% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#41 of 79 in MO · 50th State Percentile#1,617 of 3,385 in U.S. · 47th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.58× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 46% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (69/100 safety score) with 72% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
Captive ER (1.7×) & laboratory (1.6×) services average 1.36× higher multiples than routine shoppable care (1.1×)
Upper-quartile procedures (Q75 1.43×) jump +39% above the median procedure ratio (Q50 1.03×)
Unnegotiated chargemaster list prices average 7.2× Medicare (24¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.1× Medicare

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

Back-Door Captive & ER1.36× Divergence

1.5× Medicare

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

Quantile Tail Spread+39% Upper Tail

Q25 0.58× · Q50 1.03× · Q75 1.43×

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

1.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.4× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.7× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.6× MedicareGood

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

0.5× MedicareGood

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

46% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 69/100Fair

Procedure Prices at Hermann Area District Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 104 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$45,940	$45,940	$19,432	2.4×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$5,153	$5,153	$8,223	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$2,487	$2,724	$6,109	0.4×
Breast lump removal CPT Code: `19120`	$966	$966	$3,875	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,586	$585	$303	1.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,547	$585	$448	1.3×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,080	$580	$511	1.1×
MRI, lower back (no contrast) CPT Code: `72148`	$1,240	$507	$338	1.5×
MRI, brain (no contrast) CPT Code: `70551`	$1,274	$507	$343	1.5×
MRI, knee or other leg joint CPT Code: `73721`	$1,306	$507	$369	1.4×
Colonoscopy (diagnostic) CPT Code: `45378`	$818	$451	$981	0.5×
Colonoscopy with biopsy CPT Code: `45380`	$857	$451	$1,256	0.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,212	$406	$1,021	0.4×
Inguinal hernia repair CPT Code: `49505`	$1,408	$385	$3,629	0.1×
Blood transfusion CPT Code: `36430`	$342	$342	$498	0.7×
Upper endoscopy with biopsy CPT Code: `43239`	$693	$310	$987	0.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,242	$264	$258	1.0×
Rabies immune globulin HCPCS Code: `90375`	$478	$280	$322	0.9×
Screening mammogram (both breasts) CPT Code: `77067`	$348	$235	$123	1.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$428	$235	$148	1.6×
CT scan, head (with contrast) CPT Code: `70460`	$1,059	$238	$242	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$178	$192	$185	1.0×
X-ray, chest (single view) CPT Code: `71045`	$143	$143	$92	1.6×
CT scan, head (no contrast) CPT Code: `70450`	$755	$150	$160	0.9×
CT scan, pelvis CPT Code: `72192`	$949	$150	$163	0.9×
CT scan, sinuses CPT Code: `70486`	$900	$150	$166	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	$982	$150	$167	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$204	$162	$181	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,363	$177	$583	0.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,161	$150	$168	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,114	$150	$169	0.9×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$698	$149	$272	0.5×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$92	$153	$64	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$125	$102	$110	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$126	$108	$123	0.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$115	$110	$166	0.7×
Family therapy session CPT Code: `90847`	$153	$109	$173	0.6×
Physical therapy (manual therapy) CPT Code: `97140`	$62	$104	$34	unverified
Typhoid vaccine HCPCS Code: `90675`	$237	$328	$347	0.9×
Drug screening test HCPCS Code: `G0480`	$288	$137	$116	1.2×
Pneumococcal vaccine HCPCS Code: `90732`	$107	$153	$140	1.1×
Hepatitis C antibody test CPT Code: `86803`	$81	$81	$15	5.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$448	$76	$126	0.6×
Ultrasound, pelvis CPT Code: `76856`	$836	$76	$130	0.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$566	$76	$132	0.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$599	$76	$134	0.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$48	$48	$14	3.4×
Physical therapy (gait training) CPT Code: `97116`	$71	$52	$33	1.6×
Occupational therapy (self-care training) CPT Code: `97535`	$80	$52	$38	1.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$63	$52	$40	1.3×
Speech therapy (language evaluation) CPT Code: `92507`	$191	$64	$86	0.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$119	$33	$18	1.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$74	$52	$35	1.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$82	$52	$38	1.4×
Orthotic fitting and training CPT Code: `97760`	$93	$52	$51	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$84	$77	$87	0.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$115	$20	$11	1.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$97	$22	$14	1.6×
Blood test, vitamin D CPT Code: `82306`	$77	$44	$31	1.4×
X-ray, lower back CPT Code: `72110`	$347	$45	$112	0.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$43	$43	$111	0.4×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$68	$68	$203	0.3×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$76	$76	$25	unverified
Colorectal cancer screening HCPCS Code: `G0010`	$28	$46	$49	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$43	$43	$201	0.2×
Blood test, calcium CPT Code: `82310`	$25	$8	$5	1.6×
Blood test, creatinine (kidney) CPT Code: `82565`	$35	$8	$5	1.6×
Blood test, glucose (blood sugar) CPT Code: `82947`	$26	$6	$4	1.5×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$27	$6	$4	1.5×
Blood test, complete blood count (CBC) CPT Code: `85025`	$66	$12	$8	1.5×
Blood test, clotting time (PTT) CPT Code: `85730`	$43	$9	$6	1.5×
Blood test, basic metabolic panel CPT Code: `80048`	$79	$13	$9	1.4×
Culture, bacterial CPT Code: `87070`	$56	$13	$9	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$61	$20	$14	1.4×
Blood test, lipase CPT Code: `83690`	$48	$10	$7	1.4×
Blood test, magnesium CPT Code: `83735`	$39	$10	$7	1.4×
Blood test, PSA (prostate screen) CPT Code: `84153`	$61	$27	$19	1.4×
Blood test, potassium CPT Code: `84132`	$27	$7	$5	1.4×
Blood test, sodium CPT Code: `84295`	$27	$7	$5	1.4×
Culture, blood CPT Code: `87040`	$59	$15	$11	1.4×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$61	$27	$20	1.4×
Blood test, liver function panel CPT Code: `80076`	$69	$12	$9	1.3×
Hepatitis B vaccine HCPCS Code: `90744`	$26	$26	$37	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$19	$31	$49	0.6×
Flu vaccine injection HCPCS Code: `G0008`	$24	$24	$48	0.5×
X-ray, hip CPT Code: `73502`	$249	$33	$93	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$86	$5	$3	1.7×
Blood test, amylase CPT Code: `82150`	$44	$10	$7	1.4×
Blood test, vitamin B12 CPT Code: `82607`	$69	$22	$16	1.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$64	$10	$10	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$237	$30	$93	0.3×
X-ray, foot CPT Code: `73630`	$209	$26	$92	0.3×
X-ray, hand CPT Code: `73130`	$226	$26	$93	0.3×
X-ray, ankle CPT Code: `73610`	$224	$26	$93	0.3×
X-ray, shoulder CPT Code: `73030`	$210	$24	$92	0.3×
X-ray, chest (two views) CPT Code: `71046`	$217	$24	$93	0.3×
X-ray, pelvis CPT Code: `72170`	$226	$21	$110	0.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$30	$11	$86	0.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$32	$32	$39	unverified
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$33	$33	$56	unverified
Blood test, hemoglobin CPT Code: `85018`	$19	$4	$3	1.3×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$37	$6	$5	1.2×
Blood antibody screen CPT Code: `86850`	$30	$12	$46	0.3×
Diagnostic procedure preparation HCPCS Code: `G0279`	$15	$15	$35	unverified

Showing top 25 high-impact procedures of 104 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Hermann Area District Hospital (Zero PHI Required)

CMS CCN: 261314

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $45,940

Insurer Median $45,940

1. Amount on Your Bill or Quote ($) Pre-filled with Hermann Area District 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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $30,626 Paying Cash

Self-Pay Cash Rate ($45,940) Beats Your Bill

Hermann Area District Hospital's published 45 CFR § 180 self-pay cash rate is $45,940 (vs. $45,940 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$57,134 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($76,566) is $57,134 above the denoised Fair BaseRate ($19,432) and 5.5× the $14,044 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) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Hermann Area District Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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 Composite69/100

Median ER Wait86 min

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 Hermann Area District Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2024-03-28·administrative_or_closure
Closure Notice
Recorded
2023-12-06·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare. 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 Hermann Area District Hospital.

Price Index: 1.02× regional baseline

Quality: 54/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Healthy Blue McAid - All Plans

-53.3%

Median Household Income$65,096U.S. Census ACS

Local Uninsured Share7.2%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 85/100 · Verified CMS CCN 261314

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 261314) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-10-01 · 49.98 MB

Validated Rate Rows3,390 (CMS v3.0.0)

File Integrity Digest5ac9729066782e758030…

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