How many shoppable procedure prices are published for Progress West Hospital?

Progress West Hospital in Ofallon, MO currently has 97 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Progress West Hospital's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

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

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

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 69 Beds · urban Updated: 2025-12-15

Progress West Hospital

2 Progress Point Pkwy, Ofallon, MO 63368 · 97 Priced Procedures · 82% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Above Fair Market · Negotiate

1.35×vs. Fair Market Price

Typical commercial prices here are +35% above the fair benchmark (1.35×) even after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 59% of the Time

File Completeness56

Price Logic86

Peer Alignment79

Clean Billing78

Real Cash Discount100

Premium Quality Tier

4-Star CMS clinical quality rating paired with 1.35× fair market pricing.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Progress West Hospital maintains elevated commercial insurance contracts (1.35× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 59% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#64 of 79 in MO · 79th State Percentile#2,360 of 3,385 in U.S. · 69th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.85× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 59% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 82% patient recommendation (71/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (56.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.35× 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.
Captive ER (2.0×) & laboratory (2.2×) services average 1.21× higher multiples than routine shoppable care (1.4×)
Even at low-cost facilities (1.35× 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 8.5× Medicare (24¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.4× Medicare

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

Back-Door Captive & ER1.21× Divergence

1.7× Medicare

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

Quantile Tail Spread+10% Upper Tail

Q25 0.85× · Q50 1.53× · Q75 1.69×

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

1.4× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

2.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.2× MedicareFair

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

0.6× MedicareGood

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

59% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 71/100Fair

Procedure Prices at Progress West Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 97 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$42,668	$27,790	$17,936	unverified
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$66,024	$27,234	$30,775	0.9×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$27,910	$21,605	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$32,734	$18,710	$19,432	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$14,860	$10,545	$8,223	1.3×
Inguinal hernia repair CPT Code: `49505`	$12,803	$7,193	$3,629	unverified
Rabies immune globulin HCPCS Code: `90375`	$2,685	$2,685	$322	unverified
Colonoscopy with biopsy CPT Code: `45380`	$3,127	$2,111	$1,256	1.7×
Colonoscopy (diagnostic) CPT Code: `45378`	$2,095	$2,018	$981	2.1×
Upper endoscopy with biopsy CPT Code: `43239`	$3,038	$1,941	$987	2.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$5,346	$1,480	$583	unverified
MRI, knee or other leg joint CPT Code: `73721`	$1,434	$1,017	$369	2.8×
Injection procedure for pain management HCPCS Code: `G0260`	—	—	$855	—
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,361	$421	$272	1.5×
Blood transfusion CPT Code: `36430`	$1,993	$442	$498	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,839	$367	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,020	$367	$511	0.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$293	$358	$148	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$385	$331	$151	2.2×
Screening mammogram (both breasts) CPT Code: `77067`	$209	$290	$123	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$573	$237	$134	1.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,744	$251	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$1,423	$251	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$1,382	$251	$343	0.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$411	$247	$132	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$240	$219	$201	1.1×
Ultrasound, pelvis CPT Code: `76856`	$614	$219	$130	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$318	$216	$64	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$448	$179	$126	1.4×
CT scan, head (with contrast) CPT Code: `70460`	$1,023	$184	$242	0.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,219	$184	$258	0.7×
Hospital observation (per hour) HCPCS Code: `G0378`	$204	$204	$86	unverified
X-ray, hip CPT Code: `73502`	$115	$92	$93	1.0×
X-ray, lower back CPT Code: `72110`	$316	$110	$112	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$236	$90	$93	1.0×
CT scan, head (no contrast) CPT Code: `70450`	$860	$110	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$705	$110	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$793	$110	$166	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$709	$110	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$691	$110	$168	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$907	$110	$169	0.7×
X-ray, hand CPT Code: `73130`	$178	$84	$93	0.9×
X-ray, ankle CPT Code: `73610`	$166	$82	$93	0.9×
X-ray, chest (two views) CPT Code: `71046`	$274	$81	$93	0.9×
Typhoid vaccine HCPCS Code: `90675`	$571	$528	$347	1.5×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$231	$199	$111	1.8×
Drug screening test HCPCS Code: `G0480`	$128	$159	$116	1.4×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$127	$127	$27	4.7×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$92	$102	$56	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$55	$61	$37	1.6×
X-ray, shoulder CPT Code: `73030`	$199	$78	$92	0.8×
X-ray, foot CPT Code: `73630`	$173	$77	$92	0.8×
Blood test, vitamin D CPT Code: `82306`	$115	$51	$31	1.6×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$71	$62	$39	1.6×
Speech therapy (language evaluation) CPT Code: `92507`	$255	$74	$86	0.9×
Flu vaccine injection HCPCS Code: `G0008`	$82	$47	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$82	$47	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$82	$47	$49	1.0×
Orthotic fitting and training CPT Code: `97760`	$84	$45	$51	0.9×
X-ray, chest (single view) CPT Code: `71045`	$261	$60	$92	0.7×
X-ray, pelvis CPT Code: `72170`	$170	$68	$110	0.6×
Flu vaccine (high dose) HCPCS Code: `90656`	$38	$43	$25	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$25	$6	$3	2.0×
Blood test, calcium CPT Code: `82310`	$19	$9	$5	1.8×
Blood test, creatinine (kidney) CPT Code: `82565`	$22	$9	$5	1.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$34	$7	$4	1.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$17	$7	$4	1.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$92	$14	$8	1.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$58	$24	$14	1.7×
Blood test, lipase CPT Code: `83690`	$75	$12	$7	1.7×
Blood test, magnesium CPT Code: `83735`	$94	$12	$7	1.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$34	$17	$10	1.7×
Blood test, PSA (prostate screen) CPT Code: `84153`	$77	$32	$19	1.7×
Blood test, basic metabolic panel CPT Code: `80048`	$157	$15	$9	1.7×
Blood test, clotting time (PTT) CPT Code: `85730`	$79	$10	$6	1.7×
Hepatitis C antibody test CPT Code: `86803`	$61	$25	$15	1.7×
Culture, bacterial CPT Code: `87070`	$44	$15	$9	1.7×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$57	$23	$14	1.6×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$215	$18	$11	1.6×
Culture, blood CPT Code: `87040`	$194	$18	$11	1.6×
Blood test, vitamin B12 CPT Code: `82607`	$64	$26	$16	1.6×
Blood test, thyroid (TSH) CPT Code: `84443`	$66	$29	$18	1.6×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$167	$32	$20	1.6×
Blood test, amylase CPT Code: `82150`	$29	$11	$7	1.6×
Blood test, liver function panel CPT Code: `80076`	$53	$14	$9	1.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$30	$30	$35	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$112	$34	$40	0.8×
Blood test, potassium CPT Code: `84132`	$20	$8	$5	1.6×
Blood test, sodium CPT Code: `84295`	$26	$8	$5	1.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$17	$7	$5	1.4×
Physical therapy (gait training) CPT Code: `97116`	$91	$28	$33	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$101	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$112	$31	$38	0.8×
Blood test, hemoglobin CPT Code: `85018`	$20	$4	$3	1.3×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$91	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$81	$27	$34	0.8×
Blood antibody screen CPT Code: `86850`	$46	$21	$46	0.5×

Showing top 25 high-impact procedures of 97 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 56.7%

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

CMS CCN: 260219

CPT 322

Select Procedure to Audit:

Fair BaseRate™ $17,936

Medicare Rate $12,807

Self-Pay Cash $42,668

Insurer Median $27,790

1. Amount on Your Bill or Quote ($) Pre-filled with Progress West 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: $40,328 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $40,328

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (56.7% of gross = $40,328).

Step 2 · Cash vs. Insurance Arbitrage Save $28,445 Paying Cash

Self-Pay Cash Rate ($42,668) Beats Your Bill

Progress West Hospital's published 45 CFR § 180 self-pay cash rate is $42,668 (vs. $27,790 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$53,177 Above Fair BaseRate

Negotiate Toward $17,936 Fair BaseRate ($12,807 Medicare)

Your bill ($71,113) is $53,177 above the denoised Fair BaseRate ($17,936) and 5.6× the $12,807 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 (56.7% 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 Overall4/5 Stars (4/5)

Safety Composite71/100

Would Recommend82%

Rated 9 or 10 (HCAHPS)75%

Median ER Wait198 min

Left ER Before Seen3%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

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

2025-08-01·administrative_or_closure
Met Requirements
Recorded
2023-06-15·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (500 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 Progress West Hospital.

Price Index: 1.05× regional baseline

Quality: 68/100 CMS composite

Median Household Income$102,912U.S. Census ACS

Local Uninsured Share4.3%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 79/100 · Corroborated CMS CCN 260219

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 260219) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-12-15

Validated Rate Rows6,050 (CMS v3.0.0)

File Integrity DigestVerified · CCN 260219

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