How many shoppable procedure prices are published for Howard County Medical Center?

Howard County Medical Center in St Paul, NE currently has 132 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Howard County Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Howard County Medical Center's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Other 10 Beds · rural Updated: 2026-02-04

Howard County Medical Center

P O Box 406, 1113 Sherman St, St Paul, NE 68873 · 132 Priced Procedures

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.04×vs. Fair Market Price

Typical commercial prices here are +4% above the fair benchmark (1.04×) even after accounting for local nurse/doctor wages and patient complexity.

70/100 · Caution

70/100Self-Pay Cash Beats Insurance 20% of the Time

File Completeness100

Price Logic83

Peer Alignment66

Clean Billing80

Real Cash Discount6

Regional Value Leader

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

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Howard County Medical Center prices routine shoppable procedures near 0.8× Medicare (p50 0.84×) while skewing captive emergency, lab, and upper-quartile codes to 1.9× Medicare (p75 1.59×, +89% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#12 of 60 in NE · 18th State Percentile#1,466 of 3,385 in U.S. · 43rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.54× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 20% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (69/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (52.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.04× 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 (1.2×) & laboratory (0.7×) services average 2.37× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.59×) jump +89% above the median procedure ratio (Q50 0.84×)
Consolidated metro market (HHI 5,553) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.8× Medicare

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

Back-Door Captive & ER2.37× Divergence

1.9× Medicare

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

Quantile Tail Spread+89% Upper Tail

Q25 0.54× · Q50 0.84× · Q75 1.59×

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

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.7× MedicareGood

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

1.1× MedicareGood

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

20% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 69/100Fair

Procedure Prices at Howard County Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 132 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Trauma team activation HCPCS Code: `G0390`	$3,090	$3,090	$1,453	2.1×
C-section delivery (full package) CPT Code: `59510`	$5,112	$2,334	$2,975	0.8×
Vaginal delivery (full package) CPT Code: `59400`	$4,669	$2,122	$2,680	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,293	$1,293	$6,109	0.2×
Blood transfusion CPT Code: `36430`	$744	$744	$498	1.5×
Bunion correction surgery CPT Code: `28296`	—	$600	$3,446	0.2×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,873	$564	$1,021	0.6×
Mental health services (assessment) HCPCS Code: `H0031`	—	$556	$140	unverified
Cataract surgery with lens implant CPT Code: `66984`	—	$502	$2,540	0.2×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$499	$3,372	0.1×
Inguinal hernia repair CPT Code: `49505`	$1,029	$468	$3,629	0.1×
Residential mental health treatment HCPCS Code: `H2036`	—	$406	$406	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$314	$314	$64	4.9×
Rabies immune globulin HCPCS Code: `90375`	$1,556	$290	$322	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,999	$283	$448	0.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$4,627	$298	$511	0.6×
Behavioral health assessment HCPCS Code: `H0001`	$276	$249	$157	1.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$260	$260	$201	1.3×
Behavioral health residential care HCPCS Code: `H0011`	—	$256	$364	0.7×
Colonoscopy with biopsy CPT Code: `45380`	$892	$237	$1,256	0.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$283	$236	$185	unverified
Behavioral health day program HCPCS Code: `H2012`	—	$190	$100	1.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,895	$163	$258	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,842	$173	$303	0.6×
MRI, brain (no contrast) CPT Code: `70551`	$4,070	$184	$343	0.5×
MRI, lower back (no contrast) CPT Code: `72148`	$3,924	$180	$338	0.5×
MRI, knee or other leg joint CPT Code: `73721`	$2,965	$190	$369	0.5×
Psychotherapy session (60 minutes) CPT Code: `90837`	$267	$209	$181	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,339	$179	$583	0.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$696	$179	$981	0.2×
Review of medical records for care CPT Code: `90889`	—	$178	$114	unverified
Mental health services (therapy) HCPCS Code: `H0032`	—	$141	$65	2.2×
Care planning with family CPT Code: `90887`	—	$147	$107	1.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$431	$145	$148	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$146	$151	1.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,498	$168	$272	0.6×
Screening mammogram (both breasts) CPT Code: `77067`	$401	$118	$123	1.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	$208	$142	$166	0.9×
Family therapy session CPT Code: `90847`	$217	$141	$173	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$977	$106	$134	0.8×
CT scan, pelvis CPT Code: `72192`	$2,618	$124	$163	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$714	$100	$132	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$2,618	$124	$167	0.7×
Ultrasound, pelvis CPT Code: `76856`	$909	$96	$130	0.7×
CT scan, sinuses CPT Code: `70486`	$2,057	$120	$166	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,495	$122	$169	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,669	$121	$168	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$2,104	$139	$242	0.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$254	$109	$123	0.9×
Upper endoscopy with biopsy CPT Code: `43239`	$775	$128	$987	0.1×
New patient office visit (30-44 min) CPT Code: `99203`	$228	$95	$110	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$2,385	$100	$160	0.6×
Neurobehavioral status check CPT Code: `96116`	—	$120	$231	0.5×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$112	$257	0.4×
Behavioral health day treatment HCPCS Code: `H0010`	—	$121	$343	0.4×
Injection procedure for pain management HCPCS Code: `G0260`	$103	$103	$855	unverified
Typhoid vaccine HCPCS Code: `90675`	$526	$341	$347	1.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$217	$217	$203	1.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$132	$132	$111	1.2×
Pneumococcal vaccine HCPCS Code: `90732`	$171	$133	$140	0.9×
Blood test, vitamin D CPT Code: `82306`	$207	$58	$31	1.9×
Speech therapy (language evaluation) CPT Code: `92507`	$318	$72	$86	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$735	$79	$126	0.6×
Behavioral health outpatient services HCPCS Code: `H2015`	—	$40	$16	2.5×
Blood test, PSA (prostate screen) CPT Code: `84153`	$159	$36	$19	1.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$142	$35	$20	1.8×
Flu vaccine injection HCPCS Code: `G0008`	$60	$50	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$60	$50	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$60	$50	$49	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$179	$72	$87	0.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$85	$41	$35	1.2×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$35	$33	1.1×
Orthotic fitting and training CPT Code: `97760`	$268	$45	$51	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$33	$38	0.9×
Prosthetic fitting and training CPT Code: `97761`	—	$39	$45	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$1,633	$61	$86	0.7×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$60	$88	0.7×
X-ray, hip CPT Code: `73502`	$345	$43	$93	0.5×
X-ray, lower back CPT Code: `72110`	$607	$48	$112	0.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$364	$36	$93	0.4×
X-ray, hand CPT Code: `73130`	$342	$34	$93	0.4×
X-ray, ankle CPT Code: `73610`	$337	$33	$93	0.4×
X-ray, shoulder CPT Code: `73030`	$379	$32	$92	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$72	$6	$3	2.0×
Blood test, calcium CPT Code: `82310`	$72	$10	$5	2.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$73	$10	$5	2.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$61	$8	$4	2.0×
Blood test, lipase CPT Code: `83690`	$132	$14	$7	2.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$70	$8	$4	2.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$107	$12	$6	2.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$153	$27	$14	1.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$191	$21	$11	1.9×
Hepatitis B vaccine HCPCS Code: `90744`	$75	$32	$37	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$79	$46	$56	0.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$92	$19	$10	1.9×
Blood test, basic metabolic panel CPT Code: `80048`	$167	$17	$9	1.9×
Culture, bacterial CPT Code: `87070`	$145	$17	$9	1.9×
Blood test, vitamin B12 CPT Code: `82607`	$174	$30	$16	1.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$119	$15	$8	1.9×
Hepatitis C antibody test CPT Code: `86803`	$139	$28	$15	1.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$150	$26	$14	1.9×
Blood test, amylase CPT Code: `82150`	$111	$13	$7	1.9×
Blood test, magnesium CPT Code: `83735`	$100	$13	$7	1.9×
Culture, blood CPT Code: `87040`	$236	$20	$11	1.8×
Blood test, potassium CPT Code: `84132`	$67	$9	$5	1.8×
Blood test, sodium CPT Code: `84295`	$59	$9	$5	1.8×
Blood test, liver function panel CPT Code: `80076`	$152	$16	$9	1.8×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$51	$40	$39	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$42	$25	$25	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$12	$14	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$23	$27	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$318	$34	$40	0.8×
Physical therapy (gait training) CPT Code: `97116`	$219	$28	$33	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$214	$29	$35	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$258	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$284	$31	$38	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$307	$27	$34	0.8×
Behavioral health living support HCPCS Code: `H2019`	—	$22	$34	0.6×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$56	$13	$25	0.5×
Blood antibody screen CPT Code: `86850`	$120	$19	$46	0.4×
Group therapy session CPT Code: `90853`	$205	$41	$100	0.4×
X-ray, foot CPT Code: `73630`	$343	$31	$92	0.3×
X-ray, chest (two views) CPT Code: `71046`	$391	$31	$93	0.3×
Psychological testing evaluation CPT Code: `96136`	—	$38	$128	0.3×
X-ray, chest (single view) CPT Code: `71045`	$317	$24	$92	0.3×
X-ray, pelvis CPT Code: `72170`	$314	$25	$110	0.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$145	$33	$18	unverified
Blood test, hemoglobin CPT Code: `85018`	$47	$5	$3	1.7×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$75	$8	$5	1.6×
Community mental health services HCPCS Code: `H0038`	—	$2	$16	0.1×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$26	$269	0.1×
Psychological testing by technician CPT Code: `96138`	—	$32	$395	0.1×

Showing top 25 high-impact procedures of 132 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 52.8%

Audit a Bill or Quote at Howard County Medical Center (Zero PHI Required)

CMS CCN: 281338

CPT G0390

Select Procedure to Audit:

Fair BaseRate™ $1,453

Medicare Rate $1,362

Self-Pay Cash $3,090

Insurer Median $3,090

1. Amount on Your Bill or Quote ($) Pre-filled with Howard County Medical Center’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: $1,631 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $1,631

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (52.8% of gross = $1,631).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $3,090

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Howard County Medical Center's published 45 CFR § 180 self-pay cash rate is $3,090 (vs. $3,090 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$1,637 Above Fair BaseRate

Negotiate Toward $1,453 Fair BaseRate ($1,362 Medicare)

Your bill ($3,090) is $1,637 above the denoised Fair BaseRate ($1,453) and 2.3× the $1,362 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: 470681056

Filing Period: 200910

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 (52.8% 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 Composite69/100

Median ER Wait87 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

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

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Howard County Medical Center.

Price Index: 1.05× regional baseline

Quality: 57/100 CMS composite

Median Household Income$74,508U.S. Census ACS

Local Uninsured Share7.0%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 70/100 · Caution CMS CCN 281338 EIN 470681056

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 281338) ↗ Verify IRS Form 990 (EIN 470681056) ↗ CMS HCRIS Cost Reports ↗

Published MRF File470681056_howard-county-medical-center_standardcharges.csv

Publication / Vintage2026-02-04 · 85.63 MB

Validated Rate Rows6,129 (CMS v3.0.0)

File Integrity Digest94785ebbc44fd3456ab1…

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