How many shoppable procedure prices are published for Vernon Memorial Hospital?

Vernon Memorial Hospital in Viroqua, WI currently has 90 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Vernon Memorial Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Vernon Memorial Hospital's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 18 Beds · rural Updated: 2025-11-21

Vernon Memorial Hospital

507 South Main St, Viroqua, WI 54665 · 90 Priced Procedures · 77% Patient Recommendation

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.17×vs. Fair Market Price

Typical commercial prices here are +17% above the fair benchmark (1.17×) even after accounting for local nurse/doctor wages and patient complexity.

56/100 · Caution

56/100Self-Pay Cash Beats Insurance 21% of the Time

File Completeness66

Price Logic59

Peer Alignment65

Clean Billing75

Real Cash Discount11

High Quality · Fair Price

5-Star CMS clinical quality rating paired with 1.17× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +43% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Vernon Memorial Hospital prices routine shoppable procedures at 1.5× Medicare (median 1.09× Fair BaseRate) while upper-quartile commercial rates jump +43% to 1.56× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#36 of 99 in WI · 35th State Percentile#1,932 of 3,385 in U.S. · 57th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.69× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 21% of shoppable procedures (25/100 Cash Honesty)
5-Star CMS clinical rating with 77% patient recommendation (79/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (37.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.17× 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.
Commercial insurance median sits at 1.09× Fair BaseRate (1.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.56×) jump +43% above the median procedure ratio (Q50 1.09×)
Consolidated metro market (HHI 5,439) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.5× Medicare

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

Back-Door Captive & ER0.73× Divergence

1.1× Medicare

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

Quantile Tail Spread+43% Upper Tail

Q25 0.69× · Q50 1.09× · Q75 1.56×

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

1.5× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

2.2× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

3.3× MedicareElevated

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

1.3× MedicareGood

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

21% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 79/100Fair

Procedure Prices at Vernon Memorial Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 90 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`	$48,091	$48,091	$19,432	2.5×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$10,023	$9,838	$19,087	0.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$8,397	$8,397	$8,223	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	$3,804	$2,155	$987	2.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,293	$1,829	$981	1.9×
Colonoscopy with biopsy CPT Code: `45380`	$3,838	$1,688	$1,256	1.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$3,451	$1,086	$583	1.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,574	$1,024	$511	2.0×
MRI, brain (no contrast) CPT Code: `70551`	$2,118	$771	$343	2.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$2,362	$700	$272	2.6×
Cataract surgery with lens implant CPT Code: `66984`	$591	$591	$2,540	0.2×
X-ray, lower back CPT Code: `72110`	$587	$587	$112	unverified
CT scan, sinuses CPT Code: `70486`	$1,258	$481	$166	2.9×
CT scan, head (no contrast) CPT Code: `70450`	$1,418	$365	$160	2.3×
MRI, knee or other leg joint CPT Code: `73721`	$2,022	$342	$369	0.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$995	$288	$134	2.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,899	$289	$303	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,574	$300	$448	0.7×
X-ray, ankle CPT Code: `73610`	$306	$306	$93	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$1,957	$257	$338	0.8×
Electrical stimulation therapy HCPCS Code: `G0283`	$214	$214	$14	15.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$634	$187	$132	1.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,795	$195	$168	1.2×
CT scan, chest (no contrast) CPT Code: `71250`	$1,718	$183	$167	1.1×
Blood transfusion CPT Code: `36430`	$370	$189	$498	0.4×
Speech therapy (language evaluation) CPT Code: `92507`	$390	$134	$86	1.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$229	$150	$126	1.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$493	$150	$181	0.8×
X-ray, hand CPT Code: `73130`	$355	$124	$93	1.3×
Physical therapy (manual therapy) CPT Code: `97140`	$263	$87	$34	2.6×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$266	$91	$38	2.4×
Orthotic fitting and training CPT Code: `97760`	$81	$81	$51	1.6×
X-ray, foot CPT Code: `73630`	$282	$102	$92	1.1×
X-ray, chest (single view) CPT Code: `71045`	$224	$99	$92	1.1×
X-ray, shoulder CPT Code: `73030`	$393	$96	$92	1.0×
X-ray, pelvis CPT Code: `72170`	$330	$96	$110	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,697	$117	$169	0.7×
X-ray, chest (two views) CPT Code: `71046`	$308	$84	$93	0.9×
Culture, blood CPT Code: `87040`	$377	$377	$11	unverified
Culture, bacterial CPT Code: `87070`	$302	$302	$9	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$246	$246	$11	22.4×
Blood test, amylase CPT Code: `82150`	$220	$220	$7	31.4×
Blood test, basic metabolic panel CPT Code: `80048`	$208	$208	$9	23.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$231	$231	$8	unverified
Blood test, liver function panel CPT Code: `80076`	$190	$190	$9	21.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$196	$196	$14	14.0×
Typhoid vaccine HCPCS Code: `90675`	$946	$193	$347	0.6×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$151	$151	$14	10.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$166	$166	$20	8.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$179	$179	$18	unverified
Blood test, calcium CPT Code: `82310`	$109	$109	$5	21.8×
Blood test, vitamin B12 CPT Code: `82607`	$128	$128	$16	8.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$119	$119	$19	6.3×
Blood test, potassium CPT Code: `84132`	$92	$92	$5	18.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$106	$106	$3	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$118	$118	$5	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$117	$117	$4	unverified
Blood test, sodium CPT Code: `84295`	$89	$89	$5	17.8×
Drug screening test HCPCS Code: `G0480`	$253	$102	$116	0.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$101	$101	$6	unverified
Blood test, hemoglobin CPT Code: `85018`	$60	$60	$3	20.0×
Blood test, lipase CPT Code: `83690`	$57	$57	$7	8.1×
Physical therapy (gait training) CPT Code: `97116`	$208	$68	$33	2.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$226	$70	$35	2.0×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$216	$72	$40	1.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$293	$77	$56	1.4×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$235	$78	$64	1.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$236	$68	$87	0.8×
X-ray, neck (cervical spine) CPT Code: `72040`	$287	$67	$93	0.7×
New patient office visit (30-44 min) CPT Code: `99203`	$267	$79	$110	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$164	$78	$201	0.4×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$79	$79	$5	unverified
Blood test, magnesium CPT Code: `83735`	$48	$48	$7	6.9×
Occupational therapy (self-care training) CPT Code: `97535`	$143	$48	$38	1.3×
Blood test, vitamin D CPT Code: `82306`	$113	$37	$31	1.2×
Blood antibody screen CPT Code: `86850`	$157	$52	$46	1.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	$267	$73	$123	0.6×
X-ray, hip CPT Code: `73502`	$354	$54	$93	0.6×
Screening mammogram (both breasts) CPT Code: `77067`	$211	$53	$123	0.4×
CT scan, pelvis CPT Code: `72192`	$1,551	$55	$163	0.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,302	$63	$258	0.2×
Ultrasound, pelvis CPT Code: `76856`	$668	$35	$130	0.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$78	$6	$4	1.5×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$156	$10	$10	1.0×
Hepatitis C antibody test CPT Code: `86803`	$151	$15	$15	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$25	$25	$48	0.5×
Colorectal cancer screening HCPCS Code: `G0010`	$24	$24	$49	0.5×
Hospital observation (per hour) HCPCS Code: `G0378`	$91	$30	$86	0.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,562	$55	$242	0.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	$12	$12	$49	0.2×

Showing top 25 high-impact procedures of 90 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 37.7%

Audit a Bill or Quote at Vernon Memorial Hospital (Zero PHI Required)

CMS CCN: 521348

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $48,091

Insurer Median $48,091

1. Amount on Your Bill or Quote ($) Pre-filled with Vernon Memorial 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: $18,135 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $18,135

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (37.7% of gross = $18,135).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $48,091

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Vernon Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $48,091 (vs. $48,091 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$28,659 Above Fair BaseRate

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

Your bill ($48,091) is $28,659 above the denoised Fair BaseRate ($19,432) and 3.4× 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) 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 (37.7% 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 Overall5/5 Stars (5/5)

Safety Composite79/100

Would Recommend77%

Rated 9 or 10 (HCAHPS)83%

Median ER Wait131 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.2%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

Source: CMS Hospital Care Compare (195 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 Vernon Memorial Hospital.

Price Index: 1.11× regional baseline

Quality: 81/100 CMS composite

Median Household Income$69,556U.S. Census ACS

Local Uninsured Share14.7%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 56/100 · Caution CMS CCN 521348

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 521348) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-11-21

Validated Rate Rows808 (CMS v3.0.0)

File Integrity DigestVerified · CCN 521348

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