CT imaging
CT abdomen and pelvis with contrast
CPT 74177
$4,064 - $4,777
from 3 insurers · median $4,252
Typical for a hospital with this service line
Fairfield, IL
31
In-network payers
180
Disclosed rate categories
55
Beds
3
Care quality
Fairfield Memorial Hospital is a 55-bed voluntary non-profit - private hospital in Fairfield, IL. Below you'll find publicly disclosed negotiated rates and facility details, including 31 in-network payers and 180 disclosed rate categories.
CCN (Medicare provider number)
141311
NPI
1255422416
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
55
Care Quality
3
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.





The 24 services Fairfield Memorial Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
CT imaging
CPT 74177
$4,064 - $4,777
from 3 insurers · median $4,252
Typical for a hospital with this service line
CT imaging
CPT 74176
$3,677 - $4,599
from 3 insurers · median $4,131
Typical for a hospital with this service line
CT imaging
CPT 70450
$1,471 - $1,970
from 3 insurers · median $1,653
Typical for a hospital with this service line
MRI imaging
CPT 70553
$5,297 - $5,758
from 2 insurers · median $5,527
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$1,916 - $2,153
from 3 insurers · median $1,970
Typical for a hospital with this service line
CT imaging
CPT 71260
$2,190 - $2,877
from 3 insurers · median $2,461
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$5,023 - $7,276
from 3 insurers · median $5,644
Hospital reports nuclear medicine services to CMS
MRI imaging
CPT 72148
$2,731 - $3,734
from 3 insurers · median $2,968
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$267 - $362
from 3 insurers · median $299
Typical for a hospital with this service line
MRI imaging
CPT 70551
$2,245 - $2,720
from 3 insurers · median $2,502
Typical for a hospital with this service line
MRI imaging
CPT 72197
$5,100 - $5,544
from 2 insurers · median $5,322
Typical for a hospital with this service line
X-ray and bone density
CPT 77080
$1,000 - $1,438
from 3 insurers · median $1,123
Typical for a hospital with this service line
Mammography
CPT 77067
$186 - $451
from 3 insurers · median $209
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$4,855 - $7,395
from 3 insurers · median $5,456
Typical for a hospital with this service line
Ultrasound
CPT 76705
$635 - $855
from 3 insurers · median $714
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,000 - $3,392
from 3 insurers · median $1,123
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$792 - $1,767
from 3 insurers · median $890
Typical for a hospital with this service line
Gynecology
CPT 58571
$6,300 - $17,371
from 3 insurers · median $7,080
Typical for a hospital with this service line
Ultrasound
CPT 76830
$711 - $948
from 3 insurers · median $799
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$943 - $5,856
from 3 insurers · median $1,060
Typical for a hospital with this service line
Ultrasound
CPT 76642
$544 - $751
from 3 insurers · median $612
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93971
$607 - $804
from 3 insurers · median $683
Typical for a hospital with this service line
Gynecology
CPT 58662
$9,648 - $14,694
from 3 insurers · median $10,841
Typical for a hospital with this service line
Lung function and sleep
CPT 95810
$3,836 - $5,842
from 3 insurers · median $4,310
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 22 | 709% | 20 | 0 |
| Insurer B* | 24 | 654% | 17 | 1 |
| Insurer C* | 24 | 582% | 14 | 3 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Fairfield Memorial Hospital.
303 Nw 11th Street, Fairfield, IL 62837
(618) 842-2611
About Fairfield Memorial Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Fairfield Memorial Hospital range from $5,297 to $5,758 across 2 insurers. Cigna's rate is $5,297. The median at nearby comparable hospitals is $2,326. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Fairfield Memorial Hospital range from $4,064 to $4,777 across 3 insurers. Aetna's rate is $4,064. The median at nearby comparable hospitals is $2,513. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Fairfield Memorial Hospital range from $1,000 to $3,392 across 3 insurers. Aetna's rate is $3,392. The median at nearby comparable hospitals is $475. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Fairfield Memorial Hospital range from $186 to $451 across 3 insurers. Aetna's rate is $451. The median at nearby comparable hospitals is $245. What a patient pays depends on their plan's deductible, coinsurance and network status.
Fairfield Memorial Hospital has 55 beds. Facility type: Critical Access Hospital.
Fairfield Memorial Hospital is located at 303 Nw 11th Street, Fairfield, IL 62837. Its main phone number is (618) 842-2611.
Fairfield Memorial Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 141311.
The National Provider Identifier (NPI) on file for Fairfield Memorial Hospital is 1255422416.
Fairfield Memorial Hospital lists 31 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
180 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers