SSM Health · Pinckneyville, IL
26
In-network payers
163
Disclosed rate categories
17
Beds
Pinckneyville Community Hospital is a 17-bed government - hospital district or authority hospital in Pinckneyville, IL, affiliated with SSM Health. Below you'll find publicly disclosed negotiated rates and facility details, including 26 in-network payers and 163 disclosed rate categories.
CCN (Medicare provider number)
141307
NPI
1689646523
Type
Critical Access Hospital
Ownership
Government - Hospital District Or Authority
Beds
17
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 Pinckneyville Community 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
$387 - $4,257
from 4 insurers · median $2,945
Typical for a hospital with this service line
CT imaging
CPT 74176
$234 - $4,037
from 4 insurers · median $2,836
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$242 - $2,827
from 4 insurers · median $2,639
Typical for a hospital with this service line
CT imaging
CPT 70450
$135 - $1,659
from 2 insurers · median $897
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$425 - $3,321
from 4 insurers · median $3,099
Typical for a hospital with this service line
CT imaging
CPT 71260
$211 - $2,739
from 4 insurers · median $2,191
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$519 - $3,638
from 4 insurers · median $3,396
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$493 - $3,638
from 4 insurers · median $3,396
Typical for a hospital with this service line
Mammography
CPT 77067
$111 - $487
from 4 insurers · median $392
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$440 - $5,936
from 4 insurers · median $5,540
Hospital reports nuclear medicine services to CMS
Medicine & Surgery
CPT 47562
$12,064 - $13,824
from 3 insurers · median $13,740
Typical for a hospital with this service line
MRI imaging
CPT 70553
$2,222 - $2,335
from 4 insurers · median $2,271
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$34 - $323
from 4 insurers · median $301
Typical for a hospital with this service line
MRI imaging
CPT 72148
$283 - $3,317
from 4 insurers · median $2,307
Typical for a hospital with this service line
Digestive procedures
CPT 49650
$12,064 - $15,080
from 4 insurers · median $13,782
Typical for a hospital with this service line
Ultrasound
CPT 76705
$90 - $769
from 4 insurers · median $680
Typical for a hospital with this service line
Gynecology
CPT 58558
$8,094 - $10,118
from 4 insurers · median $9,247
Typical for a hospital with this service line
MRI imaging
CPT 70551
$289 - $2,010
from 4 insurers · median $1,658
Typical for a hospital with this service line
MRI imaging
CPT 72141
$1,317 - $4,396
from 4 insurers · median $2,983
Typical for a hospital with this service line
Medicine & Surgery
CPT 42820
$9,760 - $12,200
from 4 insurers · median $11,149
Typical for a hospital with this service line
Gynecology
CPT 58661
$11,707 - $14,634
from 4 insurers · median $13,374
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$646 - $3,652
from 4 insurers · median $3,409
Typical for a hospital with this service line
Ultrasound
CPT 76642
$87 - $697
from 4 insurers · median $645
Typical for a hospital with this service line
Ultrasound
CPT 76830
$122 - $907
from 4 insurers · median $749
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* | 23 | 507% | 6 | 3 |
| Insurer B* | 23 | 503% | 12 | 2 |
| Insurer C* | 24 | 417% | 1 | 12 |
| Insurer D* | 23 | 114% | 3 | 17 |
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 Pinckneyville Community Hospital.
5383 State Route 154, Pinckneyville, IL 62274
(618) 357-2187
The nearest hospitals of similar type and size. Their rates are compared with Pinckneyville Community Hospital for the same insurers and services above.
Marshall Browning Hospital
▼ Rates typically 9% lower than Pinckneyville Community Hospital (17 services)
Sparta Community Hospital
▲ Rates typically 733% higher than Pinckneyville Community Hospital (18 services)
Saint Joseph Memorial Hospital
▲ Rates typically 999% higher than Pinckneyville Community Hospital (22 services)
Memorial Hospital
▼ Rates typically 24% lower than Pinckneyville Community Hospital (17 services)
Franklin Hospital
▼ Rates typically 6% lower than Pinckneyville Community Hospital (20 services)
Red Bud Regional Hospital
▲ Rates typically 55% higher than Pinckneyville Community Hospital (24 services)
Clay County Hospital
Washington County Hospital
Rochelle Community Hospital
Osf Saint Paul Medical Center - Mendota
About Pinckneyville Community Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Pinckneyville Community Hospital range from $2,222 to $2,335 across 4 insurers. Cigna's rate is $2,335. The median at nearby comparable hospitals is $3,033. 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 Pinckneyville Community Hospital range from $387 to $4,257 across 4 insurers. Aetna's rate is $387. The median at nearby comparable hospitals is $3,112. 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 Pinckneyville Community Hospital range from $519 to $3,638 across 4 insurers. Blue Cross Blue Shield of Illinois's rate is $3,175. The median at nearby comparable hospitals is $3,085. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Pinckneyville Community Hospital range from $111 to $487 across 4 insurers. UnitedHealthcare's rate is $484. The median at nearby comparable hospitals is $375. What a patient pays depends on their plan's deductible, coinsurance and network status.
Pinckneyville Community Hospital has 17 beds. Facility type: Critical Access Hospital.
Pinckneyville Community Hospital is located at 5383 State Route 154, Pinckneyville, IL 62274. Its main phone number is (618) 357-2187.
Pinckneyville Community Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 141307.
The National Provider Identifier (NPI) on file for Pinckneyville Community Hospital is 1689646523.
Pinckneyville Community Hospital is affiliated with SSM Health.
Pinckneyville Community Hospital lists 26 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.
163 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.
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{
"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