CT imaging
CT abdomen and pelvis with contrast
CPT 74177
$261 - $934
from 2 insurers · median $597
Typical for a hospital with this service line
Milan, MO
Not rated by CMS
CMS star rating
25
Beds
105
Inpatient discharges a year
$9.7M
Net patient revenue a year
31
In-network payers
Sullivan County Memorial Hospital is a 25-bed government - local hospital in Milan, MO. Below you'll find publicly disclosed negotiated rates and facility details, including 31 in-network payers and 138 disclosed rate categories.
The 24 services Sullivan County 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, or start a free trial.
CT imaging
CPT 74177
$261 - $934
from 2 insurers · median $597
Typical for a hospital with this service line
Mammography
CPT 77067
$568
negotiated rate
Typical for a hospital with this service line
CT imaging
CPT 70450
$102 - $311
from 2 insurers · median $207
Typical for a hospital with this service line
MRI imaging
CPT 70553
$400 - $1,116
from 2 insurers · median $758
Typical for a hospital with this service line
CT imaging
CPT 74176
$121 - $478
from 2 insurers · median $299
Typical for a hospital with this service line
CT imaging
CPT 71275
$887
negotiated rate
Typical for a hospital with this service line
Laboratory and pathology
CPT 80053
$69 - $89
from 2 insurers · median $79
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$2,312
negotiated rate
Hospital reports nuclear medicine services to CMS
Ultrasound
CPT 76705
$52 - $351
from 2 insurers · median $201
Typical for a hospital with this service line
MRI imaging
CPT 72148
$287 - $630
from 2 insurers · median $458
Typical for a hospital with this service line
Laboratory and pathology
CPT 85025
$54 - $65
from 2 insurers · median $60
Typical for a hospital with this service line
MRI imaging
CPT 73721
$256 - $715
from 2 insurers · median $486
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$720
negotiated rate
Typical for a hospital with this service line
Ultrasound
CPT 76856
$63 - $427
from 2 insurers · median $245
Typical for a hospital with this service line
X-ray and bone density
CPT 73630
$114 - $154
from 2 insurers · median $134
Typical for a hospital with this service line
MRI imaging
CPT 74183
$1,672
negotiated rate
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$720
negotiated rate
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$94
negotiated rate
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$720
negotiated rate
Typical for a hospital with this service line
Mammography
CPT 77065
$538
negotiated rate
Typical for a hospital with this service line
Mammography
CPT 77066
$688
negotiated rate
Typical for a hospital with this service line
Ultrasound
CPT 76830
$495
negotiated rate
Typical for a hospital with this service line
Ultrasound
CPT 76536
$499
negotiated rate
Typical for a hospital with this service line
Laboratory and pathology
CPT 80048
$55 - $71
from 2 insurers · median $63
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* | 24 | 321% | 18 | 6 |
| Insurer B* | 12 | 109% | 4 | 8 |
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 Sullivan County Memorial Hospital, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.





Quality
Not rated by CMS
Doctors and services
16 services
Finances
$9.7M net patient revenue
Ownership and leadership
Local
The employer identification numbers (EINs) health plans and networks list for Sullivan County Memorial Hospital in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 44-6005595Sullivan County Memorial Hospital | 39Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 34 more | 1114067832 Sullivan County Memorial Hospital1285775858 Sullivan County Memorial Hospital1518008218 Sullivan County Memorial Hospitaland 5 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
630 West Third Street, Milan, MO 63556
(660) 265-4212
How Sullivan County Memorial Hospital compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Readmissions
No different on 1 measures
0 better, 1 no different, 0 worse than the US rate
Patients back in the hospital or ER soon after leaving
Time in the ER before going home
114 min
Lower than 78% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
| Measure | Result | Period |
|---|---|---|
| Readmissions | No different on 1 measures | |
| Time in the ER before going homeCMS: Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better | 114 min | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-09-30. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
Each result CMS publishes for Sullivan County Memorial Hospital, beside the US median and the average of MO hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | This hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.203 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 49 cases | 5.3 | 3.9 | 3.991 | Worse than 93% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.96 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 2.622 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 | Not Available | 8.708 | |||
| Death rate for heart failure patients2022-07-01 to 2025-06-30 | Not Available | 11.68 | |||
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 | Not Available | 15.5 | |||
| Death rate for stroke patients2023-07-01 to 2025-06-30 | Not Available | 12.03 | |||
| Pressure ulcer rate2022-07-01 to 2024-06-30 | Not Available | 0.5582 | |||
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 181 | |||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 | Not Available | 0.2094 | |||
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 | Not Available | 0.2774 | |||
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 | Not Available | 2.312 | |||
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 | Not Available | 1.619 | |||
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 | Not Available | 9.849 | |||
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 | Not Available | 3.388 | |||
| Postoperative sepsis rate2022-07-01 to 2024-06-30 | Not Available | 5.071 | |||
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 | Not Available | 1.763 | |||
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 | Not Available | 1.029 | |||
| CMS Medicare PSI 90: Patient safety and adverse events composite2022-07-01 to 2024-06-30 | Not Available | 0.9777 |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | This hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 5.15 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 | Not Available | 2.001 | |||
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 | Not Available | 0.788 | |||
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 | Not Available | 13.12 | |||
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 11.22 | |||
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 | Not Available | 5.318 | |||
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 | Not Available | 0.9815 | |||
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.32 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 11.43 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 | Not Available | 20.11 | |||
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 21.62 | |||
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 6.12 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 17.28 |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | This hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.28 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.027 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | Not Available | 4,135 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 4.122 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | Not Available | 2.604 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.6608 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2046 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.947 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | Not Available | 3,878 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 4.807 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | Not Available | 2.413 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.5467 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3088 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.21 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | Not Available | 126 | |||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 3.466 | |||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 2.877 | |||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 0.8248 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2664 | |||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 3.522 | |||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | Not Available | 93.8 | |||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 0.829 | |||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 0.8929 | |||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | 1.061 | |||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2979 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.478 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | Not Available | 41,352 | |||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 2.861 | |||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | Not Available | 1.978 | |||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.8703 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.1657 | |||
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 1.229 | |||
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | Not Available | 38,342 | |||
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | Not Available | 24.41 | |||
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | Not Available | 8.022 | |||
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | Not Available | 0.3843 |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | This hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 | Not Available | 72.59 | |||
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 | Not Available | 9.344 | |||
| Room was "usually" clean2024-10-01 to 2025-09-30 | Not Available | 18.06 | |||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 85.78 | |||
| Cleanliness - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.297 | |||
| Nurses "always" communicated well2024-10-01 to 2025-09-30 | Not Available | 79.3 | |||
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 91.27 | |||
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 | Not Available | 3.882 | |||
| Nurse communication - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.392 | |||
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 | Not Available | 16.82 | |||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 | Not Available | 79.32 | |||
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 90.65 | |||
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 | Not Available | 5.032 | |||
| Doctor communication - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.095 | |||
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 | Not Available | 15.65 | |||
| Staff "always" explained2024-10-01 to 2025-09-30 | Not Available | 60.96 | |||
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 76.66 | |||
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 | Not Available | 18.89 | |||
| Communication about medicines - star rating2024-10-01 to 2025-09-30 | Not Applicable | 2.689 | |||
| Staff "usually" explained2024-10-01 to 2025-09-30 | Not Available | 20.15 | |||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 86.27 | |||
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 | Not Available | 13.38 | |||
| Discharge information - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.432 | |||
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 | Not Available | 86.62 | |||
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 | Not Available | 14.94 | |||
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 | Not Available | 85.06 | |||
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 73.49 | |||
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 6.488 | |||
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 20.02 | |||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 | Not Available | 77.34 | |||
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 | Not Available | 5.549 | |||
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 | Not Available | 17.11 | |||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 85.12 | |||
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 3.463 | |||
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 11.41 | |||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 | Not Available | 7.366 | |||
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 | Not Available | 20.41 | |||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 | Not Available | 72.23 | |||
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 88.41 | |||
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.405 | |||
| Staff "always" explained new medications2024-10-01 to 2025-09-30 | Not Available | 73.17 | |||
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 | Not Available | 9.915 | |||
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 | Not Available | 16.91 | |||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 73.79 | |||
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 5.598 | |||
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 | Not Available | 20.61 | |||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 | Not Available | 75.55 | |||
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 | Not Available | 4.585 | |||
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 | Not Available | 19.87 | |||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 85.67 | |||
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 2.427 | |||
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 | Not Available | 11.9 | |||
| "Always" quiet at night2024-10-01 to 2025-09-30 | Not Available | 60.98 | |||
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 | Not Available | 8.344 | |||
| "Usually" quiet at night2024-10-01 to 2025-09-30 | Not Available | 30.68 | |||
| Quietness - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 82.92 | |||
| Quietness - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.568 | |||
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 | Not Available | 5.892 | |||
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 | Not Available | 70.75 | |||
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 | Not Applicable | 87.14 | |||
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 | Not Available | 23.35 | |||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.662 | |||
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 | Not Available | 45.78 | |||
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 | Not Available | 29.67 | |||
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 | Not Available | 24.55 | |||
| Summary star rating2024-10-01 to 2025-09-30 | Not Applicable | 3.311 | |||
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 | Not Available | 12.12 | |||
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 | Not Available | 87.88 |
How often the hospital gave recommended care, and how fast.
| Measure | This hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | low | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 | Not Available | 6.941 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 1.026 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0.2857 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 | Not Available | 81.12 | |||
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 299 cases | 115 | 154 | 167 | Better than 83% of US hospitals | |
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 · 288 cases | 114 | 148 | 161 | Better than 78% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 273 | |||
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 288 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 1,633 cases | 1 | 1 | 2.18 | Better than 42% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 | Not Available | 72.93 | |||
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 | Not Available | 95.34 | |||
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | 98 | |||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | 55.38 | |||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 | Not Available | 17.13 | |||
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 | Not Available | 61.69 | |||
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 66.69 | |||
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 82.85 | |||
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 78.59 | |||
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 | Not Available | 92.68 | |||
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 | Not Available | 96.61 | |||
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 69.14 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 | Not Available | 95.06 | |||
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 83.25 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 95.05 |
How often scans were ordered when they may not be needed; lower is better.
| Measure | This hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 4.2 | 5 | 5.293 | Better than 59% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | Not Available | 6.538 |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | This hospital | US median | MO average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | Not Available | 0.981 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
Not accredited
Accreditation
None
Medical school affiliation
Local
Ownership type
25
Medicare-certified beds
16
Registered nurses (full-time equivalent)
2000
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What Sullivan County Memorial Hospital reported to Medicare in its latest cost report, covering Nov 1, 2024 to Oct 31, 2025.
105
Inpatient discharges
Medicare 57%, Medicaid 8%
2,689
Inpatient days
29% of available bed days used
64
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 832562). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges Sullivan County Memorial Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 1,049 | 21 | 1,619 | 2,689 |
| Discharges | 60 | 8 | 37 | 105 |
| Average length of stay | 17.5 days | 2.6 days | 43.8 days | 25.6 days |
| Average daily census | 2.9 | 0.1 | 4.4 | 7.4 |
72
Medicare Advantage days
18 discharges
166
Observation bed days
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 25 | 337 | 194 | 4% |
Source: CMS cost report (HCRIS, Form 2552-10), report 832562, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
ZIP codes with the most Medicare inpatient stays at Sullivan County Memorial Hospital in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 40 in 2020 to 51 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 63556 | 39 | 76% | 141 | $317,285 | 34% | 27% |
| 63545 | 12 | 24% | 42 | $101,488 | 38% |
Source: CMS Hospital Service Area file. Shares are of the 51 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units Sullivan County Memorial Hospital reported at its latest Medicare certification survey (2024). Counts are people, not full-time equivalents.
1
Operating rooms
16
Registered nurses
15
Licensed practical nurses
3
Nurse practitioners
1
Pharmacists
5
Radiology technicians
1
Laboratory technicians
2
Medical technologists
47
Other personnel
Source: CMS Provider of Services file.
24 clinicians who bill Medicare list Sullivan County Memorial Hospital as a hospital affiliation. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Elangovan Balakrishnan, MD
Hematology & Oncology Physician
NPI 1407843022
See commercial rates for Elangovan Balakrishnan, MDBaydon Hilton
Dermatology Physician
NPI 1790330371
See commercial rates for Baydon HiltonTrung Tran, M.D.
Interventional Cardiology Physician
NPI 1710189592
See commercial rates for Trung Tran, M.D.Charles Sutherland, DO
Family Medicine Physician
NPI 1619945300
See commercial rates for Charles Sutherland, DODeborah Holte, DPM
Podiatrist
NPI 1487687935
See commercial rates for Deborah Holte, DPMLarry Handlin, DO
Cardiovascular Disease Physician
NPI 1437144375
See commercial rates for Larry Handlin, DOMyra Watson, D.O.
Nephrology Physician
NPI 1366448425
See commercial rates for Myra Watson, D.O.Hillary Burks, FNP
Family Nurse Practitioner
NPI 1891205357
See commercial rates for Hillary Burks, FNPJohn Bailey, D.O.
Orthopaedic Surgery of the Spine Physician
NPI 1063415354
See commercial rates for John Bailey, D.O.Azhar Assadi, DO
Internal Medicine Physician
NPI 1003320227
See commercial rates for Azhar Assadi, DORita Lutz, AGNP-C
Adult Health Nurse Practitioner
NPI 1982195285
See commercial rates for Rita Lutz, AGNP-CNaser Almasalmeh, M.D.
Internal Medicine Physician
NPI 1184698243
See commercial rates for Naser Almasalmeh, M.D.Dale Essmyer, D.O.
Family Medicine Physician
NPI 1770666984
See commercial rates for Dale Essmyer, D.O.Joshua Delozier, DNAP
Certified Registered Nurse Anesthetist
NPI 1598320558
See commercial rates for Joshua Delozier, DNAPConnie Barker, NP-C
Family Nurse Practitioner
NPI 1467861716
See commercial rates for Connie Barker, NP-CTonia Nerini, NP-C
Gerontology Nurse Practitioner
NPI 1790220606
See commercial rates for Tonia Nerini, NP-CSherri Hedges, APRN, FNP, BC
Family Nurse Practitioner
NPI 1922293109
See commercial rates for Sherri Hedges, APRN, FNP, BCMegan Duffy
Nurse Practitioner
NPI 1033938212
See commercial rates for Megan DuffyKatelin Spratt
Family Nurse Practitioner
NPI 1215755913
See commercial rates for Katelin SprattAmy Creason, FNP
Family Nurse Practitioner
NPI 1235610304
See commercial rates for Amy Creason, FNPDawn Stout, RN, BCFNP
Family Nurse Practitioner
NPI 1376654178
See commercial rates for Dawn Stout, RN, BCFNPRyan Williams, M.D.
Family Medicine Physician
NPI 1528324779
See commercial rates for Ryan Williams, M.D.Thomas Williams, D.O.
Family Medicine Physician
NPI 1659479061
See commercial rates for Thomas Williams, D.O.Hannah Gleason, FNP-BC
Family Nurse Practitioner
NPI 1851251078
See commercial rates for Hannah Gleason, FNP-BCSource: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income Sullivan County Memorial Hospital reported to Medicare for Nov 1, 2024 to Oct 31, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $14.4M | 148.7% |
| Inpatient | $3.2M | 32.8% |
| Outpatient | $11.2M | 115.9% |
| Contractual allowances and discounts | -$4.7M | -48.7% |
| Net patient revenue | $9.7M | 100.0% |
| Operating expenses | -$13.7M | -142.0% |
| Operating income from patient care | -$4.1M | -42.0% |
| Other income | $2.7M | 27.8% |
| Contributions and donations | $162,866 | 1.7% |
| Investment income | $10,409 | 0.1% |
| Government appropriations | $498,534 | 5.2% |
| COVID-19 relief funding | $748,096 | 7.7% |
| Other | $1.3M | 13.1% |
| Net income | -$1.4M | -14.2% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $3.1M | 23.1% |
| Medicaid (including managed care) | $1.4M | 10.2% |
| Other payers and self-pay | $9M | 66.7% |
| Total charges | $13.5M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 832562, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from Sullivan County Memorial Hospital's latest cost report.
-42.0%
Operating margin
Operating income from patient care / net patient revenue
-11.1%
Total margin
Net income / net patient revenue plus other income
-4.9%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
40% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
-17.1%
Return on assets
Net income for a year / total assets
-45.1%
Return on equity
Net income for a year / fund balance
0.07
Long-term debt to fund balance
Mortgages, notes and loans / fund balance
0.58
Current ratio
Current assets / current liabilities
26 days
Days in patient receivables
Net patient receivables / daily net patient revenue
108 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
1.53
Asset turnover
Total revenue for a year / total assets
15.9 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 832562, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What Sullivan County Memorial Hospital owned and owed at the end of its reporting period (Oct 2025), across all fund types: $8.1M in total assets and a $3.1M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Patient receivables, net | $679,850 | 8.4% |
| Inventory | $189,513 | 2.4% |
| Total current assets | $2.2M | 27.4% |
| Property and equipment, net of depreciation | $5.2M | 64.1% |
| Investments and other assets | $685,072 | 8.5% |
| Total assets | $8.1M | 100.0% |
| Current liabilities | $3.8M | 47.6% |
| Long-term debt | $216,190 | 2.7% |
| Total liabilities | $5M | 62.1% |
| Fund balance (net assets) | $3.1M | 37.9% |
Source: CMS cost report (HCRIS, Form 2552-10), report 832562, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care Sullivan County Memorial Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$28,261
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$615,888
Bad debt
Patient bills written off as uncollectible, at charges
$666,036
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$1M
Total unreimbursed and uncompensated care
7.5% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
$498,534
Government grants and appropriations
Government grants or transfers supporting hospital operations
Source: CMS cost report (HCRIS, Form 2552-10), report 832562, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Sullivan County Memorial Hospital's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Oct 2020 | Oct 2021 | Oct 2022 | Oct 2023 | Oct 2024 | Oct 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $7.6M | $8.5M | $9.5M | $9.7M | $10M | $9.7M |
| Operating expenses | $9.2M | $10.3M | $11.1M | $12.2M | $12.6M | $13.7M |
| Operating margin | -21.9% | -21.7% | -17.0% | -26.3% | -26.5% | -42.0% |
| Net income | -$102,264 | $2.9M | -$238,360 | -$1.4M | -$2.1M | -$1.4M |
| Total assets | $8.3M | $9.1M | $9.6M | $9M | $8.4M | $8.1M |
| Discharges | 99 | 101 | 85 | 100 | 100 | 105 |
| Inpatient days | 2,787 | 1,731 | 2,553 | 3,272 | 4,018 | 2,689 |
| Medicare Advantage days | 22 | 35 | 66 | 47 | 72 | 72 |
| Beds | 18 | 21 | 18 | 17 | 25 | 25 |
| Employees (FTE) | 66 | 59 | 62 | 65 | 65 | 64 |
Source: CMS cost report (HCRIS, Form 2552-10), report 832562, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center Sullivan County Memorial Hospital reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Rural health clinic | $1.1M | $2.7M | $2.9M | 0.92 | 1,037 |
| Emergency | $492,984 | $2M | $2.3M | 0.89 | 4,418 |
| Laboratory | $367,454 | $1.2M | $2.2M | 0.53 | 900 |
| Drugs charged to patients | $885,240 | $1.5M | 0.60 | ||
| Radiology-diagnostic | $353,405 | $784,546 | $682,312 | 1.15 | 1,720 |
| Observation beds (non-distinct part | $373,684 | $239,382 | 1.56 | ||
| Medical supplies charged to patient | $152,354 | $246,955 | 0.62 | ||
| Operating room | $14,432 | $137,058 | $158,340 | 0.87 | 1,713 |
| Ct scan | $7,661 | $132,895 | $941,938 | 0.14 | 325 |
| Physical therapy | $125,830 | $183,100 | 0.69 | 290 | |
| Mri | $76,102 | $228,737 | 0.33 | ||
| Occupational therapy | $51,893 | $81,660 | 0.64 | 130 | |
| Cardiac rehabilitation | $8,962 | $48,540 | $23,766 | 2.04 | 526 |
| Blood storing processing & trans. | $33,323 | $99,513 | 0.33 | ||
| Electrocardiology | $14,064 | $60,160 | 0.23 | 95 | |
| Speech pathology | $2,906 | $9,280 | 0.31 | ||
| Respiratory therapy | $2,421 | $43,456 | 0.06 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $1.3M | $3.6M | $1.6M | 2.29 | 8,794 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Other admin and general | $899,804 | $1.9M | 2,270 | ||
| Employee benefits department | $1.3M | ||||
| Cap rel costs-mvble equip | $416,742 | ||||
| Cap rel costs-bldg & fixt | $382,710 | 30,714 | |||
| Medicaid fra tax | $257,374 | ||||
| Dietary | $149,894 | $247,648 | 1,100 | ||
| Maintenance & repairs | $135,711 | $181,294 | 3,748 | ||
| Medical records & library | $146,991 | $152,702 | 282 | ||
| Operation of plant | $128,447 | ||||
| Housekeeping | $92,809 | $106,143 | 64 | ||
| Nursing administration | $103,777 | $104,033 | 160 | ||
| Pharmacy | $80,691 | $87,960 | 210 | ||
| Laundry & linen service | $55,482 | $57,135 | 837 | ||
| Central services & supply | $41,710 | $52,963 | 1,390 | ||
| Cap rel costs-bldg & fixt mob | $6,802 | ||||
| Cafeteria | -$14,601 | 625 |
Source: CMS cost report (HCRIS, Form 2552-10), report 832562, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The officers and board members on Sullivan County Memorial Hospital's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment; the first 2 of 6 are shown.
340B drug pricing program
Participating since 2015
340B ID CAH261306-00, registered as a critical access hospital; 8 registered outpatient sites; 38 active contract pharmacies. Authorizing official: Martha Gragg, CEO.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Accountable care organization (Medicare Shared Savings Program)
Aledade 98 MO MSSP Enhanced
ACO A4998, current agreement since 2026. Public reporting page
Source: CMS Shared Savings Program participants, 2026, matched on Sullivan County Memorial Hospital's legal name.
Scmh swing-bed snf
CCN 26Z306, certified 1983, Medicare cost reimbursed
Combined rhc
CCN 268520, certified 1998, Medicare cost reimbursed
Source: Worksheet S-2 Part I of Sullivan County Memorial Hospital's latest Medicare cost report (HCRIS).
About Sullivan County Memorial Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Sullivan County Memorial Hospital range from $400 to $1,116 across 2 insurers. Blue Cross Blue Shield's rate is $1,116. The median at nearby comparable hospitals is $662. 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 Sullivan County Memorial Hospital range from $261 to $934 across 2 insurers. Blue Cross Blue Shield's rate is $934. The median at nearby comparable hospitals is $655. 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 Sullivan County Memorial Hospital range from $720 to $720 across 1 insurers. Blue Cross Blue Shield's rate is $720. The median at nearby comparable hospitals is $1,019. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Sullivan County Memorial Hospital range from $568 to $568 across 1 insurers. Blue Cross Blue Shield's rate is $568. The median at nearby comparable hospitals is $228. What a patient pays depends on their plan's deductible, coinsurance and network status.
Sullivan County Memorial Hospital reported 105 inpatient discharges and 2,689 inpatient days from Nov 1, 2024 to Oct 31, 2025.
Sullivan County Memorial Hospital reported 64 full-time-equivalent employees on payroll from Nov 1, 2024 to Oct 31, 2025.
Sullivan County Memorial Hospital reported $9.7M in net patient revenue on $14.4M of gross charges for Nov 1, 2024 to Oct 31, 2025, an operating margin of -42.0%, and net income of -$1.4M.
Sullivan County Memorial Hospital reported $1M of unreimbursed and uncompensated care for Nov 1, 2024 to Oct 31, 2025, including $28,261 of charity care at cost.
Sullivan County Memorial Hospital's Medicare enrollment lists Martha Gragg as CEO since 2023.
Insurers' price transparency files list Sullivan County Memorial Hospital under employer identification number 44-6005595 (Sullivan County Memorial Hospital). 39 health plans and networks list 44-6005595 for it.
Yes. HRSA's 340B database lists Sullivan County Memorial Hospital (340B ID CAH261306-00) as a participating critical access hospital since 2015, with 38 active contract pharmacies.
24 clinicians who bill Medicare list Sullivan County Memorial Hospital as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are family nurse practitioner (7), family medicine physician (4), internal medicine physician (2).
CMS's Provider of Services file lists no accrediting organization for Sullivan County Memorial Hospital; it is certified for Medicare through state survey.
CMS lists 16 services at Sullivan County Memorial Hospital, including Clinical Laboratory, CT Scan, Diagnostic Radiology, Dietary Care, Emergency Department, MRI (Magnetic Resonance Imaging).
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at Sullivan County Memorial Hospital came from ZIP codes 63556 (39), 63545 (12).
Sullivan County Memorial Hospital has 25 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. Facility type: Critical Access Hospital.
Sullivan County Memorial Hospital is located at 630 West Third Street, Milan, MO 63556. Its main phone number is (660) 265-4212.
Sullivan County Memorial Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 261306.
The National Provider Identifier (NPI) on file for Sullivan County Memorial Hospital is 1114067832.
Sullivan County Memorial Hospital lists 31 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
138 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