Yes, it's called pay by procedure, and not pay by practice or pay by billing. It changed sometime in the mid 90's. Insurance companies, not hospitals, determine what the hospitals get paid, and Rural hospitals, as was pointed out, have a higher cost structure than many Urban hospitals. But there's also a reason why States the implemented Expanded Medicaid early, have a better record keeping rural hospitals open. They aren't eating as many uninsured patients. Even if medicaid doesn't pay great, it pays something. 

https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/medicaid-cuts-one-pager-(1).pdf