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CMS Price Transparency Data Hospital file updated: 2024-11-12

Colonoscopy with biopsy

Facility: Lawrence Memorial Hospital

Billing Code: 45380 (CPT)

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Good Deal · Below Fair Market
$334Fair BaseRate (0.70× Market)
Position vs. 1.00× Fair Price30% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

This hospital's typical commercial price is $234 compared to the $334 fair price benchmark.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

The BaseRate · fair price medium confidence
A fair price for this
$334
about 0.3× the $1,223 Medicare rate · typically $191–$1,249
modeled estimate · not a bill or quote
What this hospital charges insurers
$234
Below the fair price — a good deal
about $100 under the fair price · 0.2× Medicare
Medicare pays $1,223 Fair price $334 This hospital $234 Cash price $634 Hospital's list price $1,046

How we calculate the fair BaseRate →

How this hospital compares to other AR hospitals

A typical price — 4 charge more and 4 charge less, among the 9 AR hospitals compared.

Cheapest $162 Priciest $568

Black dot = this hospital, among the 9 AR hospitals with a price for this procedure. Full list below.

A fair price for a Colonoscopy with biopsy is about $334 (about 0.3× the $1,223 Medicare rate). Lawrence Memorial Hospital charges insurers about $234, or about $634 in cash — below the fair price — a good deal. Located in Walnut Ridge, AR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

Blue Cross Blue ShieldAetnaCignaHumana UnitedHealthcareKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
Blue Cross Blue Shieldmajor $185 - $1,101 15%
Aetnamajor $758 - $916 62%
Cignamajor $212 - $653 17%
Humanamajor $177 - $659 14%
Ambetter (Centene) $177 - $848 14%
Amerigroup $177 - $653 14%
CareSource $97 - $578 8%
HealthLink $881 - $1,065 72%
WellCare $186 - $1,145 15%
+ 9 smaller / regional plans $93 - $1,250

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 1309 West Main Street, Walnut Ridge, AR 72476
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals

Other Procedures at Lawrence Memorial Hospital

Compare: Colonoscopy with biopsy at other AR hospitals

Insurance negotiated median for the same procedure, sorted lowest first.

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

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

CMS CCN: 041309
CPT 45380
Fair BaseRate™ $334
Medicare Rate $1,223
Self-Pay Cash $634
Insurer Median $234
Pre-filled with Lawrence Memorial Hospital’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $380 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $380

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $380).

Step 2 · Cash vs. Insurance Arbitrage Save $412 Paying Cash

Self-Pay Cash Rate ($634) Beats Your Bill

Lawrence Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $634 (vs. $234 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$712 Above Fair BaseRate

Negotiate Toward $334 Fair BaseRate ($1,223 Medicare)

Your bill ($1,046) is $712 above the denoised Fair BaseRate ($334) and 0.9× the $1,223 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.
Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

45 CFR § 180 Primary-Source Lineage & Federal Verification Verified CMS CCN 041309

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 041309) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2024-11-12
Validated Rate RowsIndexed (CMS v2.0.0)
File Integrity DigestVerified · CCN 041309

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