How many shoppable procedure prices are published for Phoenix Children's Hospital?

Phoenix Children's Hospital in Phoenix, AZ currently has 138 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Phoenix Children's Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Phoenix Children's Hospital's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Children's Hospital Voluntary non-profit - Private 383 Beds · urban Updated: 2026-01-01

Phoenix Children's Hospital

1919 East Thomas Road, Phoenix, AZ 85016 · 138 Priced Procedures

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.44×vs. Fair Market Price

Typical commercial prices here are +44% above the fair benchmark (1.44×) even after accounting for local nurse/doctor wages and patient complexity.

66/100 · Caution

66/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness56

Price Logic72

Peer Alignment64

Clean Billing88

Real Cash Discount50

High-Markup · Check Safety

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

Behavioral Pricing FingerprintUpper-Quartile Spread · +111% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Phoenix Children's Hospital prices routine shoppable procedures at 1.7× Medicare (median 1.00× Fair BaseRate) while upper-quartile commercial rates jump +111% to 2.11× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#46 of 56 in AZ · 80th State Percentile#2,528 of 3,385 in U.S. · 74th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.90× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (26.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.44× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Commercial insurance median sits at 1.00× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.11×) jump +111% above the median procedure ratio (Q50 1.00×)
Unnegotiated chargemaster list prices average 11.8× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.76× Divergence

1.3× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+111% Upper Tail

Q25 0.90× · Q50 1.00× · Q75 2.11×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.3× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.9× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

2.9× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.6× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

0% Cash Edge · 50/100Elevated

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Phoenix Children's Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 138 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$81,393	$30,775	2.6×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$45,312	$19,432	2.3×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$43,479	$17,936	2.4×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$40,318	$19,087	2.1×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$19,307	$8,223	2.3×
Total hip replacement CPT Code: `27130`	—	$16,210	$13,413	1.2×
Total knee replacement CPT Code: `27447`	—	$16,210	$13,523	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$14,012	$6,109	unverified
Vaginal delivery (full package) CPT Code: `59400`	—	$12,382	$2,680	unverified
C-section delivery (full package) CPT Code: `59510`	—	$12,382	$2,975	unverified
Cataract surgery with lens implant CPT Code: `66984`	—	$6,396	$2,540	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$5,797	$3,372	1.7×
Inguinal hernia repair CPT Code: `49505`	—	$5,797	$3,629	1.6×
Breast lump removal CPT Code: `19120`	—	—	$3,875	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	—	$2,539	$1,021	2.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	—	$2,216	$583	unverified
Residential mental health treatment HCPCS Code: `H2036`	—	$1,885	$406	4.6×
Blood transfusion CPT Code: `36430`	—	$1,779	$498	3.6×
Trauma team activation HCPCS Code: `G0390`	—	—	$1,453	unverified
Mental health services (assessment) HCPCS Code: `H0031`	—	$1,466	$140	unverified
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$1,257	$269	4.7×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$1,151	$257	4.5×
Behavioral health residential care HCPCS Code: `H0011`	—	$1,151	$364	3.2×
Behavioral health assessment HCPCS Code: `H0001`	—	$1,151	$157	unverified
Behavioral health day treatment HCPCS Code: `H0010`	—	$803	$343	2.3×
Bunion correction surgery CPT Code: `28296`	—	$696	$3,446	0.2×
Review of medical records for care CPT Code: `90889`	—	$656	$114	5.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	—	$663	$272	2.4×
MRI, brain (with and without contrast) CPT Code: `70553`	—	$485	$511	0.9×
Injection procedure for pain management HCPCS Code: `G0260`	—	$483	$855	0.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	—	$439	$448	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	—	$455	$987	0.5×
Colonoscopy with biopsy CPT Code: `45380`	—	$447	$1,256	0.4×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$413	$88	4.7×
Behavioral health day program HCPCS Code: `H2012`	—	$413	$100	4.1×
Rabies immune globulin HCPCS Code: `90375`	—	$421	$322	1.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$387	$148	2.6×
Ultrasound, thyroid and neck CPT Code: `76536`	—	$355	$132	2.7×
Psychological testing by technician CPT Code: `96138`	—	$356	$395	0.9×
Screening mammogram (both breasts) CPT Code: `77067`	—	$321	$123	2.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	—	$303	$303	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	—	$303	$338	0.9×
MRI, brain (no contrast) CPT Code: `70551`	—	$303	$343	0.9×
MRI, knee or other leg joint CPT Code: `73721`	—	$303	$369	0.8×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$301	$981	0.3×
CT scan, head (with contrast) CPT Code: `70460`	—	$235	$242	1.0×
CT scan, head (with and without contrast) CPT Code: `70470`	—	$235	$258	0.9×
Neurobehavioral status check CPT Code: `96116`	—	—	$231	unverified
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$201	$25	8.0×
Behavioral health living support HCPCS Code: `H2019`	—	$185	$34	5.4×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	—	$185	unverified
X-ray, pelvis CPT Code: `72170`	—	$143	$110	1.3×
X-ray, lower back CPT Code: `72110`	—	$143	$112	1.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	—	$143	$126	1.1×
Ultrasound, pelvis CPT Code: `76856`	—	$143	$130	1.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	—	$143	$134	1.1×
CT scan, head (no contrast) CPT Code: `70450`	—	$143	$160	0.9×
CT scan, pelvis CPT Code: `72192`	—	$143	$163	0.9×
CT scan, sinuses CPT Code: `70486`	—	$143	$166	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	—	$143	$167	0.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	—	$143	$168	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	—	$143	$169	0.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	—	$166	unverified
Psychotherapy session (60 minutes) CPT Code: `90837`	—	—	$181	unverified
Family therapy session CPT Code: `90847`	—	—	$173	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	—	$113	$64	1.8×
X-ray, chest (single view) CPT Code: `71045`	—	$106	$92	1.2×
X-ray, shoulder CPT Code: `73030`	—	$106	$92	1.2×
X-ray, foot CPT Code: `73630`	—	$106	$92	1.2×
X-ray, chest (two views) CPT Code: `71046`	—	$106	$93	1.1×
X-ray, neck (cervical spine) CPT Code: `72040`	—	$106	$93	1.1×
X-ray, hand CPT Code: `73130`	—	$106	$93	1.1×
X-ray, hip CPT Code: `73502`	—	$106	$93	1.1×
X-ray, ankle CPT Code: `73610`	—	$106	$93	1.1×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$108	$151	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	—	$131	$201	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$81	$35	2.3×
Group therapy session CPT Code: `90853`	—	—	$100	unverified
Speech therapy (language evaluation) CPT Code: `92507`	—	—	$86	—
Community mental health services HCPCS Code: `H0038`	—	$94	$16	unverified
Typhoid vaccine HCPCS Code: `90675`	—	—	$347	unverified
Pneumococcal vaccine HCPCS Code: `90732`	—	$141	$140	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$93	$111	0.8×
Drug screening test HCPCS Code: `G0480`	—	—	$116	—
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$35	$33	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$57	$56	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	—	$35	$37	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$60	$203	0.3×
Blood test, basic metabolic panel CPT Code: `80048`	—	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	—	$14	$14	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	—	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	—	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	—	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	—	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	—	$14	$14	1.0×
Blood test, potassium CPT Code: `84132`	—	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	—	$19	$19	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	—	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	—	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	—	$15	$15	1.0×
Culture, blood CPT Code: `87040`	—	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	—	$9	$9	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	—	$20	$20	1.0×
Blood test, vitamin D CPT Code: `82306`	—	$30	$31	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	—	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	—	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	—	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	—	$7	$7	1.0×
Blood test, sodium CPT Code: `84295`	—	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	—	$4	$4	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$24	$25	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	—	$17	$18	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$36	$39	0.9×
Flu vaccine injection HCPCS Code: `G0008`	—	$38	$48	0.8×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$38	$49	0.8×
Colorectal cancer screening HCPCS Code: `G0010`	—	$38	$49	0.8×
Hospital observation (per hour) HCPCS Code: `G0378`	—	$54	$86	0.6×
Blood test, liver function panel CPT Code: `80076`	—	$8	$9	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	—	$33	$87	0.4×
New patient office visit (30-44 min) CPT Code: `99203`	—	$39	$110	0.4×
Psychological testing evaluation CPT Code: `96136`	—	$42	$128	0.3×
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$40	$123	0.3×
Blood test, clotting time (PT/INR) CPT Code: `85610`	—	$4	$5	0.8×
Blood test, hemoglobin CPT Code: `85018`	—	$2	$3	0.7×
Blood antibody screen CPT Code: `86850`	—	$10	$46	0.2×
Care planning with family CPT Code: `90887`	—	$22	$107	unverified
Speech therapy (group session) CPT Code: `92508`	—	—	$27	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	—	—	$35	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	—	$38	unverified
Physical therapy (gait training) CPT Code: `97116`	—	—	$33	unverified
Physical therapy (manual therapy) CPT Code: `97140`	—	—	$34	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	—	—	$40	unverified
Occupational therapy (self-care training) CPT Code: `97535`	—	—	$38	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	—	—	$38	—
Orthotic fitting and training CPT Code: `97760`	—	—	$51	unverified
Prosthetic fitting and training CPT Code: `97761`	—	—	$45	unverified
Blood test, vitamin B12 CPT Code: `82607`	—	$9	$16	0.6×

Showing top 25 high-impact procedures of 138 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 26.7%

Audit a Bill or Quote at Phoenix Children's Hospital (Zero PHI Required)

CMS CCN: 033302

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $81,393

1. Amount on Your Bill or Quote ($) Pre-filled with Phoenix Children's Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $52,235 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $52,235

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (26.7% of gross = $52,235).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Phoenix Children's Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$164,568 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($195,343) is $164,568 above the denoised Fair BaseRate ($30,775) and 8.3× the $23,504 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.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (26.7% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Phoenix Children's Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-05-23·administrative_or_closure
Closure Notice
Recorded
2025-04-09·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

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

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Phoenix Children's Hospital.

Price Index: 1.64× regional baseline

Quality: 54/100 CMS composite

Median Household Income$85,518U.S. Census ACS

Local Uninsured Share10.7%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 66/100 · Caution CMS CCN 033302

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 033302) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-01-01

Validated Rate Rows3,348 (CMS v3.0.0)

File Integrity DigestVerified · CCN 033302

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