Yavapai Regional Medical Center
1003 Willow Creek Road, Prescott, AZ 86301 · 111 Priced Procedures · 65% Patient Recommendation
Typical commercial prices here are +17% above the fair benchmark (1.17×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.17× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Yavapai Regional Medical Center prices routine shoppable procedures near 1.4× Medicare (p50 1.00×) while skewing captive emergency, lab, and upper-quartile codes to 1.5× Medicare (p75 1.61×, +61% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.76× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 63% of shoppable procedures (94/100 Cash Honesty)
- 2-Star CMS clinical rating with 65% patient recommendation (68/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (22.7% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.17× 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.
- Captive ER (2.0×) & laboratory (1.8×) services average 1.07× higher multiples than routine shoppable care (1.4×)
- Upper-quartile procedures (Q75 1.61×) jump +61% above the median procedure ratio (Q50 1.00×)
- Consolidated metro market (HHI 4,056) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Yavapai Regional Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 111 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $23,167 | 0.8× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $14,730 | 0.8× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $14,155 | 0.7× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $13,582 | 0.8× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $5,858 | 0.7× |
| Rabies immune globulin HCPCS Code: 90375 | $4,751 | unverified |
| C-section delivery (full package) CPT Code: 59510 | $4,204 | 1.4× |
| Vaginal delivery (full package) CPT Code: 59400 | $3,812 | 1.4× |
| Bunion correction surgery CPT Code: 28296 | $3,458 | 1.0× |
| Total hip replacement CPT Code: 27130 | $2,669 | 0.2× |
| Total knee replacement CPT Code: 27447 | $2,634 | 0.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,431 | 1.0× |
| Hepatitis B immune globulin HCPCS Code: 90371 | $2,008 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,249 | 0.2× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $1,120 | 0.3× |
| MRI, knee or other leg joint CPT Code: 73721 | $1,109 | unverified |
| Inguinal hernia repair CPT Code: 49505 | $1,077 | 0.3× |
| Breast lump removal CPT Code: 19120 | $859 | 0.2× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $764 | unverified |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $609 | unverified |
| Blood transfusion CPT Code: 36430 | $466 | 0.9× |
| Colonoscopy with biopsy CPT Code: 45380 | $434 | 0.3× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $396 | 0.9× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $400 | 0.4× |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $411 | unverified |
Audit a Bill or Quote at Yavapai Regional Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $12,621
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (22.7% of gross = $12,621).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Yavapai Regional Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($55,601) is $24,826 above the denoised Fair BaseRate ($30,775) and 2.4× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (22.7% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (500 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Yavapai Regional Medical Center.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.