How many shoppable procedure prices are published for Adventist Health Sierra Vista?

Adventist Health Sierra Vista in San Luis Obispo, CA currently has 91 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Adventist Health Sierra Vista's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Adventist Health Sierra Vista's median negotiated commercial rate is 1.7× the regionally adjusted fair BaseRate benchmark.

What is Adventist Health Sierra Vista's CMS Care Compare overall star rating?

CMS Care Compare assigns Adventist Health Sierra Vista an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 162 Beds · urban Updated: 2026-01-10

Adventist Health Sierra Vista

1010 Murray St, San Luis Obispo, CA 93405 · 91 Priced Procedures · 56% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

1.70×vs. Fair Market Price

Typical commercial prices here are +70% above the fair benchmark (1.70×) even after accounting for local nurse/doctor wages and patient complexity.

66/100 · Caution

66/100Self-Pay Cash Beats Insurance 78% of the Time

File Completeness60

Price Logic43

Peer Alignment55

Clean Billing88

Real Cash Discount100

High Price · Lower Safety

2-Star CMS clinical quality rating paired with 1.70× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 3,362), Adventist Health Sierra Vista commands a 1.70× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#215 of 240 in CA · 89th State Percentile#2,876 of 3,385 in U.S. · 84th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.51× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 78% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (57/100 safety score) with 56% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.8× markup over Medicare rates
Commercial insurance median sits at 1.69× Fair BaseRate (2.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
Even at low-cost facilities (1.70× 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.
Consolidated metro market (HHI 3,362) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.2× Medicare

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

Back-Door Captive & ER0.77× Divergence

1.7× Medicare

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

Quantile Tail Spread+8% Upper Tail

Q25 1.51× · Q50 1.69× · Q75 1.83×

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

2.2× MedicareFair

Outpatient Surgery & ORBack-Door Captive

2.8× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.7× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.9× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

1.2× MedicareGood

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

1.0× MedicareGood

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

78% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 57/100Elevated

Procedure Prices at Adventist Health Sierra Vista

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 91 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$20,222	$29,838	$19,087	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$11,775	$19,115	$19,432	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$5,282	$11,975	$8,223	1.5×
Trauma team activation HCPCS Code: `G0390`	$3,650	$3,080	$1,453	2.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$925	$1,279	$583	2.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,560	$806	$448	1.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,490	$806	$511	1.6×
CT scan, sinuses CPT Code: `70486`	$719	$719	$166	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,178	$551	$303	1.8×
MRI, lower back (no contrast) CPT Code: `72148`	$822	$551	$338	1.6×
MRI, brain (no contrast) CPT Code: `70551`	$1,098	$551	$343	1.6×
MRI, knee or other leg joint CPT Code: `73721`	$735	$551	$369	1.5×
Rabies immune globulin HCPCS Code: `90375`	$116	$504	$322	1.6×
CT scan, head (with contrast) CPT Code: `70460`	$623	$405	$242	1.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$931	$405	$258	1.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$393	$393	$134	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$58	$361	$87	4.1×
X-ray, lower back CPT Code: `72110`	$249	$242	$112	2.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$328	$242	$126	1.9×
Ultrasound, pelvis CPT Code: `76856`	$341	$242	$130	1.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$171	$242	$132	1.8×
CT scan, head (no contrast) CPT Code: `70450`	$743	$242	$160	1.5×
CT scan, pelvis CPT Code: `72192`	$737	$242	$163	1.5×
CT scan, chest (no contrast) CPT Code: `71250`	$685	$242	$167	1.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$941	$242	$168	1.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,046	$242	$169	1.4×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$248	$248	$272	unverified
X-ray, chest (single view) CPT Code: `71045`	$138	$201	$92	2.2×
X-ray, shoulder CPT Code: `73030`	$165	$201	$92	2.2×
X-ray, foot CPT Code: `73630`	$161	$201	$92	2.2×
X-ray, chest (two views) CPT Code: `71046`	$148	$201	$93	2.2×
X-ray, hand CPT Code: `73130`	$147	$201	$93	2.2×
X-ray, ankle CPT Code: `73610`	$168	$201	$93	2.2×
New patient office visit (30-44 min) CPT Code: `99203`	$38	$185	$110	1.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$36	$195	$123	1.6×
X-ray, neck (cervical spine) CPT Code: `72040`	$155	$155	$93	unverified
X-ray, pelvis CPT Code: `72170`	$120	$120	$110	unverified
X-ray, hip CPT Code: `73502`	$141	$141	$93	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$130	$130	$64	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$96	$96	$151	0.6×
Typhoid vaccine HCPCS Code: `90675`	$210	$565	$347	1.6×
Blood antibody screen CPT Code: `86850`	$45	$87	$46	1.9×
Flu vaccine injection HCPCS Code: `G0008`	$8	$87	$48	1.8×
Speech therapy (language evaluation) CPT Code: `92507`	$77	$77	$86	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$82	$82	$140	0.6×
Hepatitis B vaccine HCPCS Code: `90744`	$76	$76	$37	unverified
Blood test, amylase CPT Code: `82150`	$28	$28	$7	4.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$39	$35	$20	1.8×
Blood test, vitamin D CPT Code: `82306`	$28	$53	$31	1.7×
Occupational therapy (self-care training) CPT Code: `97535`	$44	$44	$38	1.2×
Physical therapy (manual therapy) CPT Code: `97140`	$39	$39	$34	1.1×
Prosthetic fitting and training CPT Code: `97761`	$45	$45	$45	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$1	$6	$3	2.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$1	$11	$6	1.8×
Blood test, potassium CPT Code: `84132`	—	$9	$5	1.8×
Blood test, sodium CPT Code: `84295`	$5	$9	$5	1.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$3	$25	$14	1.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$238	$19	$11	1.7×
Culture, blood CPT Code: `87040`	$185	$19	$11	1.7×
Blood test, lipase CPT Code: `83690`	$1	$12	$7	1.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$2	$17	$10	1.7×
Blood test, vitamin B12 CPT Code: `82607`	$94	$27	$16	1.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$4	$30	$18	1.7×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$35	$35	$203	0.2×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$45	$6	$4	1.5×
Blood test, hemoglobin CPT Code: `85018`	$11	$4	$3	1.3×
Hepatitis C antibody test CPT Code: `86803`	$22	$19	$15	1.3×
Physical therapy (gait training) CPT Code: `97116`	$39	$39	$33	1.2×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$44	$44	$38	1.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$40	$40	$40	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$49	$18	$19	0.9×
Orthotic fitting and training CPT Code: `97760`	$41	$41	$51	0.8×
Hospital observation (per hour) HCPCS Code: `G0378`	$43	$43	$86	0.5×
Blood test, basic metabolic panel CPT Code: `80048`	$146	$15	$9	1.7×
Blood test, liver function panel CPT Code: `80076`	$4	$15	$9	1.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$19	$19	$39	0.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$27	$27	$56	0.5×
Flu vaccine (high dose) HCPCS Code: `90656`	$9	$9	$25	0.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$22	$22	$111	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$33	$33	$201	0.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$40	$40	$35	unverified
Blood test, magnesium CPT Code: `83735`	$1	$9	$7	1.3×
Blood test, calcium CPT Code: `82310`	$7	$5	$5	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$1	$13	$14	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$10	$10	$49	0.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	$8	$8	$49	0.2×
Blood test, creatinine (kidney) CPT Code: `82565`	—	—	$5	—
Blood test, glucose (blood sugar) CPT Code: `82947`	—	—	$4	—
Blood test, complete blood count (CBC) CPT Code: `85025`	—	—	$8	—
Blood test, clotting time (PT/INR) CPT Code: `85610`	—	—	$5	—
Culture, bacterial CPT Code: `87070`	$28	$28	$9	unverified

Showing top 25 high-impact procedures of 91 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Adventist Health Sierra Vista (Zero PHI Required)

CMS CCN: 050506

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $20,222

Insurer Median $29,838

1. Amount on Your Bill or Quote ($) Pre-filled with Adventist Health Sierra Vista’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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $204,472 Paying Cash

Self-Pay Cash Rate ($20,222) Beats Your Bill

Adventist Health Sierra Vista's published 45 CFR § 180 self-pay cash rate is $20,222 (vs. $29,838 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$205,607 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($224,694) is $205,607 above the denoised Fair BaseRate ($19,087) and 15.9× the $14,117 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) For-Profit / Non-501(c)(3)

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

Public IRS & CMS ownership records classify Adventist Health Sierra Vista as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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 Overall2/5 Stars (2/5)

Safety Composite57/100

Would Recommend56%

Rated 9 or 10 (HCAHPS)53%

Median ER Wait144 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate5%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (546 completed HCAHPS patient surveys). 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

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Adventist Health Sierra Vista.

Price Index: 1.00× regional baseline

Quality: 44/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Aetna

-58.1%

Blue Cross Blue Shield

+83.8%

Median Household Income$93,398U.S. Census ACS

Local Uninsured Share5.8%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 050506

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

MRF Portal Indexed (Reports.aspx) Verify on CMS Medicare.gov (CCN 050506) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2026-01-10 · 27.32 MB

Validated Rate Rows1,332 (CMS v3.0.0)

File Integrity DigestVerified · CCN 050506

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