How many shoppable procedure prices are published for Adventist Health Vallejo?

Adventist Health Vallejo in Vallejo, CA currently has 101 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Adventist Health Vallejo's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Psychiatric Hospital Voluntary non-profit - Private 61 Beds · urban Updated: 2025-10-18

Adventist Health Vallejo

525 Oregon St, Vallejo, CA 94590 · 101 Priced Procedures

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.00×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

71/100 · Corroborated

71/100Self-Pay Cash Beats Insurance 76% of the Time

File Completeness50

Price Logic63

Peer Alignment59

Clean Billing92

Real Cash Discount100

Regional Value Leader

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

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Adventist Health Vallejo prices shoppable and inpatient services (1.1× to 1.3× Medicare, divergence 1.18×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#73 of 240 in CA · 30th State Percentile#1,270 of 3,385 in U.S. · 37th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.36× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 76% of shoppable procedures (99/100 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 (43.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.00× 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 (1.3×) & laboratory (1.7×) services average 1.18× higher multiples than routine shoppable care (1.1×)
Upper-quartile procedures (Q75 1.36×) jump +36% above the median procedure ratio (Q50 1.00×)
Consolidated metro market (HHI 3,516) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.1× Medicare

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

Back-Door Captive & ER1.18× Divergence

1.3× Medicare

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

Quantile Tail Spread+36% Upper Tail

Q25 0.36× · Q50 1.00× · Q75 1.36×

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

1.1× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.5× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.7× MedicareGood

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

0.7× MedicareGood

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

76% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Adventist Health Vallejo

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 101 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Vaginal delivery (full package) CPT Code: `59400`	$1,172	$2,698	$2,680	1.0×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,343	$1,398	$1,021	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	$320	$820	$6,109	0.1×
Bunion correction surgery CPT Code: `28296`	$150	$649	$3,446	0.2×
Inguinal hernia repair CPT Code: `49505`	$257	$665	$3,629	0.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$515	$515	$272	1.9×
Breast lump removal CPT Code: `19120`	$126	$515	$3,875	0.1×
Blood transfusion CPT Code: `36430`	$290	$437	$498	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$187	$290	$201	1.4×
Rabies immune globulin HCPCS Code: `90375`	$597	$280	$322	0.9×
Family therapy session CPT Code: `90847`	$156	$225	$173	1.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$90	$235	$981	0.2×
Colonoscopy with biopsy CPT Code: `45380`	$98	$254	$1,256	0.2×
Group therapy session CPT Code: `90853`	$93	$249	$100	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$52	$193	$86	2.2×
X-ray, lower back CPT Code: `72110`	$211	$211	$112	1.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$206	$206	$583	0.4×
X-ray, shoulder CPT Code: `73030`	$166	$166	$92	1.8×
X-ray, hip CPT Code: `73502`	$153	$153	$93	1.6×
X-ray, ankle CPT Code: `73610`	$153	$153	$93	1.6×
X-ray, hand CPT Code: `73130`	$152	$152	$93	1.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$123	$161	$166	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$194	$161	$181	0.9×
Upper endoscopy with biopsy CPT Code: `43239`	$68	$175	$987	0.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$145	$145	$93	1.6×
X-ray, foot CPT Code: `73630`	$138	$138	$92	1.5×
X-ray, chest (two views) CPT Code: `71046`	$129	$129	$93	1.4×
Speech therapy (language evaluation) CPT Code: `92507`	$149	$149	$86	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$43	$122	$38	3.2×
Physical therapy (manual therapy) CPT Code: `97140`	$39	$109	$34	3.2×
Physical therapy (gait training) CPT Code: `97116`	$58	$102	$33	3.1×
X-ray, chest (single view) CPT Code: `71045`	$123	$123	$92	1.3×
X-ray, pelvis CPT Code: `72170`	$140	$140	$110	1.3×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,979	$142	$511	0.3×
Office visit, established patient (30-39 min) CPT Code: `99214`	$28	$104	$123	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$811	$108	$303	0.4×
MRI, lower back (no contrast) CPT Code: `72148`	$1,061	$93	$338	0.3×
MRI, brain (no contrast) CPT Code: `70551`	$1,087	$93	$343	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,268	$114	$448	0.3×
Total hip replacement CPT Code: `27130`	$116	$116	$13,413	0.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$42	$116	$35	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$46	$128	$40	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$44	$128	$38	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$27	$94	$110	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$278	$84	$369	0.2×
Total knee replacement CPT Code: `27447`	$102	$102	$13,523	0.0×
Typhoid vaccine HCPCS Code: `90675`	$163	$422	$347	1.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$65	$305	$111	unverified
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$39	$105	$56	1.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	$46	$45	$35	1.3×
Orthotic fitting and training CPT Code: `97760`	$29	$53	$51	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$102	$65	$64	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$22	$76	$87	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$147	$67	$148	0.5×
CT scan, chest (no contrast) CPT Code: `71250`	$1,089	$72	$167	0.4×
CT scan, pelvis CPT Code: `72192`	$954	$68	$163	0.4×
Blood test, vitamin D CPT Code: `82306`	$26	$41	$31	1.3×
Screening mammogram (both breasts) CPT Code: `77067`	$145	$51	$123	0.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,051	$63	$169	0.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,064	$62	$168	0.4×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,058	$79	$258	0.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$410	$51	$134	0.4×
CT scan, head (no contrast) CPT Code: `70450`	$1,020	$53	$160	0.3×
Ultrasound, pelvis CPT Code: `76856`	$302	$43	$130	0.3×
CT scan, sinuses CPT Code: `70486`	$666	$53	$166	0.3×
CT scan, head (with contrast) CPT Code: `70460`	$894	$70	$242	0.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$15	$61	$25	unverified
Blood test, calcium CPT Code: `82310`	$27	$9	$5	1.8×
Culture, bacterial CPT Code: `87070`	$78	$16	$9	1.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$38	$14	$8	1.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$41	$35	$20	1.8×
Blood test, basic metabolic panel CPT Code: `80048`	$78	$15	$9	1.7×
Blood test, lipase CPT Code: `83690`	$37	$10	$7	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$13	$7	$5	1.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$23	$14	$10	1.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$45	$15	$11	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$28	$19	$14	1.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$20	$4	$3	1.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$36	$24	$18	1.3×
Hepatitis C antibody test CPT Code: `86803`	$16	$20	$15	1.3×
Blood test, vitamin B12 CPT Code: `82607`	$22	$21	$16	1.3×
Pneumococcal vaccine HCPCS Code: `90732`	$43	$43	$140	unverified
Blood test, magnesium CPT Code: `83735`	$20	$9	$7	1.3×
Culture, blood CPT Code: `87040`	$38	$14	$11	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$20	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$10	$5	$4	1.3×
Blood test, liver function panel CPT Code: `80076`	$41	$11	$9	1.2×
Blood test, sodium CPT Code: `84295`	$13	$6	$5	1.2×
Blood test, potassium CPT Code: `84132`	$12	$5	$5	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$4	$6	$6	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$3	$13	$14	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$16	$21	$25	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$260	$36	$126	0.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$222	$35	$132	0.3×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$45	$45	$3,372	0.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$2	$4	$5	0.8×
Blood test, hemoglobin CPT Code: `85018`	—	$2	$3	0.7×
Blood antibody screen CPT Code: `86850`	$30	$14	$46	0.3×
Prosthetic fitting and training CPT Code: `97761`	$37	$37	$45	unverified
Blood test, amylase CPT Code: `82150`	$37	$9	$7	1.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$2	$2	$19	0.1×

Showing top 25 high-impact procedures of 101 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 43.6%

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

CMS CCN: 054074

CPT 59400

Select Procedure to Audit:

Fair BaseRate™ $2,680

Medicare Rate $2,214

Self-Pay Cash $1,172

Insurer Median $2,698

1. Amount on Your Bill or Quote ($) Pre-filled with Adventist Health Vallejo’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: $3,407 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,407

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (43.6% of gross = $3,407).

Step 2 · Cash vs. Insurance Arbitrage Save $6,643 Paying Cash

Self-Pay Cash Rate ($1,172) Beats Your Bill

Adventist Health Vallejo's published 45 CFR § 180 self-pay cash rate is $1,172 (vs. $2,698 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$5,135 Above Fair BaseRate

Negotiate Toward $2,680 Fair BaseRate ($2,214 Medicare)

Your bill ($7,815) is $5,135 above the denoised Fair BaseRate ($2,680) and 3.5× the $2,214 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 (43.6% 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 Adventist Health Vallejo. Prior administrative notices do not necessarily reflect current compliance status.

2025-11-04·administrative_or_closure
Closure Notice
Recorded
2025-08-26·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

Regional Quality & Price Benchmark

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

Price Index: 0.99× regional baseline

Quality: 54/100 CMS composite

Median Household Income$99,994U.S. Census ACS

Local Uninsured Share4.9%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 71/100 · Corroborated CMS CCN 054074

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 054074) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2025-10-18 · 299.48 MB

Validated Rate Rows5,120 (CMS v2.0.0)

File Integrity DigestVerified · CCN 054074

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