How many shoppable procedure prices are published for AHMC Seton Medical Center?

AHMC Seton Medical Center in Daly City, CA currently has 91 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do AHMC Seton Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, AHMC Seton Medical Center's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

What is AHMC Seton Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns AHMC Seton Medical Center an overall hospital quality rating of 1 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Church 188 Beds · urban Updated: 2026-03-31

AHMC Seton Medical Center

1900 Sullivan Avenue, Daly City, CA 94015 · 91 Priced Procedures · 56% Patient Recommendation

CMS Overall Rating 1 / 5 Stars

Above Fair Market · Negotiate

1.19×vs. Fair Market Price

Typical commercial prices here are +19% above the fair benchmark (1.19×) even after accounting for local nurse/doctor wages and patient complexity.

73/100 · Corroborated

73/100Self-Pay Cash Beats Insurance 26% of the Time

File Completeness51

Price Logic88

Peer Alignment78

Clean Billing84

Real Cash Discount62

Regional Benchmark Tier

3-Star CMS clinical quality rating paired with 1.19× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

AHMC Seton Medical Center prices shoppable and inpatient services (1.7× to 1.2× Medicare, divergence 0.71×) in alignment with regional hospital peers (1.19× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#143 of 240 in CA · 59th State Percentile#1,964 of 3,385 in U.S. · 57th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.13× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 26% of shoppable procedures (62/100 Cash Honesty)
1-Star CMS clinical rating with 56% patient recommendation (65/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.19× 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 1.17× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.34×) jump +15% above the median procedure ratio (Q50 1.17×)
Unnegotiated chargemaster list prices average 17.5× 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 & ER0.71× Divergence

1.2× Medicare

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

Quantile Tail Spread+15% Upper Tail

Q25 1.13× · Q50 1.17× · Q75 1.34×

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

3.0× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.5× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

3.7× MedicareElevated

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

0.9× MedicareGood

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

26% Cash Edge · 62/100Elevated

CMS Clinical Safety & Star ValueIntegrity & Outcomes

1 CMS · 65/100Fair

Procedure Prices at AHMC Seton Medical Center

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`	—	$22,116	$19,087	1.2×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$21,969	$19,432	1.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$19,805	$17,936	1.1×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$9,536	$8,223	1.2×
Breathing treatment (nebulizer) CPT Code: `94640`	—	$1,789	$201	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$1,727	$1,306	$987	1.3×
Blood transfusion CPT Code: `36430`	$1,473	$1,085	$498	2.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,200	$809	$583	1.4×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$720	$720	$25	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$6,964	$633	$511	1.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$7,240	$507	$448	1.1×
MRI, lower back (no contrast) CPT Code: `72148`	$4,642	$433	$338	1.3×
MRI, brain (no contrast) CPT Code: `70551`	$5,310	$433	$343	1.3×
MRI, knee or other leg joint CPT Code: `73721`	$3,337	$433	$369	1.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,774	$395	$272	1.5×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$7,149	$346	$303	1.1×
CT scan, head (with contrast) CPT Code: `70460`	$4,058	$301	$242	1.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$4,286	$303	$258	1.2×
New patient office visit (30-44 min) CPT Code: `99203`	$455	$313	$110	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$429	$307	$123	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$334	$263	$86	3.1×
Office visit, established patient (20-29 min) CPT Code: `99213`	$306	$197	$87	2.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,248	$190	$126	1.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$700	$182	$148	1.2×
CT scan, head (no contrast) CPT Code: `70450`	$3,190	$190	$160	1.2×
CT scan, pelvis CPT Code: `72192`	$4,066	$190	$163	1.2×
CT scan, sinuses CPT Code: `70486`	$3,305	$190	$166	1.1×
CT scan, chest (no contrast) CPT Code: `71250`	$4,022	$190	$167	1.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$4,515	$190	$168	1.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$3,881	$190	$169	1.1×
X-ray, hip CPT Code: `73502`	$610	$128	$93	1.4×
X-ray, pelvis CPT Code: `72170`	$572	$149	$110	1.4×
Ultrasound, pelvis CPT Code: `76856`	$1,593	$152	$130	1.2×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,223	$152	$132	1.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,774	$152	$134	1.1×
X-ray, chest (single view) CPT Code: `71045`	$558	$124	$92	1.3×
X-ray, shoulder CPT Code: `73030`	$682	$124	$92	1.3×
X-ray, foot CPT Code: `73630`	$696	$124	$92	1.3×
X-ray, chest (two views) CPT Code: `71046`	$638	$124	$93	1.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$630	$124	$93	1.3×
X-ray, hand CPT Code: `73130`	$659	$124	$93	1.3×
X-ray, ankle CPT Code: `73610`	$666	$124	$93	1.3×
X-ray, lower back CPT Code: `72110`	$1,151	$149	$112	1.3×
Speech therapy (language evaluation) CPT Code: `92507`	$869	$117	$86	1.4×
Screening mammogram (both breasts) CPT Code: `77067`	$576	$126	$123	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$720	$86	$64	1.3×
Typhoid vaccine HCPCS Code: `90675`	$2,539	$394	$347	1.1×
Drug screening test HCPCS Code: `G0480`	$118	$112	$116	1.0×
Blood antibody screen CPT Code: `86850`	$126	$76	$46	1.7×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$175	$85	$56	1.5×
Pneumococcal vaccine HCPCS Code: `90732`	$454	$99	$140	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$132	$71	$35	2.0×
Flu vaccine injection HCPCS Code: `G0008`	$93	$69	$48	1.4×
Pneumonia vaccine injection HCPCS Code: `G0009`	$93	$69	$49	1.4×
Colorectal cancer screening HCPCS Code: `G0010`	$93	$69	$49	1.4×
Orthotic fitting and training CPT Code: `97760`	$138	$60	$51	1.2×
Prosthetic fitting and training CPT Code: `97761`	$123	$52	$45	1.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$182	$44	$40	1.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$172	$40	$38	1.1×
Occupational therapy (self-care training) CPT Code: `97535`	$234	$40	$38	1.1×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$143	$4	$3	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$210	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$126	$5	$4	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$229	$17	$14	1.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$306	$23	$19	1.2×
Blood test, calcium CPT Code: `82310`	$156	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$289	$6	$5	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$158	$12	$10	1.2×
Blood test, potassium CPT Code: `84132`	$167	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$218	$6	$5	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$511	$13	$11	1.2×
Blood test, lipase CPT Code: `83690`	$202	$8	$7	1.1×
Blood test, magnesium CPT Code: `83735`	$218	$8	$7	1.1×
Hepatitis C antibody test CPT Code: `86803`	$240	$17	$15	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$170	$18	$16	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$178	$9	$8	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$314	$10	$9	1.1×
Blood test, liver function panel CPT Code: `80076`	$254	$10	$9	1.1×
Culture, bacterial CPT Code: `87070`	$121	$10	$9	1.1×
Culture, blood CPT Code: `87040`	$340	$12	$11	1.1×
Physical therapy (gait training) CPT Code: `97116`	$174	$35	$33	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$113	$14	$14	1.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$169	$35	$35	1.0×
Physical therapy (manual therapy) CPT Code: `97140`	$148	$34	$34	1.0×
Blood test, amylase CPT Code: `82150`	$20	$7	$7	1.0×
Blood test, hemoglobin CPT Code: `85018`	$50	$3	$3	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$81	$6	$6	1.0×
Blood test, vitamin D CPT Code: `82306`	$32	$29	$31	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$129	$16	$18	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$37	$4	$5	0.8×
Flu vaccine (high dose) HCPCS Code: `90656`	$66	$20	$25	0.8×

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 AHMC Seton Medical Center (Zero PHI Required)

CMS CCN: 050289

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash Request Quote

Insurer Median $22,116

1. Amount on Your Bill or Quote ($) Pre-filled with AHMC Seton Medical Center’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 Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask AHMC Seton 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.

Step 3 · Fair BaseRate Target +$33,991 Above Fair BaseRate

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

Your bill ($53,078) is $33,991 above the denoised Fair BaseRate ($19,087) and 3.8× 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 AHMC Seton Medical Center 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 Overall3/5 Stars (3/5)

Safety Composite65/100

Would Recommend56%

Rated 9 or 10 (HCAHPS)57%

Median ER Wait192 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at AHMC Seton Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2026-04-08·warning_notice
Warning Notice
Recorded
2023-09-28·administrative_or_closure
Closure Notice
Recorded
2023-06-05·cap_corrective_action
CAP Request
Recorded

Source: CMS Hospital Care Compare (275 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 AHMC Seton Medical Center.

Price Index: 1.08× regional baseline

Quality: 57/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Pacificare

-48.1%

Median Household Income$156,000U.S. Census ACS

Local Uninsured Share3.9%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 73/100 · Corroborated CMS CCN 050289

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 050289) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-31

Validated Rate Rows10,729 (CMS v3.0.0)

File Integrity DigestVerified · CCN 050289

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