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Hospital Profile General Acute Care Hospital Updated: 2026-02-03

Central Valley Specialty Hospital

730 17Th St, Modesto, CA 95354 · 1 Priced Procedures

CMS Overall Rating No CMS Rating
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

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

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).30/100 · Quarantined
30/100Self-Pay Cash Beats Insurance 0% of the Time
File Completeness60Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic0Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment0Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing0Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

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

Behavioral Pricing FingerprintHigh Infusion / OR Multiples

Specialty Drug & Surgical Margin Engine

Central Valley Specialty Hospital concentrates commercial margin in outpatient surgical suites (16.5× Medicare) and specialty drug infusions (4.8× Medicare) relative to routine diagnostics (14.3×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.

Regional Benchmark in CAU.S. National Reference Pool
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (54/100 safety score) with 72% 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 16.5× markup over Medicare rates
  • Captive ER (19.1×) & laboratory (17.4×) services average 1.25× higher multiples than routine shoppable care (13.2×)
  • Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
  • Unnegotiated chargemaster list prices average 13.2× Medicare (14¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
13.2× Medicare

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

Back-Door Captive & ER1.25× Divergence
16.5× Medicare

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

Quantile Tail Spread+28% Upper Tail
Q25 0.78× · Q50 1.00× · Q75 1.28×

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
13.2× MedicareWatchout
Outpatient Surgery & ORBack-Door Captive
16.5× MedicareWatchout
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
14.3× MedicareWatchout
Back-Door Captive ER VisitsBack-Door Captive
19.1× MedicareWatchout
Inpatient Lab & PathologyBack-Door Captive
17.4× MedicareWatchout
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
4.8× MedicareWatchout
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated

Procedure Prices at Central Valley Specialty Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 1 published procedures.

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Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Sepsis treatment (inpatient stay)
MS-DRG Code: 871
 $111,751 unverified
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Central Valley Specialty Hospital (Zero PHI Required)

CMS CCN: 052055
CPT 871
Fair BaseRate™ $19,087
Medicare Rate $14,117
Self-Pay Cash $111,751
Insurer Median $111,751
Pre-filled with Central Valley Specialty Hospital’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
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 $74,501 Paying Cash

Self-Pay Cash Rate ($111,751) Beats Your Bill

Central Valley Specialty Hospital's published 45 CFR § 180 self-pay cash rate is $111,751 (vs. $111,751 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$167,165 Above Fair BaseRate

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

Your bill ($186,252) is $167,165 above the denoised Fair BaseRate ($19,087) and 13.2× 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 Central Valley Specialty Hospital 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 ↑
Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

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

Regional Value & Quality Leader

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Central Valley Specialty Hospital.

Price Index: 1.00× regional baseline
Quality: 54/100 CMS composite
Median Household Income$65,643U.S. Census ACS
Local Uninsured Share5.4%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 30/100 · Quarantined CMS CCN 052055

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

MRF Portal Indexed (Reports.aspx) Verify on CMS Medicare.gov (CCN 052055) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileReports.aspx
Publication / Vintage2026-02-03 · 0.74 MB
Validated Rate Rows0 (CMS v3.0.0)
File Integrity DigestVerified · CCN 052055

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