Madera Community Hospital
1250 E Almond Ave, Madera, CA 93637 · 78 Priced Procedures
Typical commercial prices here are 16% below the fair benchmark (0.84×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Uniform Value Leader · Low-Cost Across Departments
Madera Community Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (1.2× Medicare, p50 0.96× Fair BaseRate) and emergency/ancillary services (0.9× Medicare, p75 1.05× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 16% below peer Fair BaseRate (0.84×)
- Self-pay cash beats commercial insurance on 20% 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 (25.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
- Commercial insurance median sits at 0.96× Fair BaseRate (1.2× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.4× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 3,609) 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 Madera Community Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 78 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $703 | 1.2× |
| Blood transfusion CPT Code: 36430 | $624 | 1.3× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $471 | 1.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $471 | 0.9× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $307 | 1.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $314 | 1.0× |
| MRI, lower back (no contrast) CPT Code: 72148 | $322 | 1.0× |
| MRI, brain (no contrast) CPT Code: 70551 | $322 | 0.9× |
| MRI, knee or other leg joint CPT Code: 73721 | $322 | 0.9× |
| CT scan, head (with contrast) CPT Code: 70460 | $237 | 1.0× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $237 | 0.9× |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $176 | 1.2× |
| X-ray, pelvis CPT Code: 72170 | $134 | 1.2× |
| X-ray, lower back CPT Code: 72110 | $134 | 1.2× |
| Screening mammogram (both breasts) CPT Code: 77067 | $142 | 1.2× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $134 | 1.1× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $141 | 1.1× |
| Ultrasound, pelvis CPT Code: 76856 | $134 | 1.0× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $134 | 1.0× |
| CT scan, head (no contrast) CPT Code: 70450 | $141 | 0.9× |
| CT scan, pelvis CPT Code: 72192 | $141 | 0.9× |
| CT scan, sinuses CPT Code: 70486 | $141 | 0.8× |
| CT scan, chest (no contrast) CPT Code: 71250 | $141 | 0.8× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $141 | 0.8× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $141 | 0.8× |
Audit a Bill or Quote at Madera Community Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $323
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (25.4% of gross = $323).
Self-Pay Cash Rate ($761) Beats Your Bill
Madera Community Hospital's published 45 CFR § 180 self-pay cash rate is $761 (vs. $703 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $583 Fair BaseRate ($558 Medicare)
Your bill ($1,268) is $685 above the denoised Fair BaseRate ($583) and 2.3× the $558 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (25.4% 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
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Madera Community Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2026-04-16·cap_corrective_action
CAP Request
Recorded - 2026-01-09·warning_notice
Warning Notice
Recorded - 2023-07-11·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare. 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 Madera Community Hospital.
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.