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Hospital Profile Critical Access Hospital Government - Hospital District or Authority 8 Beds · rural Updated: 2026-09-28

Modoc Medical Center

1111 N Nagle Street, Alturas, CA 96101 · 81 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 4 / 5 Stars
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.Good Deal · Below Fair Market
0.92×vs. Fair Market Price
Position vs. 1.00× Fair Price8% Below Fair Price 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 are 8% below the fair benchmark (0.92×) 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).66/100 · Caution
66/100Self-Pay Cash Beats Insurance 1% 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 Logic94Coherence (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 Alignment73Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount6Cash 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 Rating4/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score69/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait94 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

4-Star CMS clinical quality rating paired with 0.92× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Modoc Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (1.0× Medicare, p50 0.94× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.96× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#34 of 240 in CA · 13th State Percentile#765 of 3,385 in U.S. · 22nd National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 8% below peer Fair BaseRate (0.92×)
  • Self-pay cash beats commercial insurance on 1% of shoppable procedures (25/100 Cash Honesty)
  • 4-Star CMS clinical rating with 69% patient recommendation (69/100 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)

  • Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
  • Commercial insurance median sits at 0.94× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Specialty infusion drugs (J-codes) average 1.2× Medicare — verify per-unit billing on itemized statements
  • Unnegotiated chargemaster list prices average 10.5× Medicare (28¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
1.0× Medicare

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

Back-Door Captive & ER1.00× Divergence
1.0× Medicare

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

Quantile Tail Spread+2% Upper Tail
Q25 0.81× · Q50 0.94× · Q75 0.96×

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
1.0× MedicareGood
Outpatient Surgery & ORBack-Door Captive
1.2× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.2× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
1.7× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
2.3× MedicareFair
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.2× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
1% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
4 CMS · 69/100Fair

Procedure Prices at Modoc Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 81 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Sepsis treatment (inpatient stay)
MS-DRG Code: 871
 $13,495 0.7×
Digestive disorders treatment (inpatient stay)
MS-DRG Code: 392
 $7,601 0.9×
Breast lump removal
CPT Code: 19120
 $3,800 unverified
Inguinal hernia repair
CPT Code: 49505
 $3,475 1.0×
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $2,837 0.5×
Cataract surgery with lens implant
CPT Code: 66984
 $2,334 0.9×
Colonoscopy with biopsy
CPT Code: 45380
 $1,161 0.9×
Colonoscopy (diagnostic)
CPT Code: 45378
 $941 1.0×
Upper endoscopy with biopsy
CPT Code: 43239
 $880 0.9×
Echocardiogram (heart ultrasound)
CPT Code: 93306
 $553 0.9×
Blood transfusion
CPT Code: 36430
 $451 0.9×
Rabies immune globulin
HCPCS Code: 90375
 $338 1.0×
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $356 0.8×
MRI, brain (with and without contrast)
CPT Code: 70553
 $356 0.7×
Ultrasound, leg veins (duplex)
CPT Code: 93970
 $241 0.9×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $244 0.8×
MRI, lower back (no contrast)
CPT Code: 72148
 $244 0.7×
MRI, brain (no contrast)
CPT Code: 70551
 $244 0.7×
MRI, knee or other leg joint
CPT Code: 73721
 $244 0.7×
CT scan, head (with contrast)
CPT Code: 70460
 $179 0.7×
CT scan, head (with and without contrast)
CPT Code: 70470
 $179 0.7×
Hospital observation (per hour)
HCPCS Code: G0378
 $149 1.7×
Breathing treatment (nebulizer)
CPT Code: 94640
 $135 0.7×
X-ray, pelvis
CPT Code: 72170
 $106 1.0×
X-ray, chest (single view)
CPT Code: 71045
 $88 1.0×
Showing top 25 high-impact procedures of 81 total
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Modoc Medical Center (Zero PHI Required)

CMS CCN: 051330
CPT 871
Fair BaseRate™ $19,087
Medicare Rate $14,117
Self-Pay Cash $13,495
Insurer Median $13,495
Pre-filled with Modoc Medical Center’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 Published Cash: $13,495

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Modoc Medical Center's published 45 CFR § 180 self-pay cash rate is $13,495 (vs. $13,495 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $19,087 Fair BaseRate

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

Your entered amount is at or below the modeled Fair BaseRate benchmark ($19,087).

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 Modoc 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 Overall4/5 Stars (4/5)
Safety Composite69/100
Would Recommend69%
Rated 9 or 10 (HCAHPS)72%
Median ER Wait94 min
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

Source: CMS Hospital Care Compare (54 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

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Modoc Medical Center.

Price Index: 1.91× regional baseline
Quality: 67/100 CMS composite
Median Household Income$56,648U.S. Census ACS
Local Uninsured Share9.8%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 051330

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 051330) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileReports.aspx
Publication / Vintage2026-09-28 · 18.56 MB
Validated Rate Rows2,257 (CMS v3.0.0)
File Integrity DigestVerified · CCN 051330

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