Hospital Profile
Critical Access Hospital Voluntary non-profit - Private 20 Beds · rural
Updated: 2026-07-15
Arkansas Valley Regional Medical Center
1100 Carson Avenue, Lajuna, CO 81050 · 88 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.High Markup · Shop Alternatives
1.77×vs. Fair Market Price
Position vs. 1.00× Fair Price+77% Above 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 +77% above the fair benchmark (1.77×) even 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).67/100 · Caution
67/100Self-Pay Cash Beats Insurance 97% 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 Logic57Coherence (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 Alignment59Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing65Regularity (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.High-Markup · Check Safety
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 FingerprintUpper-Quartile Spread · +80% Tail Jump
Wide Procedure Spread · Upper-Quartile Skew Pricer
Arkansas Valley Regional Medical Center prices routine shoppable procedures at 2.4× Medicare (median 1.46× Fair BaseRate) while upper-quartile commercial rates jump +80% to 2.63× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
#57 of 64 in CO · 87th State Percentile#2,936 of 3,385 in U.S. · 86th National Percentile
Advantage
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.94× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 97% 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 (90.0% AGB cap)
Watchout
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.77× 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 1.46× Fair BaseRate (2.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.63×) jump +80% above the median procedure ratio (Q50 1.46×)
- Unnegotiated chargemaster list prices average 9.7× Medicare (28¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
2.4× Medicare
Pre-scheduled outpatient procedures where patients can comparison-shop.
Back-Door Captive & ER0.50× Divergence
1.2× Medicare
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Quantile Tail Spread+80% Upper Tail
Q25 0.94× · Q50 1.46× · Q75 2.63×
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
2.4× MedicareFair
Outpatient Surgery & ORBack-Door Captive
0.8× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.8× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.9× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
0.8× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.7× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
97% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated
Procedure Prices at Arkansas Valley Regional Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 88 published procedures.
Sort:
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $6,800 | 0.3× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $4,749 | 0.8× |
| Inguinal hernia repair CPT Code: 49505 | $4,053 | 1.1× |
| Upper endoscopy with biopsy CPT Code: 43239 | $4,043 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | $4,033 | unverified |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,271 | 1.0× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,611 | unverified |
| Cataract surgery with lens implant CPT Code: 66984 | $1,678 | 0.7× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,346 | 2.6× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $1,302 | 2.9× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,184 | 3.9× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $1,197 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,003 | 3.0× |
| MRI, brain (no contrast) CPT Code: 70551 | $1,003 | 2.9× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $960 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $931 | 1.6× |
| Trauma team activation HCPCS Code: G0390 | $866 | 0.6× |
| MRI, knee or other leg joint CPT Code: 73721 | $777 | 2.1× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $629 | 2.4× |
| Group therapy session CPT Code: 90853 | $618 | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $587 | 2.4× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $561 | 3.3× |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $578 | unverified |
| Family therapy session CPT Code: 90847 | $576 | unverified |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $502 | 3.0× |
Showing top 25 high-impact procedures of 88 total
Inline Bill X-Ray & 501(r) Calculator
501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 90.0%
Audit a Bill or Quote at Arkansas Valley Regional Medical Center (Zero PHI Required)
CMS CCN: 061336
CPT 470
Fair BaseRate™ $19,432
Medicare Rate $14,044
Self-Pay Cash $6,800
Insurer Median $6,800
Pre-filled with Arkansas Valley Regional 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
501(r) AGB Cap: $10,200 (274% FPL)
Statutory 501(r) AGB Cap Limits Bill to $10,200
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (90.0% of gross = $10,200).
Step 2 · Cash vs. Insurance Arbitrage
Save $4,533 Paying Cash
Self-Pay Cash Rate ($6,800) Beats Your Bill
Arkansas Valley Regional Medical Center's published 45 CFR § 180 self-pay cash rate is $6,800 (vs. $6,800 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: $19,432 Fair BaseRate
Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($19,432).
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)
EIN: 841465990
Filing Period: 199810
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 (90.0% 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 ↑
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
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Arkansas Valley Regional Medical Center.
Price Index: 1.97× regional baseline
Quality: 54/100 CMS composite
Median Household Income$54,897U.S. Census ACS
Local Uninsured Share7.1%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 67/100 · Caution
CMS CCN 061336
EIN 841465990
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Published MRF File841465990_arkansas-valley-regional-medical-center_standardcharges.json
Publication / Vintage2026-07-15 · 20.00 MB
Validated Rate Rows910 (CMS v3.0.0)
File Integrity DigestVerified · CCN 061336
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.