Montrose Regional Health
800 S 3Rd St, Montrose, CO 81401 · 110 Priced Procedures · 74% Patient Recommendation
Typical commercial prices here are 17% below the fair benchmark (0.83×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.83× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Montrose Regional Health maintains low, disciplined commercial pricing across both routine shoppable procedures (0.7× Medicare, p50 0.90× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.97× 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 17% below peer Fair BaseRate (0.83×)
- Self-pay cash beats commercial insurance on 60% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 74% patient recommendation (73/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (56.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.83× 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.
- Captive ER (0.8×) & laboratory (1.7×) services average 1.43× higher multiples than routine shoppable care (0.7×)
- Even at low-cost facilities (0.83× 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.
- Consolidated metro market (HHI 10,000) 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 Montrose Regional Health
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 110 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $15,078 | 0.8× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $14,973 | 0.8× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $13,685 | 0.8× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $6,052 | 0.7× |
| C-section delivery (full package) CPT Code: 59510 | $4,046 | 1.4× |
| Vaginal delivery (full package) CPT Code: 59400 | $3,639 | 1.4× |
| Total hip replacement CPT Code: 27130 | $3,058 | 0.2× |
| Total knee replacement CPT Code: 27447 | $3,051 | 0.2× |
| Trauma team activation HCPCS Code: G0390 | $1,506 | 1.0× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,051 | 0.2× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $874 | 0.3× |
| Inguinal hernia repair CPT Code: 49505 | $848 | 0.2× |
| Injection procedure for pain management HCPCS Code: G0260 | $797 | 0.9× |
| Bunion correction surgery CPT Code: 28296 | $819 | 0.2× |
| Blood transfusion CPT Code: 36430 | $498 | 1.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $371 | unverified |
| X-ray, hand CPT Code: 73130 | $279 | 3.0× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $277 | 0.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $299 | 0.2× |
| Breathing treatment (nebulizer) CPT Code: 94640 | $238 | 1.2× |
| X-ray, pelvis CPT Code: 72170 | $200 | 1.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $204 | 0.5× |
| Upper endoscopy with biopsy CPT Code: 43239 | $209 | 0.2× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $204 | 0.2× |
| New patient office visit (30-44 min) CPT Code: 99203 | $119 | 1.1× |
Audit a Bill or Quote at Montrose Regional Health (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $28,369
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (56.3% of gross = $28,369).
Self-Pay Cash Rate ($37,772) Beats Your Bill
Montrose Regional Health's published 45 CFR § 180 self-pay cash rate is $37,772 (vs. $15,078 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($50,363) is $31,276 above the denoised Fair BaseRate ($19,087) and 3.6× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (56.3% 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
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Montrose Regional Health. Prior administrative notices do not necessarily reflect current compliance status.
- 2024-02-21·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare (356 completed HCAHPS patient surveys). 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 Montrose Regional Health.
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.