St Anthony Summit Medical Center
340 Peak One Drive, Frisco, CO 80443 · 124 Priced Procedures · 85% Patient Recommendation
Typical commercial prices here are +23% above the fair benchmark (1.23×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.23× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
St Anthony Summit Medical Center prices routine shoppable procedures near 3.2× Medicare (p50 1.08×) while skewing captive emergency, lab, and upper-quartile codes to 5.5× Medicare (p75 1.70×, +57% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.76× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 76% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 85% patient recommendation (74/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (46.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.6× markup over Medicare rates
- Captive ER (2.4×) & laboratory (2.5×) services average 1.72× higher multiples than routine shoppable care (3.2×)
- Upper-quartile procedures (Q75 1.70×) jump +57% above the median procedure ratio (Q50 1.08×)
- Consolidated metro market (HHI 8,113) 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 St Anthony Summit Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 124 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $46,380 | 1.5× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $27,694 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $15,552 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,945 | unverified |
| Trauma team activation HCPCS Code: G0390 | $3,966 | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $3,221 | unverified |
| C-section delivery (full package) CPT Code: 59510 | $2,553 | 0.9× |
| Vaginal delivery (full package) CPT Code: 59400 | $2,306 | 0.9× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,879 | unverified |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,760 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,695 | unverified |
| CT scan, pelvis CPT Code: 72192 | $1,674 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $1,657 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,626 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,359 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $1,240 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $1,155 | unverified |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,139 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,101 | unverified |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,018 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $913 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $890 | unverified |
| Blood transfusion CPT Code: 36430 | $843 | unverified |
| Mental health services (assessment) HCPCS Code: H0031 | $829 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $799 | unverified |
Audit a Bill or Quote at St Anthony Summit Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $51,304
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (46.1% of gross = $51,304).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask St Anthony Summit Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($111,312) is $80,537 above the denoised Fair BaseRate ($30,775) and 4.7× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (46.1% 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)Source: CMS Hospital Care Compare (185 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 St Anthony Summit Medical Center.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
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.