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Hospital Profile Acute Care Hospital Voluntary non-profit - Private 143 Beds · rural Updated: 4/1/2026

Midstate Medical Center

435 Lewis Avenue, Meriden, CT 06450 · 91 Priced Procedures · 75% 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
0.89×vs. Fair Market Price
Position vs. 1.00× Fair Price11% 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 11% below the fair benchmark (0.89×) 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).57/100 · Caution
57/100Self-Pay Cash Beats Insurance 10% of the Time
File Completeness55Provenance (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 Logic91Coherence (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 Alignment52Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing68Regularity (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 Score70/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait223 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 0.89× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Midstate Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (1.1× Medicare, p50 0.96× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 1.03× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#8 of 21 in CT · 33rd State Percentile#572 of 3,385 in U.S. · 16th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 11% below peer Fair BaseRate (0.89×)
  • Self-pay cash beats commercial insurance on 10% of shoppable procedures (25/100 Cash Honesty)
  • 4-Star CMS clinical rating with 75% patient recommendation (70/100 safety score)
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (23.0% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (0.89× 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 0.96× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Even at low-cost facilities (0.89× 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.
  • Unnegotiated chargemaster list prices average 6.1× Medicare (17¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
1.1× Medicare

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

Back-Door Captive & ER0.91× Divergence
1.0× Medicare

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

Quantile Tail Spread+7% Upper Tail
Q25 0.50× · Q50 0.96× · Q75 1.03×

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
1.1× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.7× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.7× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.9× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.3× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.8× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
10% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
4 CMS · 70/100Fair

Procedure Prices at Midstate Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 91 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Spinal fusion, single level (inpatient stay)
MS-DRG Code: 451
 $89,394 2.9×
Hip or knee replacement (inpatient stay)
MS-DRG Code: 470
 $19,321 1.0×
Sepsis treatment (inpatient stay)
MS-DRG Code: 871
 $9,006 0.5×
Digestive disorders treatment (inpatient stay)
MS-DRG Code: 392
 $8,829 1.1×
Total hip replacement
CPT Code: 27130
 $5,247 0.4×
Total knee replacement
CPT Code: 27447
 $5,247 0.4×
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $2,092 0.3×
Breast lump removal
CPT Code: 19120
 $1,600 0.4×
Knee arthroscopy with meniscus repair
CPT Code: 29881
 $1,337 0.4×
Bunion correction surgery
CPT Code: 28296
 $1,337 0.4×
Inguinal hernia repair
CPT Code: 49505
 $1,330 0.4×
Rabies immune globulin
HCPCS Code: 90375
 $693 2.2×
MRI, brain (with and without contrast)
CPT Code: 70553
 $586 1.1×
Colonoscopy with biopsy
CPT Code: 45380
 $489 0.4×
MRI, brain (no contrast)
CPT Code: 70551
 $359 1.0×
MRI, knee or other leg joint
CPT Code: 73721
 $374 1.0×
Colonoscopy (diagnostic)
CPT Code: 45378
 $380 0.4×
Upper endoscopy with biopsy
CPT Code: 43239
 $371 0.4×
Sleep study (overnight, in lab)
CPT Code: 95810
 $351 0.3×
CT scan, head (with contrast)
CPT Code: 70460
 $256 1.1×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $272 0.9×
Injection procedure for pain management
HCPCS Code: G0260
 $288 0.3×
Ultrasound, pelvis
CPT Code: 76856
 $168 1.3×
Ultrasound, thyroid and neck
CPT Code: 76536
 $168 1.3×
Ultrasound, abdomen (complete)
CPT Code: 76700
 $168 1.3×
Showing top 25 high-impact procedures of 91 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 23.0%

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

CMS CCN: 070017
CPT 451
Fair BaseRate™ $30,775
Medicare Rate $23,504
Self-Pay Cash $89,394
Insurer Median $89,394
Pre-filled with Midstate 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: $20,525 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $20,525

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (23.0% of gross = $20,525).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $89,394

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Midstate Medical Center's published 45 CFR § 180 self-pay cash rate is $89,394 (vs. $89,394 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$58,619 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($89,394) is $58,619 above the denoised Fair BaseRate ($30,775) and 3.8× the $23,504 Medicare rate.

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: 060646715
Filing Period: 192306
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 (23.0% 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 ↑
CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)
Safety Composite70/100
Would Recommend75%
Rated 9 or 10 (HCAHPS)76%
Median ER Wait223 min
Left ER Before Seen1%
30-Day Mortality vs U.S.same
Unplanned Readmissionsame
Hip/Knee Complication Rate4.7%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)
Central-Line Bloodstream Infectionbetter
C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Midstate Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

  • 2025-02-05·administrative_or_closure

    Met Requirements

    Recorded

Source: CMS Hospital Care Compare (1,057 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

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

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

Price Index: 0.68× regional baseline
Quality: 76/100 CMS composite
Median Household Income$68,961U.S. Census ACS
Local Uninsured Share4.8%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 57/100 · Caution CMS CCN 070017 EIN 060646715

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 070017) ↗ Verify IRS Form 990 (EIN 060646715) ↗ CMS HCRIS Cost Reports ↗
Published MRF File060646715_midstate_medical_center_standardcharges.csv
Publication / Vintage4/1/2026 · 36.26 MB
Validated Rate Rows1,165 (CMS v3.0.0)
File Integrity DigestVerified · CCN 070017

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