How many shoppable procedure prices are published for Jay Hospital?

Jay Hospital in Jay, FL currently has 137 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Jay Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Jay Hospital's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private Updated: 2025-12-23

Jay Hospital

14114 Alabama St, Jay, FL 32565 · 137 Priced Procedures · 90% Patient Recommendation

CMS Overall Rating No CMS Rating

Good Deal · Below Fair Market

0.84×vs. Fair Market Price

Typical commercial prices here are 16% below the fair benchmark (0.84×) after accounting for local nurse/doctor wages and patient complexity.

88/100 · Verified

88/100Self-Pay Cash Beats Insurance 77% of the Time

File Completeness100

Price Logic84

Peer Alignment71

Clean Billing85

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Jay Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (1.0× Medicare, p50 0.80× Fair BaseRate) and emergency/ancillary services (0.9× Medicare, p75 0.99× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#15 of 165 in FL · 8th State Percentile#378 of 3,385 in U.S. · 11th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 16% below peer Fair BaseRate (0.84×)
Self-pay cash beats commercial insurance on 77% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (74/100 safety score) with 90% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (23.5% AGB cap)

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 0.80× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 0.99×) jump +24% above the median procedure ratio (Q50 0.80×)
Consolidated metro market (HHI 2,763) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER0.90× Divergence

0.9× Medicare

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

Quantile Tail Spread+24% Upper Tail

Q25 0.64× · Q50 0.80× · Q75 0.99×

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

1.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.9× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.0× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.8× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

77% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 74/100Fair

Procedure Prices at Jay Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 137 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$23,295	$30,775	0.8×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$15,144	$19,087	0.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$14,553	$19,432	0.7×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$13,657	$17,936	0.8×
Total hip replacement CPT Code: `27130`	—	$6,356	$13,413	0.5×
Total knee replacement CPT Code: `27447`	—	$6,356	$13,523	0.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$6,023	$8,223	0.7×
Bunion correction surgery CPT Code: `28296`	—	$3,717	$3,446	1.1×
Inguinal hernia repair CPT Code: `49505`	—	$2,468	$3,629	0.7×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$2,451	$6,109	0.4×
C-section delivery (full package) CPT Code: `59510`	—	$1,787	$2,975	0.6×
Vaginal delivery (full package) CPT Code: `59400`	—	$1,616	$2,680	0.6×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$1,463	$3,372	0.4×
Trauma team activation HCPCS Code: `G0390`	—	$1,355	$1,453	0.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$1,165	$2,540	0.5×
Breast lump removal CPT Code: `19120`	—	$894	$3,875	0.2×
Rabies immune globulin HCPCS Code: `90375`	$638	$679	$322	2.1×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$673	$981	0.7×
Upper endoscopy with biopsy CPT Code: `43239`	—	$677	$987	0.7×
Colonoscopy with biopsy CPT Code: `45380`	—	$673	$1,256	0.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$300	$561	$583	1.0×
Hospital observation (per hour) HCPCS Code: `G0378`	—	$579	$86	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	—	$517	$1,021	0.5×
Blood transfusion CPT Code: `36430`	$202	$448	$498	0.9×
Psychological testing by technician CPT Code: `96138`	—	$409	$395	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$320	$397	$511	0.8×
Neurobehavioral status check CPT Code: `96116`	—	$394	$231	unverified
Psychological testing evaluation CPT Code: `96136`	—	$394	$128	unverified
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$359	$257	1.4×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$359	$269	1.3×
Behavioral health day treatment HCPCS Code: `H0010`	—	$359	$343	1.0×
Behavioral health residential care HCPCS Code: `H0011`	—	$359	$364	1.0×
Residential mental health treatment HCPCS Code: `H2036`	—	$355	$406	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$255	$366	$448	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$255	$316	$303	1.0×
Injection procedure for pain management HCPCS Code: `G0260`	—	$301	$855	0.4×
Behavioral health day program HCPCS Code: `H2012`	—	$323	$100	unverified
CT scan, head (with contrast) CPT Code: `70460`	$231	$266	$242	1.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$231	$266	$258	1.0×
CT scan, head (no contrast) CPT Code: `70450`	$231	$224	$160	1.4×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$107	$247	$272	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$320	$247	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$320	$247	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$320	$247	$369	0.7×
Mental health services (assessment) HCPCS Code: `H0031`	—	$162	$140	1.2×
Behavioral health assessment HCPCS Code: `H0001`	—	$162	$157	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$162	$185	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$38	$186	$86	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$151	$151	$151	unverified
Group therapy session CPT Code: `90853`	—	$162	$100	unverified
Behavioral health living support HCPCS Code: `H2019`	—	$87	$34	2.6×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$87	$88	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$45	$86	$87	1.0×
X-ray, shoulder CPT Code: `73030`	$78	$90	$92	1.0×
X-ray, lower back CPT Code: `72110`	$78	$109	$112	1.0×
Care planning with family CPT Code: `90887`	—	$104	$107	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$78	$90	$93	1.0×
X-ray, ankle CPT Code: `73610`	$78	$90	$93	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$53	$111	$123	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$105	$109	$126	0.9×
Ultrasound, pelvis CPT Code: `76856`	$105	$111	$130	0.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$105	$111	$134	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$105	$109	$132	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$45	$86	$110	0.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$48	$86	$123	0.7×
CT scan, pelvis CPT Code: `72192`	$231	$109	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$231	$109	$166	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$231	$109	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$231	$109	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$231	$109	$169	0.6×
Family therapy session CPT Code: `90847`	—	$104	$173	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$98	$166	0.6×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$98	$181	0.5×
X-ray, pelvis CPT Code: `72170`	$78	$109	$110	unverified
X-ray, hand CPT Code: `73130`	$78	$90	$93	unverified
X-ray, foot CPT Code: `73630`	$78	$90	$92	unverified
Typhoid vaccine HCPCS Code: `90675`	$315	$315	$347	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$196	$196	$140	1.4×
Mental health services (therapy) HCPCS Code: `H0032`	—	$64	$65	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$48	$61	$64	1.0×
X-ray, chest (single view) CPT Code: `71045`	$45	$74	$92	0.8×
X-ray, chest (two views) CPT Code: `71046`	$57	$74	$93	0.8×
X-ray, hip CPT Code: `73502`	$78	$74	$93	0.8×
Review of medical records for care CPT Code: `90889`	—	$64	$114	0.6×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$248	$81	$203	0.4×
Electrical stimulation therapy HCPCS Code: `G0283`	$9	$23	$14	1.6×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$26	$26	$20	1.3×
Physical therapy (gait training) CPT Code: `97116`	$14	$38	$33	1.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$15	$46	$40	1.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$16	$42	$38	1.1×
Occupational therapy (self-care training) CPT Code: `97535`	$17	$42	$38	1.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$17	$38	$35	1.1×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$32	$35	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$46	$148	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$13	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$17	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$13	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$9	$4	$4	1.0×
Blood test, potassium CPT Code: `84132`	$15	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$9	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$11	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$3	$3	$3	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$11	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$33	$9	$9	1.0×
Blood test, basic metabolic panel CPT Code: `80048`	$21	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$17	$8	$9	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$24	$27	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$8	$45	$201	0.2×
Culture, blood CPT Code: `87040`	$34	$9	$11	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$14	$4	$5	0.8×
Blood test, vitamin B12 CPT Code: `82607`	$23	$12	$16	0.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$26	$8	$11	0.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$18	$25	0.7×
Blood test, amylase CPT Code: `82150`	$10	$5	$7	0.7×
Blood test, ferritin (iron stores) CPT Code: `82728`	$16	$10	$14	0.7×
Blood test, lipase CPT Code: `83690`	$29	$5	$7	0.7×
Blood test, magnesium CPT Code: `83735`	$13	$5	$7	0.7×
Blood test, vitamin D CPT Code: `82306`	$20	$22	$31	0.7×
Flu vaccine (high dose) HCPCS Code: `90656`	$50	$17	$25	0.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$6	$12	$18	0.7×
Hepatitis C antibody test CPT Code: `86803`	$11	$10	$15	0.7×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$24	$38	0.6×
Blood test, complete blood count (CBC) CPT Code: `85025`	$15	$5	$8	0.6×
Blood test, PSA (prostate screen) CPT Code: `84153`	$16	$11	$19	0.6×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$5	$8	$14	0.6×
Flu vaccine injection HCPCS Code: `G0008`	$21	$27	$48	0.6×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$27	$49	0.6×
Colorectal cancer screening HCPCS Code: `G0010`	—	$27	$49	0.6×
Prosthetic fitting and training CPT Code: `97761`	—	$24	$45	0.5×
Orthotic fitting and training CPT Code: `97760`	—	$24	$51	0.5×
Hepatitis B vaccine HCPCS Code: `90744`	$51	$17	$37	0.5×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$58	$17	$39	0.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$17	$56	0.3×
Blood antibody screen CPT Code: `86850`	$31	$12	$46	0.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$147	$17	$111	0.2×
Physical therapy (manual therapy) CPT Code: `97140`	$15	$36	$34	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$3	$3	$10	0.3×

Showing top 25 high-impact procedures of 137 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 23.5%

Audit a Bill or Quote at Jay Hospital (Zero PHI Required)

CMS CCN: 101315

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $23,295

1. Amount on Your Bill or Quote ($) Pre-filled with Jay Hospital’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $13,161 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $13,161

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (23.5% of gross = $13,161).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Jay Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$25,133 Above Fair BaseRate

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

Your bill ($55,908) is $25,133 above the denoised Fair BaseRate ($30,775) and 2.4× 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)

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 (23.5% 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

Safety Composite74/100

Would Recommend90%

Rated 9 or 10 (HCAHPS)91%

Median ER Wait133 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Source: CMS Hospital Care Compare (44 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 Quality & Price Benchmark Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Jay Hospital.

Price Index: 0.87× regional baseline

Quality: 60/100 CMS composite

Median Household Income$88,968U.S. Census ACS

Local Uninsured Share10.4%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 88/100 · Verified CMS CCN 101315

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 101315) ↗ CMS HCRIS Cost Reports ↗

Published MRF Filejay

Publication / Vintage2025-12-23 · 241.04 MB

Validated Rate Rows4,292 (CMS v3.0.0)

File Integrity Digest42e8f5056e2a04f68fb2…

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