How many shoppable procedure prices are published for North Shore Medical Center?

North Shore Medical Center in Miami, FL currently has 115 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do North Shore Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, North Shore Medical Center's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

What is North Shore Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns North Shore Medical Center an overall hospital quality rating of 1 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 748 Beds · urban Updated: 2025-02-21

North Shore Medical Center

1100 Nw 95Th St, Miami, FL 33150 · 115 Priced Procedures · 46% Patient Recommendation

CMS Overall Rating 1 / 5 Stars

Near Fair BaseRate Benchmark

0.99×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (0.99×) after accounting for local nurse/doctor wages and patient complexity.

77/100 · Corroborated

77/100Self-Pay Cash Beats Insurance 11% of the Time

File Completeness90

Price Logic86

Peer Alignment79

Clean Billing90

Real Cash Discount31

Regional Benchmark Tier

1-Star CMS clinical quality rating paired with 0.99× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

North Shore Medical Center prices shoppable and inpatient services (1.1× to 1.3× Medicare, divergence 1.18×) in alignment with regional hospital peers (0.99× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#52 of 165 in FL · 30th State Percentile#1,224 of 3,385 in U.S. · 36th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.87× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 11% of shoppable procedures (31/100 Cash Honesty)
1-Star CMS clinical rating with 46% patient recommendation (48/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.99× 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 (1.1×) & laboratory (0.8×) services average 1.18× higher multiples than routine shoppable care (1.1×)
Even at low-cost facilities (0.99× 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 18.3× Medicare (14¢ 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 & ER1.18× Divergence

1.3× Medicare

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

Quantile Tail Spread+11% Upper Tail

Q25 0.87× · Q50 1.03× · Q75 1.14×

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

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.7× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.1× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.8× MedicareGood

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

1.0× MedicareGood

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

11% Cash Edge · 31/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

1 CMS · 48/100Watchout

Procedure Prices at North Shore Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 115 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$18,343	$23,569	$19,432	unverified
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$17,028	$21,675	$17,936	1.2×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$18,451	$21,055	$19,087	1.1×
Total hip replacement CPT Code: `27130`	$13,174	$13,407	$13,413	1.0×
Total knee replacement CPT Code: `27447`	$13,174	$13,407	$13,523	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$9,232	$9,599	$8,223	1.2×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$6,212	$6,805	$6,109	1.1×
Breast lump removal CPT Code: `19120`	$4,023	$4,498	$3,875	1.2×
Inguinal hernia repair CPT Code: `49505`	$3,679	$4,113	$3,629	1.1×
Bunion correction surgery CPT Code: `28296`	$3,362	$4,035	$3,446	1.2×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$3,362	$3,759	$3,372	1.1×
Cataract surgery with lens implant CPT Code: `66984`	$2,371	$2,892	$2,540	1.1×
Rabies immune globulin HCPCS Code: `90375`	$2,812	$2,812	$322	unverified
Vaginal delivery (full package) CPT Code: `59400`	—	$1,740	$2,680	0.6×
Colonoscopy with biopsy CPT Code: `45380`	$1,230	$1,500	$1,256	1.2×
C-section delivery (full package) CPT Code: `59510`	—	$1,511	$2,975	0.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$956	$1,165	$981	1.2×
Upper endoscopy with biopsy CPT Code: `43239`	$932	$1,137	$987	1.2×
Sleep study (overnight, in lab) CPT Code: `95810`	$16,581	$1,051	$1,021	1.0×
Injection procedure for pain management HCPCS Code: `G0260`	$2,605	$715	$855	0.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$7,092	$613	$583	1.1×
Blood transfusion CPT Code: `36430`	$1,271	$508	$498	1.0×
MRI, knee or other leg joint CPT Code: `73721`	$8,833	$385	$369	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$19,424	$364	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$15,259	$385	$511	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$966	$229	$201	1.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$3,342	$249	$272	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$16,192	$257	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$11,129	$260	$338	0.8×
MRI, brain (no contrast) CPT Code: `70551`	$8,466	$260	$343	0.8×
CT scan, head (with contrast) CPT Code: `70460`	$9,374	$205	$242	0.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$11,691	$206	$258	0.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$1,385	$212	$123	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	$304	$184	$166	1.1×
Family therapy session CPT Code: `90847`	$304	$185	$173	1.1×
Psychiatric evaluation (first visit) CPT Code: `90791`	$392	$185	$185	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	$1,178	$200	$110	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$1,214	$191	$87	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$685	$156	$151	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$874	$92	$86	1.1×
Group therapy session CPT Code: `90853`	$288	$106	$100	1.1×
X-ray, pelvis CPT Code: `72170`	$1,482	$109	$110	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$1,127	$130	$148	0.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$6,605	$117	$134	0.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$3,093	$110	$126	0.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$3,176	$115	$132	0.9×
Ultrasound, pelvis CPT Code: `76856`	$3,937	$113	$130	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$9,883	$129	$160	0.8×
CT scan, sinuses CPT Code: `70486`	$8,200	$130	$166	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$6,307	$130	$167	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$8,125	$130	$168	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$8,909	$130	$169	0.8×
CT scan, pelvis CPT Code: `72192`	$7,633	$125	$163	0.8×
X-ray, chest (single view) CPT Code: `71045`	$1,396	$91	$92	1.0×
X-ray, shoulder CPT Code: `73030`	$2,209	$91	$92	1.0×
X-ray, foot CPT Code: `73630`	$2,169	$91	$92	1.0×
X-ray, chest (two views) CPT Code: `71046`	$2,705	$91	$93	1.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$1,884	$91	$93	1.0×
X-ray, hand CPT Code: `73130`	$1,933	$91	$93	1.0×
X-ray, hip CPT Code: `73502`	$2,339	$91	$93	1.0×
X-ray, ankle CPT Code: `73610`	$2,034	$91	$93	1.0×
X-ray, lower back CPT Code: `72110`	$3,666	$109	$112	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$782	$95	$123	0.8×
Typhoid vaccine HCPCS Code: `90675`	$2,274	$347	$347	1.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$198	$203	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$510	$87	$111	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$401	$51	$38	1.3×
Blood antibody screen CPT Code: `86850`	$349	$53	$46	1.2×
Flu vaccine injection HCPCS Code: `G0008`	$360	$54	$48	1.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$330	$44	$40	1.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$1,309	$68	$64	1.1×
Pneumococcal vaccine HCPCS Code: `90732`	$48	$73	$140	0.5×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$397	$41	$38	1.1×
Electrical stimulation therapy HCPCS Code: `G0283`	$552	$15	$14	1.1×
Physical therapy (gait training) CPT Code: `97116`	$306	$35	$33	1.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$388	$37	$35	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$526	$35	$34	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$195	$49	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$234	$49	$49	1.0×
Orthotic fitting and training CPT Code: `97760`	$290	$48	$51	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$263	$46	$56	0.8×
Hospital observation (per hour) HCPCS Code: `G0378`	$218	$59	$86	0.7×
Blood test, vitamin D CPT Code: `82306`	$246	$32	$31	1.0×
Drug screening test HCPCS Code: `G0480`	$38	$38	$116	0.3×
Diagnostic procedure preparation HCPCS Code: `G0279`	$296	$56	$35	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	—	$4	$3	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$239	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$312	$5	$4	1.3×
Blood test, calcium CPT Code: `82310`	$349	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$245	$6	$5	1.2×
Blood test, potassium CPT Code: `84132`	$399	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$182	$6	$5	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	$13	$11	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$731	$7	$6	1.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$969	$16	$14	1.1×
Blood test, amylase CPT Code: `82150`	—	$8	$7	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$484	$16	$14	1.1×
Blood test, lipase CPT Code: `83690`	$1,158	$8	$7	1.1×
Blood test, magnesium CPT Code: `83735`	$258	$8	$7	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$371	$18	$16	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$613	$9	$8	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$1,219	$10	$9	1.1×
Blood test, liver function panel CPT Code: `80076`	$850	$10	$9	1.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$1,396	$20	$18	1.1×
Culture, bacterial CPT Code: `87070`	$1,481	$10	$9	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$596	$21	$19	1.1×
Prosthetic fitting and training CPT Code: `97761`	$319	$44	$45	1.0×
Culture, blood CPT Code: `87040`	$880	$12	$11	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$675	$10	$10	1.0×
Blood test, hemoglobin CPT Code: `85018`	$340	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$338	$5	$5	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$155	$27	$39	0.7×
Flu vaccine (high dose) HCPCS Code: `90656`	$64	$15	$25	0.6×
Hepatitis B vaccine HCPCS Code: `90744`	$86	$21	$37	0.6×
Hepatitis C antibody test CPT Code: `86803`	$5	$5	$15	unverified

Showing top 25 high-impact procedures of 115 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

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

CMS CCN: 100029

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $18,343

Insurer Median $23,569

1. Amount on Your Bill or Quote ($) Pre-filled with North Shore Medical Center’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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $38,223 Paying Cash

Self-Pay Cash Rate ($18,343) Beats Your Bill

North Shore Medical Center's published 45 CFR § 180 self-pay cash rate is $18,343 (vs. $23,569 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$37,134 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($56,566) is $37,134 above the denoised Fair BaseRate ($19,432) and 4.0× the $14,044 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) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 995020733

Public IRS & CMS ownership records classify North Shore Medical Center as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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 Overall1/5 Stars (1/5)

Safety Composite48/100

Would Recommend46%

Rated 9 or 10 (HCAHPS)47%

Median ER Wait176 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionworse

Hip/Knee Complication Rate3.8%

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 North Shore Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-05-30·administrative_or_closure
Closure Notice
Recorded
2025-02-24·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (450 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

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

Price Index: 0.86× regional baseline

Quality: 28/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Curative Administrators

-58.3%

Auto Insurance

-41.9%

AvMed

-41.5%

Magellan Behavioral Health

+83.2%

Median Household Income$68,694U.S. Census ACS

Local Uninsured Share14.3%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 77/100 · Corroborated CMS CCN 100029 EIN 995020733

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 100029) ↗ Verify IRS Form 990 (EIN 995020733) ↗ CMS HCRIS Cost Reports ↗

Published MRF File995020733_hsa-nsmc-llc_standardcharges.csv

Publication / Vintage2025-02-21 · 245.12 MB

Validated Rate Rows17,292 (CMS v2.0.0)

File Integrity Digest7a6e7fb97374ee862e5e…

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