Clearwater Valley Hospital & Clinics
301 Cedar Street, Orofino, ID 83544 · 100 Priced Procedures · 58% Patient Recommendation
Typical commercial prices here are 56% below the fair benchmark (0.44×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.44× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Clearwater Valley Hospital & Clinics prices routine shoppable procedures near 0.6× Medicare (p50 0.43×) while skewing captive emergency, lab, and upper-quartile codes to 1.8× Medicare (p75 0.58×, +35% 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)
- Elective shoppable care is priced 56% below peer Fair BaseRate (0.44×)
- Self-pay cash beats commercial insurance on 50% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 58% 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 (60.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.44× 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 (0.9×) & laboratory (1.1×) services average 3.00× higher multiples than routine shoppable care (0.6×)
- Upper-quartile procedures (Q75 0.58×) jump +35% above the median procedure ratio (Q50 0.43×)
- Unnegotiated chargemaster list prices average 4.9× Medicare (30¢ true HCRIS cost per $1 gross)
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 Clearwater Valley Hospital & Clinics
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 100 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| C-section delivery (full package) CPT Code: 59510 | $2,563 | 0.9× |
| Vaginal delivery (full package) CPT Code: 59400 | $2,319 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,574 | 2.7× |
| Blood transfusion CPT Code: 36430 | $1,315 | 2.6× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,163 | 0.2× |
| Inguinal hernia repair CPT Code: 49505 | $523 | 0.1× |
| Breast lump removal CPT Code: 19120 | $470 | 0.1× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $357 | 1.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $309 | 0.2× |
| Trauma team activation HCPCS Code: G0390 | $231 | 0.2× |
| Breathing treatment (nebulizer) CPT Code: 94640 | $187 | 0.9× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $199 | 0.4× |
| Upper endoscopy with biopsy CPT Code: 43239 | $213 | 0.2× |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $161 | 2.5× |
| Speech therapy (language evaluation) CPT Code: 92507 | $180 | 2.1× |
| X-ray, hand CPT Code: 73130 | $144 | 1.5× |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $169 | 0.9× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $187 | 0.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $158 | 0.4× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $168 | 0.2× |
| Physical therapy (functional capacity test) CPT Code: 97750 | $120 | 3.2× |
| Physical therapy (manual therapy) CPT Code: 97140 | $107 | 3.1× |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $107 | 2.8× |
| X-ray, ankle CPT Code: 73610 | $128 | 1.4× |
| X-ray, foot CPT Code: 73630 | $126 | 1.4× |
Audit a Bill or Quote at Clearwater Valley Hospital & Clinics (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $2,892
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (60.5% of gross = $2,892).
Self-Pay Cash Rate ($3,588) Beats Your Bill
Clearwater Valley Hospital & Clinics's published 45 CFR § 180 self-pay cash rate is $3,588 (vs. $2,563 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $2,975 Fair BaseRate ($2,473 Medicare)
Your bill ($4,784) is $1,809 above the denoised Fair BaseRate ($2,975) and 1.9× the $2,473 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (60.5% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare (102 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 Clearwater Valley Hospital & Clinics.
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.