Lost Rivers Medical Center
551 Highland Drive, Arco, ID 83213 · 98 Priced Procedures
Typical commercial prices here are +85% above the fair benchmark (1.85×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Lost Rivers Medical Center prices routine shoppable procedures at 3.9× Medicare (median 1.37× Fair BaseRate) while upper-quartile commercial rates jump +120% to 3.01× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.88× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 44% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (85/100 safety score) with 72% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.7× markup over Medicare rates
- Commercial insurance median sits at 1.37× Fair BaseRate (3.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 3.01×) jump +120% above the median procedure ratio (Q50 1.37×)
- Consolidated metro market (HHI 4,725) 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 Lost Rivers Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 98 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Inguinal hernia repair CPT Code: 49505 | $10,784 | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $6,436 | unverified |
| Bunion correction surgery CPT Code: 28296 | $3,599 | 1.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $3,150 | 6.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,800 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $2,280 | 7.5× |
| MRI, lower back (no contrast) CPT Code: 72148 | $2,150 | 6.4× |
| MRI, brain (no contrast) CPT Code: 70551 | $2,125 | 6.2× |
| MRI, knee or other leg joint CPT Code: 73721 | $2,150 | 5.8× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,820 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,752 | 3.0× |
| CT scan, sinuses CPT Code: 70486 | $1,600 | 9.6× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,580 | 9.4× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,560 | 9.2× |
| CT scan, pelvis CPT Code: 72192 | $1,480 | 9.1× |
| Trauma team activation HCPCS Code: G0390 | $1,498 | 1.0× |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,460 | 8.7× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,460 | 6.0× |
| Blood transfusion CPT Code: 36430 | $1,422 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $1,360 | 8.5× |
| Hepatitis B immune globulin HCPCS Code: 90371 | $1,040 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $819 | 3.0× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $660 | 4.9× |
| X-ray, lower back CPT Code: 72110 | $575 | 5.1× |
| Ultrasound, pelvis CPT Code: 76856 | $600 | 4.6× |
Audit a Bill or Quote at Lost Rivers Medical Center (Zero PHI Required)
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.
Self-Pay Cash Rate ($9,082) Beats Your Bill
Lost Rivers Medical Center's published 45 CFR § 180 self-pay cash rate is $9,082 (vs. $10,784 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $3,629 Fair BaseRate ($3,658 Medicare)
Your bill ($11,352) is $7,723 above the denoised Fair BaseRate ($3,629) and 3.1× the $3,658 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Lost Rivers 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.
Clinical Quality, Patient Experience & Infection Benchmarks
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Lost Rivers Medical Center. Prior administrative notices do not necessarily reflect current compliance status.
- 2024-05-30·administrative_or_closure
Closure Notice
Recorded - 2024-02-23·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare. 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 Lost Rivers 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.