Ochsner Medical Center Acute
1516 Jefferson Hwy, New Orleans, LA 70121 · 118 Priced Procedures · 73% Patient Recommendation
Typical commercial prices here are +30% above the fair benchmark (1.30×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.30× fair market pricing.
Cash-Arbitrage Bifurcated Pricer
Ochsner Medical Center Acute maintains elevated commercial insurance contracts (1.30× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 77% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.96× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 77% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 73% patient recommendation (68/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (45.2% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 3.3× markup over Medicare rates
- Commercial insurance median sits at 1.32× Fair BaseRate (2.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.69×) jump +28% above the median procedure ratio (Q50 1.32×)
- Unnegotiated chargemaster list prices average 6.0× Medicare (24¢ 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 Ochsner Medical Center Acute
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 118 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $46,460 | unverified |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $17,532 | unverified |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $16,892 | unverified |
| Total knee replacement CPT Code: 27447 | — | — |
| Total hip replacement CPT Code: 27130 | $11,814 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $11,747 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $11,568 | 1.9× |
| Breast lump removal CPT Code: 19120 | $5,193 | unverified |
| Inguinal hernia repair CPT Code: 49505 | $3,240 | 0.9× |
| Bunion correction surgery CPT Code: 28296 | $2,979 | 0.9× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $2,979 | unverified |
| Vaginal delivery (full package) CPT Code: 59400 | $2,502 | 0.9× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,300 | 2.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,300 | 1.8× |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,168 | 2.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,094 | 0.8× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,068 | 2.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,119 | 2.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $983 | 2.2× |
| Blood transfusion CPT Code: 36430 | $960 | 1.9× |
| MRI, lower back (no contrast) CPT Code: 72148 | $917 | 2.7× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $940 | 1.6× |
| MRI, brain (no contrast) CPT Code: 70551 | $916 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $913 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $750 | unverified |
Audit a Bill or Quote at Ochsner Medical Center Acute (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $86,851
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (45.1% of gross = $86,851).
Self-Pay Cash Rate ($42,319) Beats Your Bill
Ochsner Medical Center Acute's published 45 CFR § 180 self-pay cash rate is $42,319 (vs. $46,460 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($192,361) is $161,586 above the denoised Fair BaseRate ($30,775) and 8.2× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (45.1% 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
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (1,844 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 Ochsner Medical Center Acute.
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.