Martha's Vineyard Hospital Inc
One Hospital Road, First Fl, Wing 5, Po Box 1477, Oak Bluffs, MA 02557 · 95 Priced Procedures · 81% Patient Recommendation
Typical commercial prices here are +338% above the fair benchmark (4.38×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 4.38× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Martha's Vineyard Hospital Inc prices routine shoppable procedures near 5.4× Medicare (p50 3.39×) while skewing captive emergency, lab, and upper-quartile codes to 12.5× Medicare (p75 7.28×, +115% 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)
- Bottom-quartile procedures (Q25) price at 1.56× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 46% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 81% patient recommendation (69/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (70.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
- Captive ER (1.7×) & laboratory (3.9×) services average 2.31× higher multiples than routine shoppable care (5.4×)
- Upper-quartile procedures (Q75 7.28×) jump +115% above the median procedure ratio (Q50 3.39×)
- Consolidated metro market (HHI 10,000) 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 Martha's Vineyard Hospital Inc
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 95 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| C-section delivery (full package) CPT Code: 59510 | $5,364 | 1.8× |
| Vaginal delivery (full package) CPT Code: 59400 | $4,737 | 1.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $3,997 | unverified |
| Breast lump removal CPT Code: 19120 | $3,483 | 0.9× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $3,340 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,628 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,523 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $2,047 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,993 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $2,015 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $1,989 | unverified |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,909 | unverified |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,923 | unverified |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,909 | unverified |
| CT scan, pelvis CPT Code: 72192 | $1,900 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,868 | 0.3× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,846 | unverified |
| CT scan, sinuses CPT Code: 70486 | $1,703 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $1,515 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,451 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $1,446 | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $1,339 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,280 | unverified |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $1,191 | unverified |
| Ultrasound, pelvis CPT Code: 76856 | $836 | unverified |
Audit a Bill or Quote at Martha's Vineyard Hospital Inc (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $5,529
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (70.1% of gross = $5,529).
Self-Pay Cash Rate ($5,917) Beats Your Bill
Martha's Vineyard Hospital Inc's published 45 CFR § 180 self-pay cash rate is $5,917 (vs. $5,364 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 ($7,889) is $4,914 above the denoised Fair BaseRate ($2,975) and 3.2× the $2,473 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (70.1% 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)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Martha's Vineyard Hospital Inc. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-08-27·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare (189 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 Martha's Vineyard Hospital Inc.
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.