Nantucket Cottage Hospital
57 Prospect Street, Nantucket, MA 02554 · 76 Priced Procedures · 78% Patient Recommendation
Typical commercial prices here are +14% above the fair benchmark (1.14×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.14× fair market pricing.
Consolidated System Premium Pricer
Operating in a concentrated regional market (CBSA HHI 10,000), Nantucket Cottage Hospital commands a 1.14× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.
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 85% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (72/100 safety score) with 78% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (82.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.14× 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.
- Commercial insurance median sits at 1.19× Fair BaseRate (3.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (1.14× 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.
- 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 Nantucket Cottage Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 76 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $19,309 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $9,057 | 1.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $5,000 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $3,848 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $3,365 | unverified |
| Blood transfusion CPT Code: 36430 | $2,645 | 5.3× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $2,444 | 0.4× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,165 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,866 | unverified |
| CT scan, pelvis CPT Code: 72192 | $1,671 | 10.3× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,670 | 6.1× |
| CT scan, sinuses CPT Code: 70486 | $1,671 | unverified |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,671 | unverified |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,671 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $1,354 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | $1,310 | 1.0× |
| CT scan, chest (no contrast) CPT Code: 71250 | $903 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $871 | 0.9× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $852 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $697 | 1.2× |
| Speech therapy (language evaluation) CPT Code: 92507 | $589 | 6.8× |
| X-ray, lower back CPT Code: 72110 | $582 | 5.2× |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $541 | 3.7× |
| X-ray, pelvis CPT Code: 72170 | $486 | 4.4× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $454 | 1.0× |
Audit a Bill or Quote at Nantucket Cottage Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $20,036
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (82.0% of gross = $20,036).
Self-Pay Cash Rate ($18,334) Beats Your Bill
Nantucket Cottage Hospital's published 45 CFR § 180 self-pay cash rate is $18,334 (vs. $19,309 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($24,446) is $5,359 above the denoised Fair BaseRate ($19,087) and 1.7× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (82.0% 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
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Nantucket Cottage Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-09-30·administrative_or_closure
Closure Notice
Recorded - 2025-08-25·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (92 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 Nantucket Cottage Hospital.
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.