Tidalhealth Peninsula Regional, Inc
100 East Carroll Avenue, Salisbury, MD 21801 · 83 Priced Procedures · 67% Patient Recommendation
Typical commercial prices here are +59% above the fair benchmark (1.59×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.59× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Tidalhealth Peninsula Regional, Inc prices routine shoppable procedures at 1.9× Medicare (median 1.46× Fair BaseRate) while upper-quartile commercial rates jump +38% to 2.02× 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 1.10× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 81% of shoppable procedures (25/100 Cash Honesty)
- 4-Star CMS clinical rating with 67% patient recommendation (71/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (95.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.4× markup over Medicare rates
- Commercial insurance median sits at 1.46× Fair BaseRate (1.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.02×) jump +38% above the median procedure ratio (Q50 1.46×)
- 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 Tidalhealth Peninsula Regional, Inc
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 83 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,725 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,384 | unverified |
| Blood transfusion CPT Code: 36430 | $1,005 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $843 | 1.6× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $752 | unverified |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $692 | unverified |
| Ultrasound, pelvis CPT Code: 76856 | $632 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $536 | 1.5× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $553 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $501 | 1.5× |
| MRI, lower back (no contrast) CPT Code: 72148 | $479 | 1.4× |
| Family therapy session CPT Code: 90847 | $429 | unverified |
| Group therapy session CPT Code: 90853 | $358 | unverified |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $317 | 1.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $319 | 0.7× |
| X-ray, lower back CPT Code: 72110 | $276 | 2.5× |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $271 | 1.5× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $261 | 0.4× |
| X-ray, hip CPT Code: 73502 | $246 | unverified |
| X-ray, foot CPT Code: 73630 | $184 | 2.0× |
| X-ray, neck (cervical spine) CPT Code: 72040 | $184 | 2.0× |
| X-ray, hand CPT Code: 73130 | $184 | 2.0× |
| X-ray, ankle CPT Code: 73610 | $184 | 2.0× |
| X-ray, pelvis CPT Code: 72170 | $184 | 1.7× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $190 | 1.1× |
Audit a Bill or Quote at Tidalhealth Peninsula Regional, Inc (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $2,589
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (95.0% of gross = $2,589).
Self-Pay Cash Rate ($2,671) Beats Your Bill
Tidalhealth Peninsula Regional, Inc's published 45 CFR § 180 self-pay cash rate is $2,671 (vs. $2,725 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $1,021 Fair BaseRate ($877 Medicare)
Your bill ($2,725) is $1,704 above the denoised Fair BaseRate ($1,021) and 3.1× the $877 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (95.0% 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
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (591 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 Tidalhealth Peninsula Regional, 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.