How many shoppable procedure prices are published for Lakeland Hospital, St Joseph?

Lakeland Hospital, St Joseph in St Joseph, MI currently has 128 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Lakeland Hospital, St Joseph's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Lakeland Hospital, St Joseph's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

What is Lakeland Hospital, St Joseph's CMS Care Compare overall star rating?

CMS Care Compare assigns Lakeland Hospital, St Joseph an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 231 Beds · urban Updated: 2026-05-01

Lakeland Hospital, St Joseph

1234 Napier Avenue, St Joseph, MI 49085 · 128 Priced Procedures · 60% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Above Fair Market · Negotiate

1.24×vs. Fair Market Price

Typical commercial prices here are +24% above the fair benchmark (1.24×) even after accounting for local nurse/doctor wages and patient complexity.

75/100 · Corroborated

75/100Self-Pay Cash Beats Insurance 2% of the Time

File Completeness100

Price Logic95

Peer Alignment82

Clean Billing74

Real Cash Discount6

Premium Quality Tier

3-Star CMS clinical quality rating paired with 1.24× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 9,991), Lakeland Hospital, St Joseph commands a 1.24× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#82 of 91 in MI · 89th State Percentile#2,110 of 3,385 in U.S. · 62nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.98× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 2% of shoppable procedures (25/100 Cash Honesty)
4-Star CMS clinical rating with 60% patient recommendation (66/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (26.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
Captive ER (1.0×) & laboratory (1.2×) services average 1.15× higher multiples than routine shoppable care (1.3×)
Specialty infusion drugs (J-codes) average 1.5× Medicare — verify per-unit billing on itemized statements
Consolidated metro market (HHI 9,991) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.3× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.15× Divergence

1.5× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+13% Upper Tail

Q25 0.98× · Q50 1.24× · Q75 1.40×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.3× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.8× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.2× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

2% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 66/100Fair

Procedure Prices at Lakeland Hospital, St Joseph

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 128 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$27,865	$30,775	0.9×
Total knee replacement CPT Code: `27447`	—	$19,189	$13,523	1.4×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$17,047	$19,087	0.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$16,933	$19,432	0.9×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$15,540	$17,936	0.9×
Total hip replacement CPT Code: `27130`	—	$13,123	$13,413	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$7,280	$8,223	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$6,024	$6,109	1.0×
Inguinal hernia repair CPT Code: `49505`	—	$3,568	$3,629	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,260	$3,372	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,260	$3,446	0.9×
C-section delivery (full package) CPT Code: `59510`	—	$2,477	$2,975	0.8×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,300	$2,540	0.9×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,275	$2,680	0.8×
Trauma team activation HCPCS Code: `G0390`	$4,305	$1,846	$1,453	1.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,931	$1,283	$1,021	1.3×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,256	$1,256	1.0×
Breast lump removal CPT Code: `19120`	$1,216	$1,216	$3,875	0.3×
Upper endoscopy with biopsy CPT Code: `43239`	—	$1,111	$987	1.1×
Injection procedure for pain management HCPCS Code: `G0260`	—	$1,055	$855	1.2×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$960	$981	1.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,778	$817	$583	1.4×
Behavioral health day treatment HCPCS Code: `H0010`	—	$734	$343	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$3,254	$521	$511	1.0×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$4,522	$521	$448	unverified
Blood transfusion CPT Code: `36430`	$752	$489	$498	1.0×
Psychological testing by technician CPT Code: `96138`	—	$445	$395	1.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,436	$357	$272	1.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,947	$357	$303	1.2×
Rabies immune globulin HCPCS Code: `90375`	—	$349	$322	1.1×
MRI, lower back (no contrast) CPT Code: `72148`	$2,822	$357	$338	1.1×
MRI, brain (no contrast) CPT Code: `70551`	$2,715	$357	$343	1.0×
MRI, knee or other leg joint CPT Code: `73721`	$2,223	$357	$369	1.0×
Neurobehavioral status check CPT Code: `96116`	$468	$323	$231	1.4×
CT scan, head (with contrast) CPT Code: `70460`	$1,893	$262	$242	1.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,199	$262	$258	1.0×
Family therapy session CPT Code: `90847`	—	$234	$173	1.4×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$205	$151	1.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$253	$218	$166	1.3×
Psychotherapy session (60 minutes) CPT Code: `90837`	$289	$218	$181	1.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$289	$218	$185	1.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$284	$218	$201	1.1×
New patient office visit (30-44 min) CPT Code: `99203`	—	$167	$110	1.5×
X-ray, lower back CPT Code: `72110`	$599	$156	$112	1.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$161	$123	1.3×
X-ray, pelvis CPT Code: `72170`	$291	$138	$110	1.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$771	$156	$126	1.2×
Ultrasound, pelvis CPT Code: `76856`	$886	$156	$130	1.2×
Ultrasound, thyroid and neck CPT Code: `76536`	$580	$156	$132	1.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,218	$156	$134	1.2×
CT scan, head (no contrast) CPT Code: `70450`	$1,209	$156	$160	1.0×
CT scan, pelvis CPT Code: `72192`	$1,459	$156	$163	1.0×
CT scan, sinuses CPT Code: `70486`	$1,259	$156	$166	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	$1,638	$156	$167	0.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,554	$156	$168	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,234	$156	$169	0.9×
X-ray, shoulder CPT Code: `73030`	$473	$130	$92	1.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$430	$130	$93	1.4×
X-ray, hand CPT Code: `73130`	$352	$130	$93	1.4×
X-ray, ankle CPT Code: `73610`	$443	$130	$93	1.4×
Speech therapy (language evaluation) CPT Code: `92507`	$377	$113	$86	1.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	—	$114	$87	1.3×
Group therapy session CPT Code: `90853`	—	$125	$100	1.3×
Review of medical records for care CPT Code: `90889`	—	$140	$114	1.2×
Psychological testing evaluation CPT Code: `96136`	$217	$133	$128	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$585	$152	$148	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$515	$125	$123	1.0×
X-ray, foot CPT Code: `73630`	$431	$130	$92	unverified
Care planning with family CPT Code: `90887`	—	$104	$107	1.0×
X-ray, chest (single view) CPT Code: `71045`	$329	$87	$92	0.9×
X-ray, chest (two views) CPT Code: `71046`	$390	$87	$93	0.9×
X-ray, hip CPT Code: `73502`	$369	$87	$93	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$278	$88	$64	unverified
Typhoid vaccine HCPCS Code: `90675`	—	$440	$347	1.3×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$181	$203	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$135	$84	$56	1.5×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$135	$108	$111	1.0×
Drug screening test HCPCS Code: `G0480`	$103	$103	$116	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	—	$86	$140	0.6×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$54	$25	2.2×
Hepatitis B vaccine HCPCS Code: `90744`	—	$48	$37	1.3×
Orthotic fitting and training CPT Code: `97760`	$166	$65	$51	1.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$105	$67	$86	0.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$63	$12	$8	1.5×
Blood test, PSA (prostate screen) CPT Code: `84153`	$99	$28	$19	1.5×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	—	$29	$20	1.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$127	$50	$40	1.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$121	$47	$38	1.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$149	$42	$35	1.2×
Physical therapy (manual therapy) CPT Code: `97140`	$149	$40	$34	1.2×
Prosthetic fitting and training CPT Code: `97761`	$111	$52	$45	1.2×
Flu vaccine injection HCPCS Code: `G0008`	—	$47	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$47	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	—	$70	$49	unverified
Blood test, vitamin D CPT Code: `82306`	$182	$44	$31	1.4×
Physical therapy (gait training) CPT Code: `97116`	$118	$43	$33	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$140	$46	$38	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$88	$50	$38	unverified
Blood test, calcium CPT Code: `82310`	$36	$8	$5	1.6×
Blood test, creatinine (kidney) CPT Code: `82565`	$46	$8	$5	1.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$63	$15	$10	1.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$75	$16	$11	1.5×
Blood test, basic metabolic panel CPT Code: `80048`	$59	$13	$9	1.4×
Culture, bacterial CPT Code: `87070`	$77	$13	$9	1.4×
Blood test, vitamin B12 CPT Code: `82607`	$125	$23	$16	1.4×
Hepatitis C antibody test CPT Code: `86803`	$119	$21	$15	1.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$125	$25	$18	1.4×
Speech therapy (group session) CPT Code: `92508`	—	$36	$27	1.3×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$46	$39	1.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$78	$20	$14	1.4×
Blood test, amylase CPT Code: `82150`	$70	$10	$7	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$147	$20	$14	1.4×
Blood antibody screen CPT Code: `86850`	$44	$44	$46	1.0×
Blood test, lipase CPT Code: `83690`	$74	$10	$7	1.4×
Blood test, potassium CPT Code: `84132`	$44	$7	$5	1.4×
Culture, blood CPT Code: `87040`	$63	$15	$11	1.4×
Blood test, liver function panel CPT Code: `80076`	$48	$12	$9	1.3×
Blood test, hemoglobin CPT Code: `85018`	$25	$4	$3	1.3×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$18	$14	1.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$38	$24	$25	1.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	$96	$17	$35	0.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$34	$5	$3	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$40	$6	$4	unverified
Blood test, magnesium CPT Code: `83735`	$52	$10	$7	unverified
Blood test, sodium CPT Code: `84295`	$34	$7	$5	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$40	$6	$4	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$42	$6	$5	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$65	$9	$6	unverified

Showing top 25 high-impact procedures of 128 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 26.0%

Audit a Bill or Quote at Lakeland Hospital, St Joseph (Zero PHI Required)

CMS CCN: 230021

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $27,865

1. Amount on Your Bill or Quote ($) Pre-filled with Lakeland Hospital, St Joseph’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $17,401 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $17,401

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (26.0% of gross = $17,401).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Lakeland Hospital, St Joseph's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$36,101 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($66,876) is $36,101 above the denoised Fair BaseRate ($30,775) and 2.8× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 382156872

Filing Period: 201403

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (26.0% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend60%

Rated 9 or 10 (HCAHPS)65%

Median ER Wait157 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (824 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Lakeland Hospital, St Joseph.

Price Index: 1.10× regional baseline

Quality: 58/100 CMS composite

Median Household Income$63,152U.S. Census ACS

Local Uninsured Share6.2%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 75/100 · Corroborated CMS CCN 230021 EIN 382156872

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 230021) ↗ Verify IRS Form 990 (EIN 382156872) ↗ CMS HCRIS Cost Reports ↗

Published MRF File382156872_lakeland-hospitals-at-niles-and-st-joseph-inc_standardcharges.csv

Publication / Vintage2026-05-01 · 15.26 MB

Validated Rate Rows391 (CMS v3.0.0)

File Integrity Digest0fd8f0ab094688de887c…

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.

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