How many shoppable procedure prices are published for Mercy Health Saint Mary's?

Mercy Health Saint Mary's in Grand Rapids, MI currently has 126 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Mercy Health Saint Mary's's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Mercy Health Saint Mary's's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

What is Mercy Health Saint Mary's's CMS Care Compare overall star rating?

CMS Care Compare assigns Mercy Health Saint Mary's an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Church 275 Beds · rural Updated: 2026-03-31

Mercy Health Saint Mary's

200 Jefferson Avenue Se, Grand Rapids, MI 49503 · 126 Priced Procedures · 78% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Near Fair BaseRate Benchmark

1.01×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.01×) after accounting for local nurse/doctor wages and patient complexity.

69/100 · Caution

69/100Self-Pay Cash Beats Insurance 52% of the Time

File Completeness66

Price Logic49

Peer Alignment68

Clean Billing88

Real Cash Discount82

Regional Value Leader

4-Star CMS clinical quality rating paired with 1.01× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Mercy Health Saint Mary's prices shoppable and inpatient services (1.0× to 1.3× Medicare, divergence 1.30×) in alignment with regional hospital peers (1.01× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#64 of 91 in MI · 69th State Percentile#1,331 of 3,385 in U.S. · 39th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.72× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 52% of shoppable procedures (82/100 Cash Honesty)
CMS clinical safety score (73/100 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 (52.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.01× 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.
Captive ER (1.0×) & laboratory (1.2×) services average 1.30× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.23×) jump +38% above the median procedure ratio (Q50 0.89×)
Consolidated metro market (HHI 3,149) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER1.30× Divergence

1.3× Medicare

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

Quantile Tail Spread+38% Upper Tail

Q25 0.72× · Q50 0.89× · Q75 1.23×

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

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.4× 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

1.2× MedicareGood

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

52% Cash Edge · 82/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 73/100Fair

Procedure Prices at Mercy Health Saint Mary's

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 126 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`	$57,469	$53,231	$30,775	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$25,158	$32,009	$19,087	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$34,911	$31,784	$19,432	1.6×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$40,389	$29,051	$17,936	unverified
Total knee replacement CPT Code: `27447`	—	—	$13,523	—
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$13,710	$12,846	$8,223	unverified
Breast lump removal CPT Code: `19120`	—	—	$3,875	—
Bunion correction surgery CPT Code: `28296`	—	—	$3,446	—
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	—	$3,372	—
Hepatitis B immune globulin HCPCS Code: `90371`	$2,047	$2,047	$151	unverified
Trauma team activation HCPCS Code: `G0390`	$3,769	$1,981	$1,453	1.4×
Colonoscopy with biopsy CPT Code: `45380`	—	—	$1,256	—
C-section delivery (full package) CPT Code: `59510`	$938	$1,174	$2,975	0.4×
Vaginal delivery (full package) CPT Code: `59400`	—	$1,080	$2,680	0.4×
Upper endoscopy with biopsy CPT Code: `43239`	—	—	$987	—
Colonoscopy (diagnostic) CPT Code: `45378`	—	—	$981	—
Total hip replacement CPT Code: `27130`	$904	$904	$13,413	0.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$842	$842	$6,109	0.1×
Rabies immune globulin HCPCS Code: `90375`	$2,089	$799	$322	2.5×
Injection procedure for pain management HCPCS Code: `G0260`	$716	$704	$855	0.8×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$430	$1,021	0.4×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,014	$352	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,051	$345	$511	0.7×
Blood transfusion CPT Code: `36430`	—	$308	$498	0.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$294	$311	$148	unverified
Inguinal hernia repair CPT Code: `49505`	$278	$278	$3,629	0.1×
Screening mammogram (both breasts) CPT Code: `77067`	$221	$257	$123	unverified
MRI, knee or other leg joint CPT Code: `73721`	$1,499	$228	$369	0.6×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,151	$186	$258	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$1,362	$208	$343	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	$1,546	$199	$338	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,713	$167	$303	0.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	—	$170	$583	0.3×
Psychiatric evaluation (first visit) CPT Code: `90791`	$176	$184	$185	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	—	—	$201	—
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$138	$123	1.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$501	$124	$134	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$94	$98	$86	1.1×
New patient office visit (30-44 min) CPT Code: `99203`	—	$111	$110	1.0×
Ultrasound, pelvis CPT Code: `76856`	$402	$116	$130	0.9×
CT scan, sinuses CPT Code: `70486`	$841	$139	$166	0.8×
CT scan, pelvis CPT Code: `72192`	$892	$134	$163	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$913	$135	$167	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$960	$136	$169	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$960	$135	$168	0.8×
CT scan, head (with contrast) CPT Code: `70460`	$989	$156	$242	0.6×
Psychotherapy session (60 minutes) CPT Code: `90837`	$164	$120	$181	0.7×
Family therapy session CPT Code: `90847`	$123	$123	$173	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	—	$136	$272	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$83	$84	$87	1.0×
Ultrasound, abdomen (limited) CPT Code: `76705`	$358	$94	$126	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$779	$109	$160	0.7×
X-ray, lower back CPT Code: `72110`	—	—	$112	—
X-ray, pelvis CPT Code: `72170`	—	—	$110	—
X-ray, chest (single view) CPT Code: `71045`	$172	$82	$92	0.9×
X-ray, chest (two views) CPT Code: `71046`	$159	$81	$93	0.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$114	$82	$166	0.5×
Neurobehavioral status check CPT Code: `96116`	$210	$90	$231	0.4×
X-ray, neck (cervical spine) CPT Code: `72040`	—	—	$93	—
X-ray, shoulder CPT Code: `73030`	—	—	$92	—
X-ray, hand CPT Code: `73130`	—	—	$93	—
X-ray, hip CPT Code: `73502`	—	—	$93	—
X-ray, ankle CPT Code: `73610`	—	—	$93	—
X-ray, foot CPT Code: `73630`	—	—	$92	—
Typhoid vaccine HCPCS Code: `90675`	$1,351	$496	$347	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$109	$198	$203	1.0×
Drug screening test HCPCS Code: `G0480`	$612	$134	$116	1.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$103	$111	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	—	$63	$64	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$207	$75	$86	0.9×
Ultrasound, thyroid and neck CPT Code: `76536`	—	$69	$132	0.5×
Electrical stimulation therapy HCPCS Code: `G0283`	$65	$22	$14	1.6×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$65	$16	$11	1.5×
Blood test, basic metabolic panel CPT Code: `80048`	—	$13	$9	1.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$57	$20	$14	1.4×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$99	$35	$27	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$59	$18	$14	1.3×
Blood test, vitamin D CPT Code: `82306`	$47	$39	$31	1.3×
Blood test, liver function panel CPT Code: `80076`	$56	$12	$9	1.3×
Blood test, lipase CPT Code: `83690`	$16	$9	$7	1.3×
Blood test, magnesium CPT Code: `83735`	$7	$9	$7	1.3×
Blood test, vitamin B12 CPT Code: `82607`	$30	$20	$16	1.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$69	$25	$20	1.3×
Orthotic fitting and training CPT Code: `97760`	$104	$44	$51	0.9×
Blood test, clotting time (PTT) CPT Code: `85730`	$17	$8	$6	1.3×
Hepatitis C antibody test CPT Code: `86803`	$50	$19	$15	1.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$44	$24	$19	1.3×
Diagnostic procedure preparation HCPCS Code: `G0279`	$83	$44	$35	1.3×
Blood test, thyroid (TSH) CPT Code: `84443`	—	$22	$18	1.2×
Blood test, amylase CPT Code: `82150`	$9	$8	$7	1.1×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$33	$33	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$81	$33	$37	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$88	$33	$38	0.9×
Prosthetic fitting and training CPT Code: `97761`	$86	$39	$45	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$84	$32	$38	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$39	$56	0.7×
Flu vaccine injection HCPCS Code: `G0008`	$36	$32	$48	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$36	$32	$49	0.7×
Psychological testing evaluation CPT Code: `96136`	$21	$41	$128	0.3×
Psychological testing by technician CPT Code: `96138`	$21	$47	$395	0.1×
Pneumococcal vaccine HCPCS Code: `90732`	$57	$57	$140	unverified
Culture, bacterial CPT Code: `87070`	$56	$11	$9	1.2×
Culture, blood CPT Code: `87040`	$65	$13	$11	1.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$81	$34	$40	0.8×
Group therapy session CPT Code: `90853`	—	$31	$100	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$25	$3	$3	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$36	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$27	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$24	$10	$10	1.0×
Blood test, potassium CPT Code: `84132`	$41	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$22	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$25	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$30	$8	$8	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$41	$23	$25	0.9×
Speech therapy (group session) CPT Code: `92508`	$54	$23	$27	0.9×
Physical therapy (gait training) CPT Code: `97116`	$80	$28	$33	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$87	$32	$38	0.8×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$32	$39	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$10	$4	$5	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$85	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$101	$27	$34	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$17	$25	0.7×
Blood test, hemoglobin CPT Code: `85018`	$10	$2	$3	0.7×
Colorectal cancer screening HCPCS Code: `G0010`	$25	$25	$49	0.5×
Blood antibody screen CPT Code: `86850`	$51	$14	$46	0.3×
Blood test, calcium CPT Code: `82310`	—	—	$5	unverified

Showing top 25 high-impact procedures of 126 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 52.5%

Audit a Bill or Quote at Mercy Health Saint Mary's (Zero PHI Required)

CMS CCN: 230059

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $57,469

Insurer Median $53,231

1. Amount on Your Bill or Quote ($) Pre-filled with Mercy Health Saint Mary's’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: $67,096 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $67,096

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (52.5% of gross = $67,096).

Step 2 · Cash vs. Insurance Arbitrage Save $70,285 Paying Cash

Self-Pay Cash Rate ($57,469) Beats Your Bill

Mercy Health Saint Mary's's published 45 CFR § 180 self-pay cash rate is $57,469 (vs. $53,231 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$96,979 Above Fair BaseRate

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

Your bill ($127,754) is $96,979 above the denoised Fair BaseRate ($30,775) and 5.4× 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)

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 (52.5% 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 Overall4/5 Stars (4/5)

Safety Composite73/100

Would Recommend78%

Rated 9 or 10 (HCAHPS)78%

Median ER Wait138 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.8%

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 (508 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

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Mercy Health Saint Mary's.

Price Index: 1.11× regional baseline

Quality: 73/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Access Health

-49.2%

CareSource

+72.7%

Median Household Income$80,390U.S. Census ACS

Local Uninsured Share4.9%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 69/100 · Caution CMS CCN 230059

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 230059) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-31

Validated Rate Rows52,179 (CMS v3.0.0)

File Integrity DigestVerified · CCN 230059

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.

Submit MRF Update Correction Policy