Barnes Jewish Hospital
One Barnes-Jewish Hospital Plaza, Saint Louis, MO 63110 · 98 Priced Procedures · 79% Patient Recommendation
Typical commercial prices here are +48% above the fair benchmark (1.48×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.48× fair market pricing.
Cash-Arbitrage Bifurcated Pricer
Barnes Jewish Hospital maintains elevated commercial insurance contracts (1.48× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 60% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.87× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 60% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 79% patient recommendation (72/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (58.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
- Captive ER (2.7×) & laboratory (2.5×) services average 1.19× higher multiples than routine shoppable care (1.6×)
- Even at low-cost facilities (1.48× 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.
- Unnegotiated chargemaster list prices average 9.9× Medicare (23¢ true HCRIS cost per $1 gross)
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 Barnes Jewish Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 98 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $50,792 | unverified |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $36,149 | unverified |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $32,548 | unverified |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $22,457 | 1.2× |
| Trauma team activation HCPCS Code: G0390 | $9,510 | 6.5× |
| Inguinal hernia repair CPT Code: 49505 | $8,138 | unverified |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $8,010 | 1.0× |
| Injection procedure for pain management HCPCS Code: G0260 | $6,259 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $3,163 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,740 | 2.8× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,740 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,529 | 2.6× |
| MRI, knee or other leg joint CPT Code: 73721 | $1,504 | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $924 | 2.9× |
| Hepatitis B immune globulin HCPCS Code: 90371 | $942 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $860 | 0.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $858 | unverified |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $475 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $436 | 1.6× |
| Blood transfusion CPT Code: 36430 | $442 | 0.9× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $367 | 0.7× |
| Screening mammogram (both breasts) CPT Code: 77067 | $389 | unverified |
| Ultrasound, thyroid and neck CPT Code: 76536 | $287 | unverified |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $280 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $251 | 0.8× |
Audit a Bill or Quote at Barnes Jewish Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $103,498
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (58.0% of gross = $103,498).
Self-Pay Cash Rate ($107,066) Beats Your Bill
Barnes Jewish Hospital's published 45 CFR § 180 self-pay cash rate is $107,066 (vs. $50,792 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($178,444) is $147,669 above the denoised Fair BaseRate ($30,775) and 7.6× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (58.0% 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)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Barnes Jewish Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-03-12·administrative_or_closure
Met Requirements
Recorded - 2022-03-09·administrative_or_closure
Closure Notice
Recorded - 2021-08-25·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (6,685 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 Barnes Jewish 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.