Big Sandy Medical Center
166 Montana Ave E, Big Sandy, MT 59520 · 72 Priced Procedures
Typical commercial prices here are +74% above the fair benchmark (1.74×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Big Sandy Medical Center prices routine shoppable procedures at 1.8× Medicare (median 1.60× Fair BaseRate) while upper-quartile commercial rates jump +36% to 2.17× 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 1.31× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 94% of shoppable procedures (97/100 Cash Honesty)
- CMS clinical safety score (85/100 safety score) with 72% patient recommendation
- 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)
- Even at low-cost facilities (1.74× 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 1.60× Fair BaseRate (1.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.17×) jump +36% above the median procedure ratio (Q50 1.60×)
- Unnegotiated chargemaster list prices average 4.9× Medicare (35¢ 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 Big Sandy Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 72 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Breast lump removal CPT Code: 19120 | $1,057 | 0.3× |
| Upper endoscopy with biopsy CPT Code: 43239 | $945 | 1.0× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $525 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $422 | 1.6× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $315 | 2.4× |
| Ultrasound, pelvis CPT Code: 76856 | $310 | 2.4× |
| New patient office visit (30-44 min) CPT Code: 99203 | $239 | 2.2× |
| X-ray, lower back CPT Code: 72110 | $208 | 1.9× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $224 | 1.8× |
| Screening mammogram (both breasts) CPT Code: 77067 | $218 | 1.8× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $233 | 1.3× |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $218 | 1.2× |
| X-ray, chest (single view) CPT Code: 71045 | $187 | unverified |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $146 | 2.3× |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $143 | 1.6× |
| X-ray, hand CPT Code: 73130 | $150 | 1.6× |
| X-ray, ankle CPT Code: 73610 | $148 | 1.6× |
| X-ray, foot CPT Code: 73630 | $146 | 1.6× |
| X-ray, chest (two views) CPT Code: 71046 | $147 | 1.6× |
| X-ray, neck (cervical spine) CPT Code: 72040 | $139 | 1.5× |
| X-ray, shoulder CPT Code: 73030 | $136 | 1.5× |
| X-ray, pelvis CPT Code: 72170 | $144 | 1.3× |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $154 | 1.3× |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $106 | 3.0× |
| Orthotic fitting and training CPT Code: 97760 | $117 | 2.3× |
Audit a Bill or Quote at Big Sandy Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $995
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 = $995).
Self-Pay Cash Rate ($838) Beats Your Bill
Big Sandy Medical Center's published 45 CFR § 180 self-pay cash rate is $838 (vs. $1,057 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $3,875 Fair BaseRate ($4,000 Medicare)
Your entered amount is at or below the modeled Fair BaseRate benchmark ($3,875).
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
Source: CMS Hospital Care Compare. 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 Big Sandy Medical Center.
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.