How many shoppable procedure prices are published for Central Montana Medical Center?

Central Montana Medical Center in Lewistown, MT currently has 119 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Central Montana Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Central Montana Medical Center's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2025-11-21

Central Montana Medical Center

408 Wendell Ave, Lewistown, MT 59457 · 119 Priced Procedures · 62% Patient Recommendation

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.06×vs. Fair Market Price

Typical commercial prices here are +6% above the fair benchmark (1.06×) even after accounting for local nurse/doctor wages and patient complexity.

72/100 · Corroborated

72/100Self-Pay Cash Beats Insurance 54% of the Time

File Completeness90

Price Logic61

Peer Alignment57

Clean Billing74

Real Cash Discount80

High Quality · Fair Price

4-Star CMS clinical quality rating paired with 1.06× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Central Montana Medical Center prices routine shoppable procedures near 0.8× Medicare (p50 0.91×) while skewing captive emergency, lab, and upper-quartile codes to 1.8× Medicare (p75 1.66×, +82% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#11 of 26 in MT · 38th State Percentile#1,549 of 3,385 in U.S. · 45th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.35× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 54% of shoppable procedures (80/100 Cash Honesty)
4-Star CMS clinical rating with 62% 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 (56.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.06× 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 (1.2×) & laboratory (1.3×) services average 2.25× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.66×) jump +82% above the median procedure ratio (Q50 0.91×)
Unnegotiated chargemaster list prices average 5.6× Medicare (28¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.8× Medicare

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

Back-Door Captive & ER2.25× Divergence

1.8× Medicare

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

Quantile Tail Spread+82% Upper Tail

Q25 0.35× · Q50 0.91× · Q75 1.66×

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

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.3× MedicareGood

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

1.1× MedicareGood

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

54% Cash Edge · 80/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 72/100Fair

Procedure Prices at Central Montana Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 119 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$22,564	$22,564	$19,432	1.2×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$16,430	$16,430	$19,087	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$6,526	$6,526	$8,223	0.8×
Rabies immune globulin HCPCS Code: `90375`	$5,002	$5,002	$322	unverified
C-section delivery (full package) CPT Code: `59510`	$4,338	$3,693	$2,975	1.2×
Vaginal delivery (full package) CPT Code: `59400`	$3,910	$3,330	$2,680	1.2×
Cataract surgery with lens implant CPT Code: `66984`	$2,908	$2,908	$2,540	1.1×
Trauma team activation HCPCS Code: `G0390`	$2,373	$2,373	$1,453	1.6×
Total hip replacement CPT Code: `27130`	$2,392	$2,392	$13,413	0.2×
Total knee replacement CPT Code: `27447`	$2,389	$2,119	$13,523	0.2×
Injection procedure for pain management HCPCS Code: `G0260`	$1,488	$1,488	$855	1.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,448	$1,284	$1,021	1.3×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,243	$1,038	$6,109	0.2×
Blood transfusion CPT Code: `36430`	$984	$984	$498	2.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$971	$844	$3,372	0.3×
Bunion correction surgery CPT Code: `28296`	$887	$801	$3,446	0.2×
Inguinal hernia repair CPT Code: `49505`	$1,472	$821	$3,629	0.2×
Breast lump removal CPT Code: `19120`	$778	$649	$3,875	0.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,485	$290	$981	0.3×
Colonoscopy with biopsy CPT Code: `45380`	$1,632	$313	$1,256	0.2×
X-ray, hip CPT Code: `73502`	$262	$262	$93	2.8×
Upper endoscopy with biopsy CPT Code: `43239`	$1,471	$216	$987	0.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$241	$188	$181	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$363	$189	$185	1.0×
X-ray, hand CPT Code: `73130`	$158	$158	$93	1.7×
X-ray, ankle CPT Code: `73610`	$158	$158	$93	1.7×
X-ray, shoulder CPT Code: `73030`	$156	$156	$92	1.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,456	$180	$511	0.4×
Speech therapy (language evaluation) CPT Code: `92507`	$224	$145	$86	1.7×
X-ray, foot CPT Code: `73630`	$145	$145	$92	1.6×
X-ray, pelvis CPT Code: `72170`	$151	$151	$110	1.4×
Family therapy session CPT Code: `90847`	$202	$158	$173	0.9×
X-ray, chest (single view) CPT Code: `71045`	$124	$124	$92	1.3×
New patient office visit (30-44 min) CPT Code: `99203`	$121	$117	$110	1.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	$141	$122	$123	1.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	$162	$126	$166	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$846	$137	$303	0.5×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,145	$144	$448	0.3×
MRI, lower back (no contrast) CPT Code: `72148`	$1,137	$117	$338	0.3×
CT scan, chest (no contrast) CPT Code: `71250`	$956	$91	$167	0.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$953	$115	$583	0.2×
CT scan, pelvis CPT Code: `72192`	$1,080	$85	$163	0.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,193	$100	$258	0.4×
MRI, brain (no contrast) CPT Code: `70551`	$1,137	$117	$343	0.3×
CT scan, head (with contrast) CPT Code: `70460`	$805	$89	$242	0.4×
MRI, knee or other leg joint CPT Code: `73721`	$1,149	$106	$369	0.3×
Typhoid vaccine HCPCS Code: `90675`	$533	$533	$347	unverified
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$251	$251	$203	unverified
Blood test, vitamin B12 CPT Code: `82607`	$172	$172	$16	10.8×
Pneumococcal vaccine HCPCS Code: `90732`	$188	$188	$140	unverified
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$145	$145	$111	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$119	$119	$14	8.5×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$89	$89	$10	8.9×
Drug screening test HCPCS Code: `G0480`	$113	$113	$116	1.0×
Hepatitis B vaccine HCPCS Code: `90744`	$129	$129	$37	unverified
Blood test, lipase CPT Code: `83690`	$79	$79	$7	11.3×
Electrical stimulation therapy HCPCS Code: `G0283`	$73	$73	$14	5.2×
Blood test, vitamin D CPT Code: `82306`	$154	$64	$31	2.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$107	$72	$40	1.8×
Prosthetic fitting and training CPT Code: `97761`	$119	$77	$45	1.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$224	$79	$148	0.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$92	$92	$56	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$107	$64	$38	1.7×
Physical therapy (functional capacity test) CPT Code: `97750`	$107	$64	$38	1.7×
Physical therapy (gait training) CPT Code: `97116`	$107	$55	$33	1.7×
Occupational therapy (self-care training) CPT Code: `97535`	$107	$63	$38	1.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$92	$79	$87	0.9×
Speech therapy (group session) CPT Code: `92508`	$71	$44	$27	1.6×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$107	$56	$35	1.6×
Physical therapy (manual therapy) CPT Code: `97140`	$82	$52	$34	1.5×
Orthotic fitting and training CPT Code: `97760`	$111	$77	$51	1.5×
Diagnostic procedure preparation HCPCS Code: `G0279`	$70	$46	$35	1.3×
Pneumonia vaccine injection HCPCS Code: `G0009`	$73	$62	$49	1.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$64	$64	$86	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$172	$60	$123	0.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$417	$64	$134	0.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$947	$79	$168	0.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$947	$79	$169	0.5×
CT scan, head (no contrast) CPT Code: `70450`	$726	$67	$160	0.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$105	$29	$14	2.1×
Ultrasound, pelvis CPT Code: `76856`	$379	$54	$130	0.4×
CT scan, sinuses CPT Code: `70486`	$804	$68	$166	0.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$101	$23	$11	2.1×
Group therapy session CPT Code: `90853`	$46	$38	$100	0.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$319	$46	$126	0.4×
Ultrasound, thyroid and neck CPT Code: `76536`	$304	$44	$132	0.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$414	$54	$272	0.2×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$57	$57	$39	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$45	$7	$3	2.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$52	$9	$4	2.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$52	$9	$4	2.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$70	$17	$8	2.1×
Blood test, basic metabolic panel CPT Code: `80048`	$87	$18	$9	2.0×
Blood test, liver function panel CPT Code: `80076`	$93	$18	$9	2.0×
Blood test, potassium CPT Code: `84132`	$44	$10	$5	2.0×
Blood test, sodium CPT Code: `84295`	$48	$10	$5	2.0×
Culture, blood CPT Code: `87040`	$159	$22	$11	2.0×
Hepatitis C antibody test CPT Code: `86803`	$88	$28	$15	1.9×
Blood test, amylase CPT Code: `82150`	$125	$13	$7	1.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$47	$9	$5	1.8×
Blood test, hemoglobin CPT Code: `85018`	$24	$5	$3	1.7×
Blood test, calcium CPT Code: `82310`	$86	$8	$5	1.6×
Blood test, magnesium CPT Code: `83735`	$63	$10	$7	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$49	$7	$5	1.4×
Blood test, PSA (prostate screen) CPT Code: `84153`	$109	$25	$19	1.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$109	$25	$20	1.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$100	$7	$6	1.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$92	$19	$18	1.1×
Extended office visit (prolonged) HCPCS Code: `G2212`	$60	$30	$33	0.9×
Flu vaccine injection HCPCS Code: `G0008`	$73	$43	$48	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$40	$40	$49	0.8×
Culture, bacterial CPT Code: `87070`	$73	$8	$9	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$20	$20	$25	0.8×
Blood antibody screen CPT Code: `86850`	$155	$21	$46	0.5×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$258	$22	$64	0.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$175	$18	$93	0.2×
X-ray, lower back CPT Code: `72110`	$320	$21	$112	0.2×
X-ray, chest (two views) CPT Code: `71046`	$167	$17	$93	0.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$122	$28	$201	0.1×

Showing top 25 high-impact procedures of 119 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 56.4%

Audit a Bill or Quote at Central Montana Medical Center (Zero PHI Required)

CMS CCN: 271345

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $22,564

Insurer Median $22,564

1. Amount on Your Bill or Quote ($) Pre-filled with Central Montana Medical Center’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: $14,983 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $14,983

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (56.4% of gross = $14,983).

Step 2 · Cash vs. Insurance Arbitrage Save $3,982 Paying Cash

Self-Pay Cash Rate ($22,564) Beats Your Bill

Central Montana Medical Center's published 45 CFR § 180 self-pay cash rate is $22,564 (vs. $22,564 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$7,114 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($26,546) is $7,114 above the denoised Fair BaseRate ($19,432) and 1.9× the $14,044 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 (56.4% 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 Composite72/100

Would Recommend62%

Rated 9 or 10 (HCAHPS)66%

Median ER Wait107 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Central Montana Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2024-05-31·administrative_or_closure
Closure Notice
Recorded
2024-02-23·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (116 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

Regional Value & Quality Leader

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Central Montana Medical Center.

Price Index: 0.88× regional baseline

Quality: 68/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

UnitedHealthcare

+86.5%

Median Household Income$59,731U.S. Census ACS

Local Uninsured Share15.1%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 72/100 · Corroborated CMS CCN 271345

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 271345) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileReports.aspx

Publication / Vintage2025-11-21 · 60.73 MB

Validated Rate Rows2,848 (CMS v3.0.0)

File Integrity Digest086077694e62269d346d…

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