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Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-07-30

Roundup Memorial Healthcare

1202 3Rd St W, Roundup, MT 59072 · 64 Priced Procedures

CMS Overall Rating No CMS Rating
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
0.96×vs. Fair Market Price
Position vs. 1.00× Fair Price4% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 4% below the fair benchmark (0.96×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).64/100 · Caution
64/100Self-Pay Cash Beats Insurance 16% of the Time
File Completeness85Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic86Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment62Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing64Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount6Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score85/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait97 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Roundup Memorial Healthcare prices routine shoppable procedures near 0.6× Medicare (p50 0.96×) while skewing captive emergency, lab, and upper-quartile codes to 1.0× Medicare (p75 0.97×, +1% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#9 of 26 in MT · 30th State Percentile#1,054 of 3,385 in U.S. · 31st National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 4% below peer Fair BaseRate (0.96×)
  • Self-pay cash beats commercial insurance on 16% of shoppable procedures (25/100 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 (90.0% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (0.96× 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 (0.9×) & laboratory (1.4×) services average 1.67× higher multiples than routine shoppable care (0.6×)
  • Specialty infusion drugs (J-codes) average 1.1× Medicare — verify per-unit billing on itemized statements
  • Unnegotiated chargemaster list prices average 7.9× Medicare (30¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
0.6× Medicare

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

Back-Door Captive & ER1.67× Divergence
1.0× Medicare

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

Quantile Tail Spread+1% Upper Tail
Q25 0.93× · Q50 0.96× · Q75 0.97×

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
0.6× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.8× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.6× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.9× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.4× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
16% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 85/100Good

Procedure Prices at Roundup Memorial Healthcare

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 64 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Trauma team activation
HCPCS Code: G0390
 $3,102 2.1×
Rabies immune globulin
HCPCS Code: 90375
 $2,015 6.3×
Upper endoscopy with biopsy
CPT Code: 43239
 $1,753 1.8×
Colonoscopy with biopsy
CPT Code: 45380
 $1,747 1.4×
Breast lump removal
CPT Code: 19120
 $1,677 0.4×
Blood transfusion
CPT Code: 36430
 $1,243 2.5×
Electrocardiogram (EKG, tracing only)
CPT Code: 93005
 $399 6.2×
Hospital observation (per hour)
HCPCS Code: G0378
 $306 3.6×
New patient office visit (30-44 min)
CPT Code: 99203
 $298 2.7×
Colonoscopy (diagnostic)
CPT Code: 45378
 $309 0.3×
Office visit, established patient (30-39 min)
CPT Code: 99214
 $283 2.3×
Psychiatric evaluation (first visit)
CPT Code: 90791
 $285 1.5×
Group therapy session
CPT Code: 90853
 $251 2.5×
Office visit, established patient (20-29 min)
CPT Code: 99213
 $188 2.2×
Family therapy session
CPT Code: 90847
 $212 1.2×
Psychotherapy session (60 minutes)
CPT Code: 90837
 $196 1.1×
Physical therapy (gait training)
CPT Code: 97116
 $146 4.4×
Psychotherapy session (45 minutes)
CPT Code: 90834
 $170 1.0×
Breathing treatment (nebulizer)
CPT Code: 94640
 $195 1.0×
Electrical stimulation therapy
HCPCS Code: G0283
 $132 9.4×
Physical therapy (manual therapy)
CPT Code: 97140
 $134 3.9×
Physical therapy (neuromuscular re-education)
CPT Code: 97112
 $148 3.9×
Occupational therapy (therapeutic activities)
CPT Code: 97530
 $149 3.7×
Occupational therapy (self-care training)
CPT Code: 97535
 $137 3.6×
Physical therapy (functional capacity test)
CPT Code: 97750
 $95 2.5×
Showing top 25 high-impact procedures of 64 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 90.0%

Audit a Bill or Quote at Roundup Memorial Healthcare (Zero PHI Required)

CMS CCN: 271346
CPT G0390
Fair BaseRate™ $1,453
Medicare Rate $1,362
Self-Pay Cash $3,102
Insurer Median $3,102
Pre-filled with Roundup Memorial Healthcare’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $2,792 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $2,792

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (90.0% of gross = $2,792).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $3,102

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Roundup Memorial Healthcare's published 45 CFR § 180 self-pay cash rate is $3,102 (vs. $3,102 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$1,649 Above Fair BaseRate

Negotiate Toward $1,453 Fair BaseRate ($1,362 Medicare)

Your bill ($3,102) is $1,649 above the denoised Fair BaseRate ($1,453) and 2.3× the $1,362 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 (90.0% 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

Safety Composite85/100
Median ER Wait97 min

CMS Price Transparency Administrative Enforcement Log

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

  • 2025-09-09·administrative_or_closure

    Met Requirements

    Recorded
  • 2024-06-28·administrative_or_closure

    Closure Notice

    Recorded
  • 2024-06-04·cap_corrective_action

    CAP Request

    Recorded
  • 2024-02-28·warning_notice

    Warning Notice

    Recorded
  • 2023-07-10·administrative_or_closure

    Closure Notice

    Recorded
  • 2023-03-22·warning_notice

    Warning Notice

    Recorded

Source: CMS Hospital Care Compare. 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 Roundup Memorial Healthcare.

Price Index: 1.32× regional baseline
Quality: 54/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

UnitedHealthcare
-54.8%
Median Household Income$59,010U.S. Census ACS
Local Uninsured Share9.0%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 64/100 · Caution CMS CCN 271346

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 271346) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileReports.aspx
Publication / Vintage2026-07-30 · 11.77 MB
Validated Rate Rows1,310 (CMS v3.0.0)
File Integrity Digest69774f6a22d2cd43adaf…

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