Hospital Profile
Critical Access Hospital Government - Hospital District or Authority 7 Beds · rural
Updated: 2026-08-14
Ruby Valley Medical Center
321 Madison St, Sheridan, MT 59749 · 99 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
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%)
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 match the fair market benchmark (1.00×) 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).75/100 · Corroborated
75/100Self-Pay Cash Beats Insurance 74% of the Time
File Completeness100Provenance (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 Logic85Coherence (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 Alignment69Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing66Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount44Cash 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 ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian 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 FingerprintConsistent Department Multiples
Aligned Regional Benchmark Peer
Ruby Valley Medical Center prices shoppable and inpatient services (6.1× to 4.6× Medicare, divergence 0.75×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Regional Benchmark in MTU.S. National Reference Pool
Advantage
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 74% of shoppable procedures (44/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Watchout
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
- Commercial insurance median sits at 1.00× Fair BaseRate (6.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
- Unnegotiated chargemaster list prices average 7.5× Medicare (30¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
6.1× Medicare
Pre-scheduled outpatient procedures where patients can comparison-shop.
Back-Door Captive & ER0.75× Divergence
4.6× Medicare
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Quantile Tail Spread+28% Upper Tail
Q25 0.78× · Q50 1.00× · Q75 1.28×
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
6.1× MedicareWatchout
Outpatient Surgery & ORBack-Door Captive
1.4× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.7× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
1.4× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.6× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.4× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
74% Cash Edge · 44/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated
Procedure Prices at Ruby Valley Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 99 published procedures.
Sort:
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Trauma team activation HCPCS Code: G0390 | $3,542 | 2.4× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,886 | 6.4× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,827 | 2.3× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,667 | 2.7× |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,629 | 2.7× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,569 | 5.0× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $2,267 | 7.5× |
| MRI, brain (no contrast) CPT Code: 70551 | $2,214 | 6.5× |
| MRI, knee or other leg joint CPT Code: 73721 | $2,172 | 5.9× |
| MRI, lower back (no contrast) CPT Code: 72148 | $2,138 | 6.3× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,010 | 7.8× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,715 | 2.9× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,592 | 6.6× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,537 | 9.1× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,454 | 8.7× |
| CT scan, head (no contrast) CPT Code: 70450 | $1,366 | 8.5× |
| CT scan, pelvis CPT Code: 72192 | $1,391 | 8.5× |
| CT scan, sinuses CPT Code: 70486 | $1,370 | 8.3× |
| Rabies immune globulin HCPCS Code: 90375 | $1,128 | 3.5× |
| X-ray, shoulder CPT Code: 73030 | $642 | 7.0× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $662 | 2.4× |
| Blood transfusion CPT Code: 36430 | $601 | 1.2× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $537 | 4.0× |
| Ultrasound, pelvis CPT Code: 76856 | $481 | 3.7× |
| X-ray, lower back CPT Code: 72110 | $433 | 3.9× |
Showing top 25 high-impact procedures of 99 total
Inline Bill X-Ray & 501(r) Calculator
For-Profit Facility · Cash & Fair BaseRate Audit
Audit a Bill or Quote at Ruby Valley Medical Center (Zero PHI Required)
CMS CCN: 271319
CPT G0390
Fair BaseRate™ $1,453
Medicare Rate $1,362
Self-Pay Cash $3,542
Insurer Median $3,542
Pre-filled with Ruby Valley Medical Center’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
274% of 2026 FPL
Above Standard 400% FPL Financial-Assistance Ceiling
At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.
Step 2 · Cash vs. Insurance Arbitrage
Save $394 Paying Cash
Self-Pay Cash Rate ($3,542) Beats Your Bill
Ruby Valley Medical Center's published 45 CFR § 180 self-pay cash rate is $3,542 (vs. $3,542 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Step 3 · Fair BaseRate Target
+$2,483 Above Fair BaseRate
Negotiate Toward $1,453 Fair BaseRate ($1,362 Medicare)
Your bill ($3,936) is $2,483 above the denoised Fair BaseRate ($1,453) and 2.9× 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)
For-Profit / Non-501(c)(3)
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Ruby Valley Medical Center as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.
Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines:
Calculate Your 501(r) Cap Above ↑
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 Ruby Valley Medical Center.
Price Index: 1.83× regional baseline
Quality: 54/100 CMS composite
Median Household Income$67,420U.S. Census ACS
Local Uninsured Share7.4%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 75/100 · Corroborated
CMS CCN 271319
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Published MRF Fileexport
Publication / Vintage2026-08-14 · 19.46 MB
Validated Rate Rows4,712 (CMS v3.0.0)
File Integrity Digest779ed0cbbc7e8ced75af…
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.