How many shoppable procedure prices are published for Duke University Hospital?

Duke University Hospital in Durham, NC currently has 110 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Duke University Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Duke University Hospital's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

What is Duke University Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Duke University Hospital an overall hospital quality rating of 5 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 1079 Beds · rural Updated: 04/01/2026

Duke University Hospital

2301 Erwin Rd, Durham, NC 27705 · 110 Priced Procedures · 81% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

Good Deal · Below Fair Market

0.94×vs. Fair Market Price

Typical commercial prices here are 6% below the fair benchmark (0.94×) after accounting for local nurse/doctor wages and patient complexity.

78/100 · Corroborated

78/100Self-Pay Cash Beats Insurance 67% of the Time

File Completeness51

Price Logic95

Peer Alignment68

Clean Billing76

Real Cash Discount100

Regional Value Leader

4-Star CMS clinical quality rating paired with 0.94× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Duke University Hospital prices shoppable and inpatient services (1.0× to 1.3× Medicare, divergence 1.30×) in alignment with regional hospital peers (0.94× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#22 of 69 in NC · 30th State Percentile#933 of 3,385 in U.S. · 27th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 6% below peer Fair BaseRate (0.94×)
Self-pay cash beats commercial insurance on 67% of shoppable procedures (99/100 Cash Honesty)
5-Star CMS clinical rating with 81% patient recommendation (71/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.94× 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 (1.4×) & laboratory (3.0×) services average 1.30× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.15×) jump +28% above the median procedure ratio (Q50 0.90×)
Consolidated metro market (HHI 5,266) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER1.30× Divergence

1.3× Medicare

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

Quantile Tail Spread+28% Upper Tail

Q25 0.69× · Q50 0.90× · Q75 1.15×

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

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.6× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.4× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

3.0× MedicareFair

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

0.6× MedicareGood

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

67% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 71/100Fair

Procedure Prices at Duke University Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 110 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$15,970	$34,175	$30,775	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$13,741	$21,438	$19,432	unverified
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$21,662	$19,253	$17,936	1.1×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$5,839	$7,494	$8,223	0.9×
Total hip replacement CPT Code: `27130`	$3,391	$3,391	$13,413	0.3×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,650	$1,650	$6,109	unverified
Trauma team activation HCPCS Code: `G0390`	$411	$1,302	$1,453	0.9×
Cataract surgery with lens implant CPT Code: `66984`	$979	$730	$2,540	0.3×
Inguinal hernia repair CPT Code: `49505`	$2,296	$720	$3,629	0.2×
Injection procedure for pain management HCPCS Code: `G0260`	$830	$672	$855	0.8×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,246	$631	$1,021	0.6×
Breast lump removal CPT Code: `19120`	$829	$565	$3,875	0.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$609	$468	$583	0.8×
Blood transfusion CPT Code: `36430`	$307	$428	$498	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$396	$396	$148	2.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,546	$355	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,402	$353	$511	0.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$432	$326	$132	2.5×
Colonoscopy with biopsy CPT Code: `45380`	$1,200	$351	$1,256	0.3×
Rabies immune globulin HCPCS Code: `90375`	$2,351	$290	$322	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$1,314	$279	$369	0.8×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,084	$292	$981	0.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$434	$229	$272	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$966	$238	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$876	$235	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$876	$238	$343	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$227	$198	$201	1.0×
CT scan, head (with contrast) CPT Code: `70460`	$742	$175	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$742	$175	$258	0.7×
Hepatitis B immune globulin HCPCS Code: `90371`	$784	$143	$151	0.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$191	$161	$185	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$253	$150	$181	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$389	$133	$167	0.8×
Upper endoscopy with biopsy CPT Code: `43239`	$1,145	$133	$987	0.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$58	$80	$40	2.0×
Orthotic fitting and training CPT Code: `97760`	$45	$100	$51	2.0×
X-ray, pelvis CPT Code: `72170`	$139	$104	$110	0.9×
X-ray, shoulder CPT Code: `73030`	$154	$86	$92	0.9×
X-ray, lower back CPT Code: `72110`	$139	$104	$112	0.9×
CT scan, neck (cervical spine) CPT Code: `72125`	$452	$118	$169	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$103	$86	$93	0.9×
X-ray, hip CPT Code: `73502`	$62	$86	$93	0.9×
X-ray, ankle CPT Code: `73610`	$154	$86	$93	0.9×
Ultrasound, pelvis CPT Code: `76856`	$485	$104	$130	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$621	$106	$134	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$165	$81	$110	0.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$159	$89	$123	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$293	$83	$123	0.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$345	$84	$126	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$452	$106	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$457	$106	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$452	$106	$166	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$457	$106	$168	0.6×
Family therapy session CPT Code: `90847`	$171	$102	$173	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$172	$91	$166	0.5×
Neurobehavioral status check CPT Code: `96116`	$89	$83	$231	0.4×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$304	$658	$203	3.2×
Blood antibody screen CPT Code: `86850`	$339	$339	$46	7.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$149	$341	$111	3.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$309	$309	$27	11.4×
Typhoid vaccine HCPCS Code: `90675`	$676	$318	$347	0.9×
Hepatitis C antibody test CPT Code: `86803`	$159	$159	$15	10.6×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$40	$107	$39	2.7×
Drug screening test HCPCS Code: `G0480`	$75	$114	$116	1.0×
Pneumococcal vaccine HCPCS Code: `90732`	$138	$131	$140	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$54	$72	$38	1.9×
Physical therapy (gait training) CPT Code: `97116`	$37	$62	$33	1.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$60	$71	$38	1.9×
Occupational therapy (self-care training) CPT Code: `97535`	$75	$70	$38	1.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$59	$63	$35	1.8×
Speech therapy (language evaluation) CPT Code: `92507`	$117	$72	$86	0.8×
Blood test, hemoglobin CPT Code: `85018`	$33	$33	$3	11.0×
Physical therapy (manual therapy) CPT Code: `97140`	$39	$58	$34	1.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$75	$71	$87	0.8×
Extended office visit (prolonged) HCPCS Code: `G2212`	$60	$67	$33	unverified
Behavioral health outpatient services HCPCS Code: `H2015`	$13	$23	$16	1.4×
Diagnostic procedure preparation HCPCS Code: `G0279`	$85	$41	$35	1.2×
Blood test, vitamin D CPT Code: `82306`	$230	$36	$31	1.2×
Flu vaccine injection HCPCS Code: `G0008`	$25	$42	$48	0.9×
X-ray, hand CPT Code: `73130`	$242	$58	$93	0.6×
X-ray, foot CPT Code: `73630`	$92	$53	$92	0.6×
Culture, bacterial CPT Code: `87070`	$161	$11	$9	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$41	$12	$10	1.2×
Culture, blood CPT Code: `87040`	$197	$13	$11	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$90	$7	$6	1.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$92	$22	$19	1.2×
Blood test, lipase CPT Code: `83690`	$31	$8	$7	1.1×
Blood test, magnesium CPT Code: `83735`	$18	$8	$7	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$114	$9	$8	1.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$173	$20	$18	1.1×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$92	$22	$20	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$55	$14	$14	1.0×
X-ray, chest (two views) CPT Code: `71046`	$156	$32	$93	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$81	$6	$3	2.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$104	$5	$4	1.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$20	$6	$5	1.2×
Blood test, amylase CPT Code: `82150`	$31	$8	$7	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$64	$18	$16	1.1×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$52	$5	$5	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$35	$23	$25	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$48	$12	$14	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	$36	$31	$37	0.8×
Speech therapy (group session) CPT Code: `92508`	$65	$22	$27	0.8×
Pneumonia vaccine injection HCPCS Code: `G0009`	$25	$33	$49	0.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$73	$16	$25	0.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$64	$27	$56	0.5×
X-ray, chest (single view) CPT Code: `71045`	$94	$24	$92	0.3×
Colorectal cancer screening HCPCS Code: `G0010`	$7	$7	$49	0.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$74	$9	$64	0.1×
Hospital observation (per hour) HCPCS Code: `G0378`	$9	$9	$86	0.1×

Showing top 25 high-impact procedures of 110 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Duke University Hospital (Zero PHI Required)

CMS CCN: 340030

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $15,970

Insurer Median $34,175

1. Amount on Your Bill or Quote ($) Pre-filled with Duke University Hospital’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 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 $43,179 Paying Cash

Self-Pay Cash Rate ($15,970) Beats Your Bill

Duke University Hospital's published 45 CFR § 180 self-pay cash rate is $15,970 (vs. $34,175 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$28,374 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($59,149) is $28,374 above the denoised Fair BaseRate ($30,775) and 2.5× the $23,504 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 Duke University Hospital 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 ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite71/100

Would Recommend81%

Rated 9 or 10 (HCAHPS)78%

Median ER Wait296 min

Left ER Before Seen5%

30-Day Mortality vs U.S.better

Unplanned Readmissionsame

Hip/Knee Complication Rate4.7%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

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

2025-06-17·administrative_or_closure
Closure Notice
Recorded
2025-03-17·warning_notice
Warning Notice
Recorded
2023-09-19·administrative_or_closure
Closure Notice
Recorded
2023-03-16·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (1,653 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

Higher-Quality, Above-Median Price Tier Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Duke University Hospital.

Price Index: 1.01× regional baseline

Quality: 83/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Humana

+77.0%

Median Household Income$79,501U.S. Census ACS

Local Uninsured Share11.6%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 78/100 · Corroborated CMS CCN 340030

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 340030) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage04/01/2026

Validated Rate Rows7,996 (CMS v3.0.0)

File Integrity DigestVerified · CCN 340030

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