How many shoppable procedure prices are published for Pender Memorial Hospital?

Pender Memorial Hospital in Burgaw, NC currently has 87 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Pender Memorial Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Pender Memorial Hospital's median negotiated commercial rate is 1.8× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Government - Local 25 Beds · urban Updated: 2026-03-30

Pender Memorial Hospital

507 E Fremont St, Burgaw, NC 28425 · 87 Priced Procedures

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

1.78×vs. Fair Market Price

Typical commercial prices here are +78% above the fair benchmark (1.78×) even after accounting for local nurse/doctor wages and patient complexity.

69/100 · Caution

69/100Self-Pay Cash Beats Insurance 56% of the Time

File Completeness61

Price Logic50

Peer Alignment65

Clean Billing82

Real Cash Discount100

High-Markup · Check Safety

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

Behavioral Pricing FingerprintUpper-Quartile Spread · +27% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Pender Memorial Hospital prices routine shoppable procedures at 2.4× Medicare (median 1.77× Fair BaseRate) while upper-quartile commercial rates jump +27% to 2.24× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#67 of 69 in NC · 95th State Percentile#2,948 of 3,385 in U.S. · 87th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.99× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 56% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (65/100 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)

Even at low-cost facilities (1.78× 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 1.77× Fair BaseRate (2.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.24×) jump +27% above the median procedure ratio (Q50 1.77×)
Consolidated metro market (HHI 7,134) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.4× Medicare

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

Back-Door Captive & ER0.63× Divergence

1.5× Medicare

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

Quantile Tail Spread+27% Upper Tail

Q25 0.99× · Q50 1.77× · Q75 2.24×

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

2.4× MedicareFair

Outpatient Surgery & ORBack-Door Captive

0.7× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.3× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

3.5× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

4.3× MedicareElevated

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

2.8× MedicareFair

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

56% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 65/100Fair

Procedure Prices at Pender Memorial Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 87 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`	—	$31,606	$30,775	1.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$19,826	$19,432	1.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$19,136	$19,087	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$17,806	$17,936	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$6,930	$8,223	0.8×
Breast lump removal CPT Code: `19120`	$3,883	$5,349	$3,875	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$1,515	$1,116	$338	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$1,644	$1,047	$511	unverified
MRI, brain (no contrast) CPT Code: `70551`	$1,373	$1,002	$343	2.9×
MRI, knee or other leg joint CPT Code: `73721`	$1,154	$984	$369	2.7×
Blood transfusion CPT Code: `36430`	$789	$985	$498	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,511	$962	$448	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,260	$802	$303	2.6×
CT scan, pelvis CPT Code: `72192`	$859	$638	$163	3.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,012	$644	$258	2.5×
CT scan, chest (no contrast) CPT Code: `71250`	$762	$613	$167	3.7×
CT scan, sinuses CPT Code: `70486`	$792	$577	$166	3.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$800	$509	$168	3.0×
CT scan, neck (cervical spine) CPT Code: `72125`	$800	$509	$169	3.0×
CT scan, head (with contrast) CPT Code: `70460`	$810	$516	$242	2.1×
CT scan, head (no contrast) CPT Code: `70450`	$702	$447	$160	2.8×
X-ray, chest (two views) CPT Code: `71046`	$650	$469	$93	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$555	$354	$583	0.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$334	$278	$126	2.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$198	$272	$148	1.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$432	$275	$272	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$154	$213	$123	1.7×
X-ray, hip CPT Code: `73502`	$157	$216	$93	unverified
X-ray, chest (single view) CPT Code: `71045`	$103	$142	$92	1.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$261	$166	$134	1.2×
Office visit, established patient (20-29 min) CPT Code: `99213`	$119	$124	$87	1.4×
New patient office visit (30-44 min) CPT Code: `99203`	$133	$135	$110	1.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$158	$149	$123	1.2×
Ultrasound, pelvis CPT Code: `76856`	$244	$156	$130	1.2×
Breathing treatment (nebulizer) CPT Code: `94640`	$199	$147	$201	0.7×
Prosthetic fitting and training CPT Code: `97761`	$69	$81	$45	1.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$113	$86	$64	1.3×
X-ray, hand CPT Code: `73130`	$144	$92	$93	1.0×
X-ray, ankle CPT Code: `73610`	$144	$92	$93	1.0×
X-ray, lower back CPT Code: `72110`	$158	$101	$112	0.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$151	$110	$132	0.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$749	$749	$8	unverified
Drug screening test HCPCS Code: `G0480`	$214	$214	$116	unverified
Blood test, vitamin D CPT Code: `82306`	$148	$148	$31	4.8×
Blood antibody screen CPT Code: `86850`	$112	$139	$46	3.0×
Blood test, lipase CPT Code: `83690`	$111	$111	$7	15.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$81	$81	$14	5.8×
Hepatitis C antibody test CPT Code: `86803`	$86	$86	$15	5.7×
Blood test, vitamin B12 CPT Code: `82607`	$90	$90	$16	5.6×
Blood test, PSA (prostate screen) CPT Code: `84153`	$109	$109	$19	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$114	$114	$20	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$81	$81	$11	7.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$80	$80	$14	5.7×
Speech therapy (group session) CPT Code: `92508`	$58	$79	$27	2.9×
Physical therapy (gait training) CPT Code: `97116`	$54	$74	$33	2.2×
Physical therapy (manual therapy) CPT Code: `97140`	$54	$74	$34	2.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$54	$74	$35	2.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$54	$74	$38	1.9×
Occupational therapy (self-care training) CPT Code: `97535`	$54	$74	$38	1.9×
Orthotic fitting and training CPT Code: `97760`	$54	$74	$51	1.5×
X-ray, foot CPT Code: `73630`	$125	$79	$92	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$122	$78	$93	0.8×
X-ray, shoulder CPT Code: `73030`	$121	$77	$92	0.8×
Blood test, thyroid (TSH) CPT Code: `84443`	$96	$96	$18	unverified
Blood test, sodium CPT Code: `84295`	$39	$39	$5	7.8×
Blood test, potassium CPT Code: `84132`	$36	$36	$5	7.2×
Culture, bacterial CPT Code: `87070`	$51	$51	$9	5.7×
Blood test, basic metabolic panel CPT Code: `80048`	$50	$50	$9	5.6×
Culture, blood CPT Code: `87040`	$61	$61	$11	5.5×
Physical therapy (functional capacity test) CPT Code: `97750`	$54	$74	$38	1.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$54	$74	$40	1.9×
Speech therapy (language evaluation) CPT Code: `92507`	$54	$75	$86	0.9×
Blood test, liver function panel CPT Code: `80076`	$49	$49	$9	5.4×
X-ray, pelvis CPT Code: `72170`	$100	$64	$110	0.6×
Blood test, creatinine (kidney) CPT Code: `82565`	$33	$33	$5	6.6×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$58	$58	$10	unverified
Blood test, hemoglobin CPT Code: `85018`	$21	$21	$3	7.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$19	$19	$3	6.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$35	$35	$6	5.8×
Blood test, glucose (blood sugar) CPT Code: `82947`	$23	$23	$4	5.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$23	$23	$4	5.8×
Blood test, magnesium CPT Code: `83735`	$39	$39	$7	5.6×
Blood test, amylase CPT Code: `82150`	$38	$38	$7	5.4×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$25	$25	$5	5.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$20	$25	0.8×
Hospital observation (per hour) HCPCS Code: `G0378`	$27	$37	$86	0.4×
Blood test, calcium CPT Code: `82310`	$31	$31	$5	unverified

Showing top 25 high-impact procedures of 87 total

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

Audit a Bill or Quote at Pender Memorial Hospital (Zero PHI Required)

CMS CCN: 341307

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $31,606

1. Amount on Your Bill or Quote ($) Pre-filled with Pender Memorial 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 Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Pender Memorial Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$45,079 Above Fair BaseRate

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

Your bill ($75,854) is $45,079 above the denoised Fair BaseRate ($30,775) and 3.2× 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 Pender Memorial 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

Safety Composite65/100

Left ER Before Seen2%

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 Pender Memorial Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-08-20·administrative_or_closure
Met Requirements
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

Regional Quality & Price Benchmark

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

Price Index: 1.00× regional baseline

Quality: 55/100 CMS composite

Median Household Income$76,838U.S. Census ACS

Local Uninsured Share9.7%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 69/100 · Caution CMS CCN 341307

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 341307) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-30

Validated Rate Rows3,775 (CMS v3.0.0)

File Integrity DigestVerified · CCN 341307

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