Tioga Medical Center
810 N Welo St, Tioga, ND 58852 · 93 Priced Procedures
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Specialty Drug & Surgical Margin Engine
Tioga Medical Center concentrates commercial margin in outpatient surgical suites (5.3× Medicare) and specialty drug infusions (2.7× Medicare) relative to routine diagnostics (10.0×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.
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 24% of shoppable procedures (25/100 Cash Honesty)
- CMS clinical safety score (69/100 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 (95.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 5.3× markup over Medicare rates
- Commercial insurance median sits at 1.00× Fair BaseRate (9.5× 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×)
- Consolidated metro market (HHI 8,485) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Tioga Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 93 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Bunion correction surgery CPT Code: 28296 | $6,237 | 1.8× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | — | — |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $6,082 | 1.8× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $5,010 | 9.8× |
| Breast lump removal CPT Code: 19120 | — | — |
| Inguinal hernia repair CPT Code: 49505 | — | — |
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,463 | 3.4× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,777 | 6.2× |
| MRI, knee or other leg joint CPT Code: 73721 | $2,699 | 7.3× |
| MRI, lower back (no contrast) CPT Code: 72148 | $2,673 | 7.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,434 | 9.4× |
| CT scan, pelvis CPT Code: 72192 | $2,039 | 12.5× |
| CT scan, chest (no contrast) CPT Code: 71250 | $2,039 | 12.2× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,039 | 12.1× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $2,039 | 12.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $2,039 | 6.7× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,952 | 8.1× |
| CT scan, head (no contrast) CPT Code: 70450 | $1,632 | 10.2× |
| CT scan, sinuses CPT Code: 70486 | $1,632 | 9.8× |
| MRI, brain (no contrast) CPT Code: 70551 | $1,640 | 4.8× |
| Blood transfusion CPT Code: 36430 | $1,558 | 3.1× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,526 | 5.6× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,458 | 2.5× |
| Hospital observation (per hour) HCPCS Code: G0378 | $1,253 | 14.6× |
| Colonoscopy with biopsy CPT Code: 45380 | — | — |
Audit a Bill or Quote at Tioga Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $5,925
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (95.0% of gross = $5,925).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Tioga Medical Center's published 45 CFR § 180 self-pay cash rate is $6,237 (vs. $6,237 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $3,446 Fair BaseRate ($3,343 Medicare)
Your bill ($6,237) is $2,791 above the denoised Fair BaseRate ($3,446) and 1.9× the $3,343 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (95.0% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Tioga Medical Center.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.