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Hospital Profile Rural Emergency Hospital Government - Local Updated: 7/1/2024

Guadalupe County Hospital

117 Camino De Vida, Suite 100, Santa Rosa, NM 88435 · 53 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).78/100 · Corroborated
78/100Self-Pay Cash Beats Insurance 72% of the Time
File Completeness61Provenance (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 Logic88Coherence (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 Alignment79Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing61Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount100Cash 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 FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Guadalupe County Hospital prices routine shoppable procedures near 7.6× Medicare (p50 1.00×) while skewing captive emergency, lab, and upper-quartile codes to 14.0× Medicare (p75 1.28×, +28% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

Regional Benchmark in NMU.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 72% of shoppable procedures (99/100 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 9.5× markup over Medicare rates
  • Captive ER (11.0×) & laboratory (11.7×) services average 1.84× higher multiples than routine shoppable care (7.6×)
  • Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
  • Unnegotiated chargemaster list prices average 9.6× Medicare (20¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
7.6× Medicare

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

Back-Door Captive & ER1.84× Divergence
14.0× 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
7.6× MedicareWatchout
Outpatient Surgery & ORBack-Door Captive
9.5× MedicareWatchout
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
5.1× MedicareWatchout
Back-Door Captive ER VisitsBack-Door Captive
11.0× MedicareWatchout
Inpatient Lab & PathologyBack-Door Captive
11.7× MedicareWatchout
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
8.7× MedicareWatchout
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
72% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 54/100Elevated

Procedure Prices at Guadalupe County Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 53 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $2,209 4.9×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $1,489 4.9×
CT scan, head (with and without contrast)
CPT Code: 70470
 $1,428 5.5×
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $1,314 7.8×
CT scan, neck (cervical spine)
CPT Code: 72125
 $1,288 7.6×
CT scan, pelvis
CPT Code: 72192
 $1,223 7.5×
CT scan, chest (no contrast)
CPT Code: 71250
 $1,240 7.4×
CT scan, sinuses
CPT Code: 70486
 $1,071 6.5×
CT scan, head (with contrast)
CPT Code: 70460
 $1,055 4.4×
CT scan, head (no contrast)
CPT Code: 70450
 $1,022 6.4×
Blood transfusion
CPT Code: 36430
 $668 1.3×
X-ray, lower back
CPT Code: 72110
 $286 2.6×
X-ray, shoulder
CPT Code: 73030
 $204 2.2×
X-ray, hip
CPT Code: 73502
 $186 2.0×
X-ray, pelvis
CPT Code: 72170
 $200 1.8×
X-ray, ankle
CPT Code: 73610
 $171 1.8×
X-ray, hand
CPT Code: 73130
 $166 1.8×
X-ray, chest (two views)
CPT Code: 71046
 $152 1.6×
X-ray, neck (cervical spine)
CPT Code: 72040
 $152 1.6×
X-ray, foot
CPT Code: 73630
 $145 1.6×
Electrocardiogram (EKG, tracing only)
CPT Code: 93005
 $119 1.9×
X-ray, chest (single view)
CPT Code: 71045
 $110 1.2×
Blood test, vitamin D
CPT Code: 82306
 $397 12.8×
Blood test, vitamin B12
CPT Code: 82607
 $178 11.1×
Culture, blood
CPT Code: 87040
 $141 12.8×
Showing top 25 high-impact procedures of 53 total
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Guadalupe County Hospital (Zero PHI Required)

CMS CCN: 320779
CPT 74177
Fair BaseRate™ $448
Medicare Rate $356
Self-Pay Cash $2,209
Insurer Median $2,209
Pre-filled with Guadalupe County Hospital’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 $552 Paying Cash

Self-Pay Cash Rate ($2,209) Beats Your Bill

Guadalupe County Hospital's published 45 CFR § 180 self-pay cash rate is $2,209 (vs. $2,209 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$2,313 Above Fair BaseRate

Negotiate Toward $448 Fair BaseRate ($356 Medicare)

Your bill ($2,761) is $2,313 above the denoised Fair BaseRate ($448) and 7.8× the $356 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 Guadalupe County 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 Price Transparency Administrative Enforcement Log

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

  • 2026-05-05·cap_corrective_action

    CAP Request

    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 Guadalupe County Hospital.

Price Index: 1.84× regional baseline
Quality: 54/100 CMS composite
Median Household Income$40,149U.S. Census ACS
Local Uninsured Share6.5%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 320779

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 320779) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage7/1/2024
Validated Rate Rows303 (CMS v2.0.0)
File Integrity DigestVerified · CCN 320779

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