Union County General Hospital
300 Wilson Street, Clayton, NM 88415 · 79 Priced Procedures · 81% Patient Recommendation
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.
Aligned Regional Benchmark Peer
Union County General Hospital prices shoppable and inpatient services (8.5× to 10.6× Medicare, divergence 1.25×) 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.
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 86% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (72/100 safety score) with 81% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (90.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
- Captive ER (1.2×) & laboratory (1.4×) services average 1.25× higher multiples than routine shoppable care (8.5×)
- Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
- Unnegotiated chargemaster list prices average 7.7× Medicare (30¢ true HCRIS cost per $1 gross)
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 Union County General Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 79 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Inguinal hernia repair CPT Code: 49505 | $6,176 | 1.7× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $3,772 | 0.6× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $3,218 | 6.3× |
| MRI, lower back (no contrast) CPT Code: 72148 | $2,811 | 8.3× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,684 | 2.6× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,490 | 5.6× |
| MRI, brain (no contrast) CPT Code: 70551 | $2,316 | 6.8× |
| MRI, knee or other leg joint CPT Code: 73721 | $2,316 | 6.3× |
| Breast lump removal CPT Code: 19120 | $2,169 | 0.6× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $2,012 | 6.6× |
| Bunion correction surgery CPT Code: 28296 | $2,001 | 0.6× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,847 | 11.0× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,782 | 6.9× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,526 | 1.2× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,316 | 7.8× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,336 | 2.3× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,293 | 5.3× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,269 | 1.3× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,154 | 1.2× |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,029 | 6.2× |
| CT scan, head (no contrast) CPT Code: 70450 | $973 | 6.1× |
| CT scan, pelvis CPT Code: 72192 | $970 | 6.0× |
| CT scan, sinuses CPT Code: 70486 | $942 | 5.7× |
| Blood transfusion CPT Code: 36430 | $483 | 1.0× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $414 | 3.1× |
Audit a Bill or Quote at Union County General Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $7,939
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (90.0% of gross = $7,939).
Self-Pay Cash Rate ($6,176) Beats Your Bill
Union County General Hospital's published 45 CFR § 180 self-pay cash rate is $6,176 (vs. $6,176 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $3,629 Fair BaseRate ($3,658 Medicare)
Your bill ($8,823) is $5,194 above the denoised Fair BaseRate ($3,629) and 2.4× the $3,658 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (90.0% 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 (31 completed HCAHPS patient surveys). 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 Union County General Hospital.
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.