How many shoppable procedure prices are published for Erie County Medical Center?

Erie County Medical Center in Buffalo, NY currently has 142 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Erie County Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Erie County Medical Center's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

What is Erie County Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Erie County Medical Center an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Other 410 Beds · urban Updated: 2026-08-25

Erie County Medical Center

462 Grider Street, Buffalo, NY 14215 · 142 Priced Procedures · 64% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Above Fair Market · Negotiate

1.38×vs. Fair Market Price

Typical commercial prices here are +38% above the fair benchmark (1.38×) even after accounting for local nurse/doctor wages and patient complexity.

85/100 · Corroborated

85/100Self-Pay Cash Beats Insurance 33% of the Time

File Completeness95

Price Logic90

Peer Alignment61

Clean Billing80

Real Cash Discount95

High Price · Lower Safety

2-Star CMS clinical quality rating paired with 1.38× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 2,537), Erie County Medical Center commands a 1.38× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#74 of 92 in NY · 79th State Percentile#2,418 of 3,385 in U.S. · 71st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.89× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 33% of shoppable procedures (95/100 Cash Honesty)
2-Star CMS clinical rating with 64% patient recommendation (56/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (25.1% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.3× markup over Medicare rates
Commercial insurance median sits at 1.08× Fair BaseRate (1.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.27×) jump +18% above the median procedure ratio (Q50 1.08×)
Consolidated metro market (HHI 2,537) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.5× Medicare

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

Back-Door Captive & ER0.80× Divergence

1.2× Medicare

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

Quantile Tail Spread+18% Upper Tail

Q25 0.89× · Q50 1.08× · Q75 1.27×

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

1.5× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.3× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.7× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.1× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.6× MedicareFair

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

2.2× MedicareFair

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

33% Cash Edge · 95/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 56/100Elevated

Procedure Prices at Erie County Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 142 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`	—	$36,047	$30,775	1.2×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$21,676	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$21,524	$19,432	1.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$19,673	$17,936	1.1×
Total hip replacement CPT Code: `27130`	$9,882	$10,366	$13,413	0.8×
Total knee replacement CPT Code: `27447`	$7,053	$10,366	$13,523	0.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$8,699	$8,223	1.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$7,053	$6,266	$6,109	unverified
Inguinal hernia repair CPT Code: `49505`	$6,167	$4,603	$3,629	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	$6,167	$4,207	$3,372	1.2×
Bunion correction surgery CPT Code: `28296`	$4,265	$4,084	$3,446	1.2×
Breast lump removal CPT Code: `19120`	—	—	$3,875	unverified
Cataract surgery with lens implant CPT Code: `66984`	$9,711	$3,616	$2,540	1.4×
Vaginal delivery (full package) CPT Code: `59400`	$6,363	$2,525	$2,680	0.9×
Trauma team activation HCPCS Code: `G0390`	—	$2,329	$1,453	1.6×
Colonoscopy with biopsy CPT Code: `45380`	$787	$1,873	$1,256	1.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,710	$1,625	$981	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$3,710	$1,585	$987	unverified
Injection procedure for pain management HCPCS Code: `G0260`	$2,717	$1,072	$855	1.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,459	$1,088	$1,021	1.1×
C-section delivery (full package) CPT Code: `59510`	$7,029	$1,102	$2,975	0.4×
Blood transfusion CPT Code: `36430`	$100	$685	$498	1.4×
MRI, brain (with and without contrast) CPT Code: `70553`	$825	$610	$511	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$690	$450	$448	1.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$450	$419	$272	1.5×
MRI, brain (no contrast) CPT Code: `70551`	$507	$404	$343	1.2×
MRI, knee or other leg joint CPT Code: `73721`	$551	$417	$369	1.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$382	$374	$303	1.2×
MRI, lower back (no contrast) CPT Code: `72148`	$499	$391	$338	1.2×
Residential mental health treatment HCPCS Code: `H2036`	—	$406	$406	1.0×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$484	$411	$583	0.7×
Rabies immune globulin HCPCS Code: `90375`	—	$350	$322	1.1×
CT scan, head (with contrast) CPT Code: `70460`	$334	$294	$242	1.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$413	$307	$258	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$324	$282	$123	unverified
Mental health services (assessment) HCPCS Code: `H0031`	—	$239	$140	1.7×
Behavioral health assessment HCPCS Code: `H0001`	—	$239	$157	1.5×
Behavioral health day program HCPCS Code: `H2012`	—	$192	$100	1.9×
Ultrasound, abdomen (complete) CPT Code: `76700`	$299	$183	$134	1.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$263	$201	$166	1.2×
CT scan, sinuses CPT Code: `70486`	$372	$195	$166	1.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$394	$201	$181	1.1×
Psychological testing by technician CPT Code: `96138`	$114	$212	$395	0.5×
Psychological testing evaluation CPT Code: `96136`	$143	$168	$128	1.3×
CT scan, pelvis CPT Code: `72192`	$286	$189	$163	1.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$372	$192	$169	1.1×
CT scan, chest (no contrast) CPT Code: `71250`	$372	$189	$167	1.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$372	$190	$168	1.1×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$168	$151	1.1×
Neurobehavioral status check CPT Code: `96116`	$270	$192	$231	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$241	$183	$160	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$279	$185	$132	unverified
Screening mammogram (both breasts) CPT Code: `77067`	—	$155	$123	1.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$157	$148	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$236	$174	$126	unverified
Ultrasound, pelvis CPT Code: `76856`	$267	$183	$130	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	—	—	$185	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$95	$153	$86	1.8×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$144	$88	1.6×
New patient office visit (30-44 min) CPT Code: `99203`	$323	$165	$110	1.5×
Care planning with family CPT Code: `90887`	$270	$145	$107	1.4×
Group therapy session CPT Code: `90853`	$81	$127	$100	1.3×
Family therapy session CPT Code: `90847`	$329	$151	$173	0.9×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$152	$257	0.6×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$152	$269	0.6×
Behavioral health day treatment HCPCS Code: `H0010`	—	$152	$343	0.4×
Behavioral health residential care HCPCS Code: `H0011`	—	$154	$364	0.4×
Office visit, established patient (20-29 min) CPT Code: `99213`	$219	$165	$87	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	$76	$155	$35	unverified
Behavioral health living support HCPCS Code: `H2019`	—	$144	$34	unverified
Orthotic fitting and training CPT Code: `97760`	$95	$90	$51	1.8×
X-ray, hip CPT Code: `73502`	$89	$87	$93	0.9×
X-ray, lower back CPT Code: `72110`	$100	$93	$112	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$53	$108	$201	0.5×
Speech therapy (group session) CPT Code: `92508`	$95	$90	$27	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$95	$90	$35	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$95	$90	$38	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$95	$90	$34	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$95	$90	$40	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$128	$90	$38	unverified
Prosthetic fitting and training CPT Code: `97761`	$95	$90	$45	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	—	—	$86	unverified
Extended office visit (prolonged) HCPCS Code: `G2212`	$101	$89	$33	unverified
Typhoid vaccine HCPCS Code: `90675`	—	$315	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$196	$203	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$94	$94	$27	3.5×
Drug screening test HCPCS Code: `G0480`	$250	$114	$116	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$97	$111	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	—	$119	$140	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$50	$50	$25	2.0×
Review of medical records for care CPT Code: `90889`	—	$73	$114	0.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$42	$32	$14	2.3×
Hepatitis B vaccine HCPCS Code: `90744`	—	$38	$37	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$39	$39	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$24	$53	$64	0.8×
X-ray, neck (cervical spine) CPT Code: `72040`	$72	$67	$93	0.7×
X-ray, hand CPT Code: `73130`	$72	$67	$93	0.7×
X-ray, ankle CPT Code: `73610`	$75	$65	$93	0.7×
X-ray, shoulder CPT Code: `73030`	$63	$61	$92	0.7×
X-ray, foot CPT Code: `73630`	$69	$59	$92	0.6×
X-ray, chest (two views) CPT Code: `71046`	$58	$56	$93	0.6×
X-ray, chest (single view) CPT Code: `71045`	$31	$47	$92	0.5×
X-ray, pelvis CPT Code: `72170`	$59	$56	$110	0.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$13	$4	$3	1.3×
Blood test, calcium CPT Code: `82310`	$22	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$22	$6	$5	1.2×
Blood test, lipase CPT Code: `83690`	$27	$8	$7	1.1×
Blood test, magnesium CPT Code: `83735`	$29	$8	$7	1.1×
Blood test, complete blood count (CBC) CPT Code: `85025`	$33	$9	$8	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$34	$10	$9	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$45	$12	$11	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$57	$15	$14	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$58	$15	$14	1.1×
Blood test, vitamin D CPT Code: `82306`	$124	$33	$31	1.1×
Blood test, vitamin B12 CPT Code: `82607`	$63	$17	$16	1.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$72	$19	$18	1.1×
Blood test, liver function panel CPT Code: `80076`	$34	$9	$9	1.0×
Blood test, amylase CPT Code: `82150`	$28	$7	$7	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$17	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$41	$10	$10	1.0×
Blood test, potassium CPT Code: `84132`	$20	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$20	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$17	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$10	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$17	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$78	$18	$19	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$42	$56	0.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$26	$7	$6	1.2×
Culture, bacterial CPT Code: `87070`	$37	$10	$9	1.1×
Culture, blood CPT Code: `87040`	$44	$12	$11	1.1×
Hepatitis C antibody test CPT Code: `86803`	$61	$15	$15	1.0×
Physical therapy (gait training) CPT Code: `97116`	$95	$32	$33	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$78	$19	$20	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$95	$36	$38	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$22	$25	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$49	$43	$49	0.9×
Community mental health services HCPCS Code: `H0038`	—	$14	$16	0.9×
Blood antibody screen CPT Code: `86850`	$16	$34	$46	0.7×
Flu vaccine injection HCPCS Code: `G0008`	$75	$30	$48	0.6×
Behavioral health outpatient services HCPCS Code: `H2015`	—	$10	$16	0.6×
Pneumonia vaccine injection HCPCS Code: `G0009`	$75	$30	$49	0.6×
Mental health services (therapy) HCPCS Code: `H0032`	—	$12	$65	0.2×

Showing top 25 high-impact procedures of 142 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 25.1%

Audit a Bill or Quote at Erie County Medical Center (Zero PHI Required)

CMS CCN: 330219

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $36,047

1. Amount on Your Bill or Quote ($) Pre-filled with Erie County Medical Center’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 501(r) AGB Cap: $21,741 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $21,741

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (25.1% of gross = $21,741).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Erie County Medical Center'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 +$55,738 Above Fair BaseRate

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

Your bill ($86,513) is $55,738 above the denoised Fair BaseRate ($30,775) and 3.7× 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) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 830382654

Filing Period: 199602

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (25.1% 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.

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 Overall2/5 Stars (2/5)

Safety Composite56/100

Would Recommend64%

Rated 9 or 10 (HCAHPS)62%

Median ER Wait346 min

Left ER Before Seen8%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

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 Erie County Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-25·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (1,063 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

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Erie County Medical Center.

Price Index: 2.20× regional baseline

Quality: 41/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

UnitedHealthcare

+117.6%

Median Household Income$71,175U.S. Census ACS

Local Uninsured Share2.8%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 85/100 · Corroborated CMS CCN 330219 EIN 830382654

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 330219) ↗ Verify IRS Form 990 (EIN 830382654) ↗ CMS HCRIS Cost Reports ↗

Published MRF File830382654_erie-county-medical-center_standardcharges.json

Publication / Vintage2026-08-25 · 166.05 MB

Validated Rate Rows4,667 (CMS v3.0.0)

File Integrity Digest91861eb398a2f91cc708…

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