How many shoppable procedure prices are published for Garnet Health Medical Center?

Garnet Health Medical Center in Middletown, NY currently has 137 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Garnet Health Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Garnet Health Medical Center's median negotiated commercial rate is 1.6× the regionally adjusted fair BaseRate benchmark.

What is Garnet Health Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Garnet Health Medical Center an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 329 Beds · rural Updated: 2026-04-01

Garnet Health Medical Center

707 East Main Street, Middletown, NY 10940 · 137 Priced Procedures · 63% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.59×vs. Fair Market Price

Typical commercial prices here are +59% above the fair benchmark (1.59×) even after accounting for local nurse/doctor wages and patient complexity.

81/100 · Corroborated

81/100Self-Pay Cash Beats Insurance 48% of the Time

File Completeness61

Price Logic91

Peer Alignment64

Clean Billing93

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.59× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +51% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Garnet Health Medical Center prices routine shoppable procedures at 2.0× Medicare (median 1.38× Fair BaseRate) while upper-quartile commercial rates jump +51% to 2.08× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#82 of 92 in NY · 88th State Percentile#2,761 of 3,385 in U.S. · 81st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.17× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 48% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 63% patient recommendation (65/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (19.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.5× markup over Medicare rates
Commercial insurance median sits at 1.38× Fair BaseRate (2.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.08×) jump +51% above the median procedure ratio (Q50 1.38×)
Consolidated metro market (HHI 2,645) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.0× Medicare

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

Back-Door Captive & ER0.65× Divergence

1.3× Medicare

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

Quantile Tail Spread+51% Upper Tail

Q25 1.17× · Q50 1.38× · Q75 2.08×

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

2.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.5× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

3.2× MedicareElevated

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

2.3× MedicareFair

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

48% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 65/100Fair

Procedure Prices at Garnet Health Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 137 published procedures.

Sort:

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`	—	$34,442	$30,775	1.1×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$20,870	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$20,727	$19,432	1.1×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$18,978	$17,936	1.1×
Vaginal delivery (full package) CPT Code: `59400`	—	$9,002	$2,680	3.4×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$8,615	$8,223	1.0×
C-section delivery (full package) CPT Code: `59510`	—	$8,354	$2,975	2.8×
Total hip replacement CPT Code: `27130`	—	$6,602	$13,413	0.5×
Total knee replacement CPT Code: `27447`	—	$6,593	$13,523	0.5×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$5,528	$6,109	0.9×
Inguinal hernia repair CPT Code: `49505`	—	$4,148	$3,629	1.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,956	$3,372	1.2×
Bunion correction surgery CPT Code: `28296`	—	$3,545	$3,446	1.0×
Breast lump removal CPT Code: `19120`	—	$3,545	$3,875	0.9×
Cataract surgery with lens implant CPT Code: `66984`	—	$3,262	$2,540	1.3×
Colonoscopy with biopsy CPT Code: `45380`	—	$2,792	$1,256	2.2×
Behavioral health day treatment HCPCS Code: `H0010`	—	$2,551	$343	unverified
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$2,428	$269	unverified
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,217	$855	2.6×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,151	$987	2.2×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,800	$2,037	$1,021	2.0×
Residential mental health treatment HCPCS Code: `H2036`	—	$1,789	$406	4.4×
Behavioral health residential care HCPCS Code: `H0011`	—	$1,717	$364	4.7×
Trauma team activation HCPCS Code: `G0390`	$694	$1,700	$1,453	1.2×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$1,313	$257	5.1×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$1,172	$981	1.2×
Blood transfusion CPT Code: `36430`	$253	$964	$498	1.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,261	$864	$511	1.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$620	$832	$448	1.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$842	$689	$583	1.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$418	$566	$272	2.1×
MRI, brain (no contrast) CPT Code: `70551`	$813	$555	$343	1.6×
MRI, knee or other leg joint CPT Code: `73721`	$890	$575	$369	1.6×
MRI, lower back (no contrast) CPT Code: `72148`	$890	$543	$338	1.6×
CT scan, head (with and without contrast) CPT Code: `70470`	$457	$441	$258	1.7×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$478	$426	$303	1.4×
Family therapy session CPT Code: `90847`	$207	$450	$173	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	$175	$421	$166	2.5×
CT scan, head (with contrast) CPT Code: `70460`	$427	$391	$242	1.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$208	$343	$123	2.8×
Behavioral health assessment HCPCS Code: `H0001`	—	$362	$157	2.3×
Neurobehavioral status check CPT Code: `96116`	—	$366	$231	1.6×
Psychological testing by technician CPT Code: `96138`	—	$371	$395	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$191	$319	$148	2.2×
CT scan, sinuses CPT Code: `70486`	$217	$297	$166	1.8×
Rabies immune globulin HCPCS Code: `90375`	—	—	$322	—
New patient office visit (30-44 min) CPT Code: `99203`	$218	$292	$110	2.7×
CT scan, pelvis CPT Code: `72192`	$471	$289	$163	1.8×
CT scan, chest (no contrast) CPT Code: `71250`	$833	$289	$167	1.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$217	$291	$169	1.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$478	$289	$168	1.7×
Screening mammogram (both breasts) CPT Code: `77067`	$143	$256	$123	2.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$203	$253	$132	1.9×
Psychiatric evaluation (first visit) CPT Code: `90791`	$272	$272	$185	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$163	$233	$87	2.7×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$218	$88	2.5×
Care planning with family CPT Code: `90887`	—	$236	$107	2.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$383	$235	$134	1.8×
CT scan, head (no contrast) CPT Code: `70450`	$396	$258	$160	1.6×
Speech therapy (language evaluation) CPT Code: `92507`	$188	$201	$86	2.3×
Review of medical records for care CPT Code: `90889`	—	$218	$114	1.9×
Ultrasound, pelvis CPT Code: `76856`	$203	$222	$130	1.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$335	$196	$126	1.6×
Psychotherapy session (60 minutes) CPT Code: `90837`	$198	$198	$181	unverified
X-ray, lower back CPT Code: `72110`	$65	$171	$112	1.5×
X-ray, hip CPT Code: `73502`	$182	$139	$93	1.5×
Mental health services (assessment) HCPCS Code: `H0031`	—	$162	$140	1.2×
X-ray, neck (cervical spine) CPT Code: `72040`	$87	$135	$93	1.5×
X-ray, hand CPT Code: `73130`	$52	$135	$93	1.5×
X-ray, ankle CPT Code: `73610`	$50	$133	$93	1.4×
X-ray, foot CPT Code: `73630`	$48	$127	$92	1.4×
X-ray, shoulder CPT Code: `73030`	$76	$120	$92	1.3×
Group therapy session CPT Code: `90853`	$94	$130	$100	1.3×
Psychological testing evaluation CPT Code: `96136`	—	$143	$128	1.1×
Prosthetic fitting and training CPT Code: `97761`	$55	$103	$45	2.3×
Orthotic fitting and training CPT Code: `97760`	$54	$113	$51	2.2×
X-ray, chest (two views) CPT Code: `71046`	$126	$111	$93	1.2×
X-ray, chest (single view) CPT Code: `71045`	$86	$91	$92	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$60	$115	$201	0.6×
Hospital observation (per hour) HCPCS Code: `G0378`	$113	$113	$86	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	$48	$86	$38	2.3×
Occupational therapy (self-care training) CPT Code: `97535`	$50	$84	$38	2.2×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$48	$83	$38	2.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$50	$86	$40	2.1×
Behavioral health day program HCPCS Code: `H2012`	—	$80	$100	0.8×
Typhoid vaccine HCPCS Code: `90675`	—	—	$347	—
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$215	$111	1.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	—	$203	—
Pneumococcal vaccine HCPCS Code: `90732`	—	$147	$140	1.1×
Drug screening test HCPCS Code: `G0480`	$39	$114	$116	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$69	$25	2.8×
Speech therapy (group session) CPT Code: `92508`	$76	$62	$27	2.3×
Physical therapy (gait training) CPT Code: `97116`	$40	$71	$33	2.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$57	$74	$35	2.1×
Physical therapy (manual therapy) CPT Code: `97140`	$43	$70	$34	2.1×
Flu vaccine injection HCPCS Code: `G0008`	—	$60	$48	1.3×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$60	$49	1.2×
Colorectal cancer screening HCPCS Code: `G0010`	—	$60	$49	1.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$75	$69	$64	1.1×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$32	$14	2.3×
Behavioral health outpatient services HCPCS Code: `H2015`	—	$30	$16	1.9×
Community mental health services HCPCS Code: `H0038`	—	$29	$16	1.8×
Blood test, clotting time (PTT) CPT Code: `85730`	$86	$8	$6	1.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$45	$10	$8	1.3×
Culture, bacterial CPT Code: `87070`	$62	$11	$9	1.2×
Hepatitis C antibody test CPT Code: `86803`	$64	$18	$15	1.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$55	$24	$20	1.2×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$42	$35	1.2×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$32	$27	1.2×
Behavioral health living support HCPCS Code: `H2019`	—	$38	$34	1.1×
Mental health services (therapy) HCPCS Code: `H0032`	—	$42	$65	0.6×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$9	$4	$3	1.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$57	$18	$14	1.3×
Blood test, vitamin D CPT Code: `82306`	$112	$38	$31	1.2×
Blood test, calcium CPT Code: `82310`	$19	$7	$5	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$10	$7	$5	1.4×
Blood test, magnesium CPT Code: `83735`	$29	$9	$7	1.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$65	$24	$19	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$10	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$18	$5	$4	1.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$59	$22	$18	1.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$37	$17	$14	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$23	$12	$10	1.2×
Blood test, potassium CPT Code: `84132`	$18	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$18	$6	$5	1.2×
Blood test, vitamin B12 CPT Code: `82607`	$245	$19	$16	1.2×
Blood test, amylase CPT Code: `82150`	$21	$8	$7	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$15	$10	$9	1.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$50	$12	$11	1.1×
Blood test, lipase CPT Code: `83690`	$32	$7	$7	1.0×
Blood test, hemoglobin CPT Code: `85018`	$22	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$48	$5	$5	1.0×
Culture, blood CPT Code: `87040`	$98	$11	$11	1.0×
Blood test, liver function panel CPT Code: `80076`	$24	$8	$9	0.9×
Blood antibody screen CPT Code: `86850`	$60	$23	$46	0.5×
X-ray, pelvis CPT Code: `72170`	$32	$32	$110	0.3×
Hepatitis B immune globulin HCPCS Code: `90371`	$1	$1	$151	0.0×

Showing top 25 high-impact procedures of 137 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 19.6%

Audit a Bill or Quote at Garnet Health Medical Center (Zero PHI Required)

CMS CCN: 330126

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $34,442

1. Amount on Your Bill or Quote ($) Pre-filled with Garnet Health 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: $16,160 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $16,160

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (19.6% of gross = $16,160).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Garnet Health 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 +$51,886 Above Fair BaseRate

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

Your bill ($82,661) is $51,886 above the denoised Fair BaseRate ($30,775) and 3.5× 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: 141364536

Filing Period: 193712

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 (19.6% 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 Overall3/5 Stars (3/5)

Safety Composite65/100

Would Recommend63%

Rated 9 or 10 (HCAHPS)64%

Median ER Wait255 min

Left ER Before Seen5%

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 Infectionbetter

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 Garnet Health Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-04-24·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (1,197 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

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

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

Price Index: 0.61× regional baseline

Quality: 60/100 CMS composite

Median Household Income$96,497U.S. Census ACS

Local Uninsured Share4.8%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 81/100 · Corroborated CMS CCN 330126 EIN 141364536

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 330126) ↗ Verify IRS Form 990 (EIN 141364536) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows1,728 (CMS v3.0.0)

File Integrity DigestVerified · CCN 330126

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