Glens Falls Hospital
100 Park Street, Glens Falls, NY 12801 · 136 Priced Procedures · 62% Patient Recommendation
Typical commercial prices here are +43% above the fair benchmark (1.43×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.43× fair market pricing.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Glens Falls Hospital prices routine shoppable procedures at 1.7× Medicare (median 1.33× Fair BaseRate) while upper-quartile commercial rates jump +38% to 1.84× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.92× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 51% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (63/100 safety score) with 62% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (39.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.43× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 1.33× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.84×) jump +38% above the median procedure ratio (Q50 1.33×)
- Consolidated metro market (HHI 10,000) 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 Glens Falls Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 136 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $24,938 | 0.8× |
| Total knee replacement CPT Code: 27447 | — | — |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $7,270 | 0.9× |
| C-section delivery (full package) CPT Code: 59510 | $6,294 | 2.1× |
| Vaginal delivery (full package) CPT Code: 59400 | $5,015 | 1.9× |
| Hospital observation (per hour) HCPCS Code: G0378 | $3,943 | 45.8× |
| Bunion correction surgery CPT Code: 28296 | $2,740 | 0.8× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,700 | unverified |
| Cataract surgery with lens implant CPT Code: 66984 | $2,556 | 1.0× |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,190 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,103 | unverified |
| Trauma team activation HCPCS Code: G0390 | $1,581 | 1.1× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,461 | 1.7× |
| Total hip replacement CPT Code: 27130 | $1,336 | 0.1× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $1,173 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $976 | unverified |
| Hepatitis B immune globulin HCPCS Code: 90371 | $925 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $718 | 0.1× |
| Blood transfusion CPT Code: 36430 | $685 | 1.4× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $653 | 0.6× |
| MRI, brain (no contrast) CPT Code: 70551 | $624 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $618 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $602 | unverified |
| Breast lump removal CPT Code: 19120 | $574 | 0.1× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $534 | 0.2× |
Audit a Bill or Quote at Glens Falls Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $23,384
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (39.1% of gross = $23,384).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Glens Falls Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($59,851) is $29,076 above the denoised Fair BaseRate ($30,775) and 2.5× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (39.1% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Glens Falls Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-04-29·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare (1,767 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 Glens Falls Hospital.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
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.