How many shoppable procedure prices are published for Highland Hospital?

Highland Hospital in Rochester, NY currently has 125 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Highland Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Highland Hospital's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

What is Highland Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Highland Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 261 Beds · rural Updated: 7/1/2026

Highland Hospital

1000 South Avenue, Rochester, NY 14617 · 125 Priced Procedures · 72% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.20×vs. Fair Market Price

Typical commercial prices here are +20% above the fair benchmark (1.20×) even after accounting for local nurse/doctor wages and patient complexity.

86/100 · Verified

86/100Self-Pay Cash Beats Insurance 9% of the Time

File Completeness94

Price Logic93

Peer Alignment63

Clean Billing80

Real Cash Discount96

Premium Quality Tier

3-Star CMS clinical quality rating paired with 1.20× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Highland Hospital prices shoppable and inpatient services (1.4× to 1.2× Medicare, divergence 0.86×) in alignment with regional hospital peers (1.20× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#64 of 92 in NY · 68th State Percentile#2,011 of 3,385 in U.S. · 59th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.00× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 9% of shoppable procedures (96/100 Cash Honesty)
CMS clinical safety score (63/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (25.7% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 3.5× markup over Medicare rates
Commercial insurance median sits at 1.16× Fair BaseRate (1.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.38×) jump +19% above the median procedure ratio (Q50 1.16×)
Unnegotiated chargemaster list prices average 5.2× Medicare (20¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.4× Medicare

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

Back-Door Captive & ER0.86× Divergence

1.2× Medicare

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

Quantile Tail Spread+19% Upper Tail

Q25 1.00× · Q50 1.16× · Q75 1.38×

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

1.4× MedicareGood

Outpatient Surgery & ORBack-Door Captive

3.5× MedicareElevated

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.9× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

2.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.9× MedicareGood

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

1.1× MedicareGood

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

9% Cash Edge · 96/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 63/100Elevated

Procedure Prices at Highland Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 125 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$18,246	$21,466	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$17,340	$20,400	$19,432	1.0×
Total hip replacement CPT Code: `27130`	—	$19,904	$13,413	1.5×
Total knee replacement CPT Code: `27447`	—	$19,904	$13,523	1.5×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$16,816	$19,784	$17,936	1.1×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$9,372	$6,109	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$7,498	$8,821	$8,223	1.1×
Breast lump removal CPT Code: `19120`	—	$6,070	$3,875	1.6×
Inguinal hernia repair CPT Code: `49505`	—	$5,551	$3,629	1.5×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$5,073	$3,372	1.5×
Bunion correction surgery CPT Code: `28296`	—	$5,073	$3,446	1.5×
Cataract surgery with lens implant CPT Code: `66984`	—	$3,578	$2,540	1.4×
Trauma team activation HCPCS Code: `G0390`	—	$2,826	$1,453	1.9×
Colonoscopy with biopsy CPT Code: `45380`	$4,973	$2,107	$1,256	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	$3,820	$1,638	$981	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$3,818	$1,597	$987	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	—	$1,565	$1,021	1.5×
Injection procedure for pain management HCPCS Code: `G0260`	—	$1,189	$855	1.4×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,325	$843	$583	unverified
Psychological testing by technician CPT Code: `96138`	—	$675	$395	unverified
Blood transfusion CPT Code: `36430`	$2,189	$601	$498	1.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,680	$561	$511	1.1×
MRI, brain (no contrast) CPT Code: `70551`	$1,675	$505	$343	1.5×
MRI, knee or other leg joint CPT Code: `73721`	$1,675	$505	$369	1.4×
MRI, lower back (no contrast) CPT Code: `72148`	$1,675	$505	$338	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,680	$477	$448	1.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$449	$376	$181	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,107	$325	$272	1.2×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,675	$326	$303	1.1×
Neurobehavioral status check CPT Code: `96116`	—	$296	$231	1.3×
Behavioral health assessment HCPCS Code: `H0001`	—	$259	$157	1.6×
Rabies immune globulin HCPCS Code: `90375`	—	$280	$322	0.9×
Family therapy session CPT Code: `90847`	—	$251	$173	1.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$442	$249	$185	1.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,301	$272	$242	1.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,301	$272	$258	1.1×
Psychotherapy session (45 minutes) CPT Code: `90834`	$299	$251	$166	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$213	$213	$201	1.1×
Care planning with family CPT Code: `90887`	—	$235	$107	unverified
New patient office visit (30-44 min) CPT Code: `99203`	—	$215	$110	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$326	$177	$123	1.4×
Psychological testing evaluation CPT Code: `96136`	—	$181	$128	1.4×
X-ray, pelvis CPT Code: `72170`	$502	$140	$110	1.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$632	$143	$126	1.1×
Ultrasound, pelvis CPT Code: `76856`	$506	$140	$130	1.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$632	$143	$134	1.1×
Ultrasound, thyroid and neck CPT Code: `76536`	$632	$140	$132	1.1×
CT scan, head (no contrast) CPT Code: `70450`	$794	$162	$160	1.0×
CT scan, pelvis CPT Code: `72192`	$794	$162	$163	1.0×
CT scan, sinuses CPT Code: `70486`	$794	$162	$166	1.0×
CT scan, chest (no contrast) CPT Code: `71250`	$794	$162	$167	1.0×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$794	$162	$168	1.0×
CT scan, neck (cervical spine) CPT Code: `72125`	$794	$162	$169	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	—	—	$151	—
Office visit, established patient (20-29 min) CPT Code: `99213`	$218	$175	$87	unverified
X-ray, foot CPT Code: `73630`	$371	$119	$92	1.3×
X-ray, shoulder CPT Code: `73030`	$371	$118	$92	1.3×
X-ray, ankle CPT Code: `73610`	$371	$119	$93	1.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$587	$129	$148	0.9×
X-ray, lower back CPT Code: `72110`	$502	$143	$112	unverified
Screening mammogram (both breasts) CPT Code: `77067`	$587	$106	$123	0.9×
X-ray, chest (single view) CPT Code: `71045`	$371	$113	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$371	$113	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$371	$119	$93	unverified
X-ray, hand CPT Code: `73130`	$371	$119	$93	unverified
Group therapy session CPT Code: `90853`	—	$143	$100	unverified
X-ray, hip CPT Code: `73502`	$371	$117	$93	unverified
Typhoid vaccine HCPCS Code: `90675`	—	$406	$347	1.2×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$210	$203	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$142	$153	$111	1.4×
Pneumococcal vaccine HCPCS Code: `90732`	$191	$130	$140	0.9×
Drug screening test HCPCS Code: `G0480`	$128	$106	$116	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	$108	$58	$33	1.8×
Flu vaccine injection HCPCS Code: `G0008`	$68	$65	$48	1.4×
Pneumonia vaccine injection HCPCS Code: `G0009`	$68	$65	$49	1.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$208	$77	$64	1.2×
Physical therapy (gait training) CPT Code: `97116`	$90	$41	$33	1.2×
Colorectal cancer screening HCPCS Code: `G0010`	$60	$60	$49	1.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$281	$77	$86	0.9×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$113	$34	$27	1.3×
Occupational therapy (self-care training) CPT Code: `97535`	$96	$45	$38	1.2×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$43	$46	$39	1.2×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$84	$40	$35	1.1×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$30	$11	$10	1.1×
Blood test, vitamin D CPT Code: `82306`	$82	$33	$31	1.1×
Orthotic fitting and training CPT Code: `97760`	$99	$42	$51	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$77	$46	$56	0.8×
Speech therapy (language evaluation) CPT Code: `92507`	$213	$57	$86	0.7×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$16	$5	$4	1.3×
Blood test, calcium CPT Code: `82310`	$27	$6	$5	1.2×
Culture, blood CPT Code: `87040`	$49	$12	$11	1.1×
Blood test, liver function panel CPT Code: `80076`	$39	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$13	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$32	$7	$7	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$98	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$19	$4	$4	1.0×
Blood test, lipase CPT Code: `83690`	$24	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$30	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$26	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$55	$19	$19	1.0×
Blood test, hemoglobin CPT Code: `85018`	$10	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$26	$5	$5	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$89	$20	$20	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$71	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	$70	$14	$15	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$63	$13	$14	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$32	$23	$25	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$82	$16	$18	0.9×
Prosthetic fitting and training CPT Code: `97761`	$65	$37	$45	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	—	$28	$38	0.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$43	$17	$25	0.7×
Hepatitis B vaccine HCPCS Code: `90744`	—	—	$37	—
Blood test, complete blood count (CBC) CPT Code: `85025`	$38	$7	$8	0.9×
Speech therapy (group session) CPT Code: `92508`	—	$22	$27	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$90	$30	$38	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$84	$26	$34	0.8×
Blood antibody screen CPT Code: `86850`	$249	$15	$46	0.3×
Blood test, basic metabolic panel CPT Code: `80048`	$39	$9	$9	unverified
Blood test, comprehensive metabolic panel CPT Code: `80053`	$51	$12	$11	unverified
Community mental health services HCPCS Code: `H0038`	—	$35	$16	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$35	$7	$5	unverified
Blood test, sodium CPT Code: `84295`	$26	$6	$5	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$31	$7	$6	unverified
Culture, bacterial CPT Code: `87070`	$41	$10	$9	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$94	$13	$40	unverified

Showing top 25 high-impact procedures of 125 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 25.7%

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

CMS CCN: 330164

CPT 871

Select Procedure to Audit:

Fair BaseRate™ $19,087

Medicare Rate $14,117

Self-Pay Cash $18,246

Insurer Median $21,466

1. Amount on Your Bill or Quote ($) Pre-filled with Highland Hospital’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: $13,225 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $13,225

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (25.7% of gross = $13,225).

Step 2 · Cash vs. Insurance Arbitrage Save $33,272 Paying Cash

Self-Pay Cash Rate ($18,246) Beats Your Bill

Highland Hospital's published 45 CFR § 180 self-pay cash rate is $18,246 (vs. $21,466 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$32,431 Above Fair BaseRate

Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)

Your bill ($51,518) is $32,431 above the denoised Fair BaseRate ($19,087) and 3.6× the $14,117 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: 160743037

Filing Period: 199011

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 (25.7% 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 Composite63/100

Would Recommend72%

Rated 9 or 10 (HCAHPS)65%

Median ER Wait312 min

Left ER Before Seen4%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.2%

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 Highland Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2026-02-13·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (1,027 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

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Highland Hospital.

Price Index: 1.61× regional baseline

Quality: 58/100 CMS composite

Median Household Income$74,409U.S. Census ACS

Local Uninsured Share3.1%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 86/100 · Verified CMS CCN 330164 EIN 160743037

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 330164) ↗ Verify IRS Form 990 (EIN 160743037) ↗ CMS HCRIS Cost Reports ↗

Published MRF File160743037-HIGHLAND-HOSPITAL-OF-ROCHESTER-standardcharges.csv

Publication / Vintage7/1/2026 · 346.71 MB

Validated Rate Rows4,765 (CMS v3.0.0)

File Integrity Digest0d610d4ebf7f73f07b7e…

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