How many shoppable procedure prices are published for Mount St. Mary's Hospital & Health Center?

Mount St. Mary's Hospital & Health Center in Lewiston, NY currently has 121 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Mount St. Mary's Hospital & Health Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Mount St. Mary's Hospital & Health Center's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

What is Mount St. Mary's Hospital & Health Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Mount St. Mary's Hospital & Health 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 - Private 175 Beds · urban Updated: 04/01/2026

Mount St. Mary's Hospital & Health Center

5300 Military Road, Lewiston, NY 14092 · 121 Priced Procedures · 71% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Good Deal · Below Fair Market

0.90×vs. Fair Market Price

Typical commercial prices here are 10% below the fair benchmark (0.90×) after accounting for local nurse/doctor wages and patient complexity.

65/100 · Caution

65/100Self-Pay Cash Beats Insurance 18% of the Time

File Completeness60

Price Logic88

Peer Alignment68

Clean Billing88

Real Cash Discount9

Regional Value Leader

4-Star CMS clinical quality rating paired with 0.90× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Mount St. Mary's Hospital & Health Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.87× Fair BaseRate) and emergency/ancillary services (1.3× Medicare, p75 1.01× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#25 of 92 in NY · 26th State Percentile#648 of 3,385 in U.S. · 19th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 10% below peer Fair BaseRate (0.90×)
Self-pay cash beats commercial insurance on 18% of shoppable procedures (25/100 Cash Honesty)
2-Star CMS clinical rating with 71% patient recommendation (75/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (29.8% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.7× markup over Medicare rates
Captive ER (2.5×) & laboratory (1.1×) services average 1.63× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.01×) jump +16% above the median procedure ratio (Q50 0.87×)
Consolidated metro market (HHI 2,537) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.8× Medicare

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

Back-Door Captive & ER1.63× Divergence

1.3× Medicare

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

Quantile Tail Spread+16% Upper Tail

Q25 0.64× · Q50 0.87× · Q75 1.01×

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

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.7× MedicareFair

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.2× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

2.5× MedicareFair

Inpatient Lab & PathologyBack-Door Captive

1.1× MedicareGood

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

1.1× MedicareGood

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

18% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 75/100Fair

Procedure Prices at Mount St. Mary's Hospital & Health Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 121 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`	—	$30,859	$30,775	1.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$20,561	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$18,612	$19,432	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$17,149	$17,936	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$8,589	$8,223	1.0×
Total hip replacement CPT Code: `27130`	$5,463	$5,463	$13,413	0.4×
Total knee replacement CPT Code: `27447`	$4,138	$4,138	$13,523	0.3×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,869	$1,869	$3,372	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,863	$1,863	$6,109	0.3×
Bunion correction surgery CPT Code: `28296`	$1,652	$1,652	$3,446	0.5×
Inguinal hernia repair CPT Code: `49505`	$1,491	$1,491	$3,629	0.4×
C-section delivery (full package) CPT Code: `59510`	$4,870	$1,220	$2,975	0.4×
Vaginal delivery (full package) CPT Code: `59400`	$4,666	$1,119	$2,680	0.4×
Breast lump removal CPT Code: `19120`	$864	$864	$3,875	0.2×
Rabies immune globulin HCPCS Code: `90375`	$6,786	$697	$322	2.2×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,153	$511	$1,021	0.5×
Breathing treatment (nebulizer) CPT Code: `94640`	$392	$392	$201	2.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$372	$372	$86	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$711	$336	$511	0.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$298	$257	$448	0.6×
MRI, brain (no contrast) CPT Code: `70551`	$556	$226	$343	0.7×
MRI, lower back (no contrast) CPT Code: `72148`	$573	$222	$338	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$816	$236	$369	0.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$664	$209	$583	0.4×
Colonoscopy with biopsy CPT Code: `45380`	$922	$208	$1,256	0.2×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,428	$152	$151	1.0×
Behavioral health assessment HCPCS Code: `H0001`	$244	$156	$157	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$352	$165	$185	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$292	$155	$181	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$357	$179	$258	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$409	$171	$272	0.6×
Screening mammogram (both breasts) CPT Code: `77067`	$282	$110	$123	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$204	$130	$148	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$194	$152	$303	0.5×
Upper endoscopy with biopsy CPT Code: `43239`	$730	$177	$987	0.2×
CT scan, chest (no contrast) CPT Code: `71250`	$312	$134	$167	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$312	$132	$169	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$643	$131	$168	0.8×
CT scan, sinuses CPT Code: `70486`	$260	$123	$166	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$287	$147	$242	0.6×
Colonoscopy (diagnostic) CPT Code: `45378`	$762	$148	$981	0.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$235	$122	$123	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$143	$107	$134	0.8×
Family therapy session CPT Code: `90847`	$361	$118	$173	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$247	$108	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$268	$132	$163	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	$324	$106	$166	0.6×
Neurobehavioral status check CPT Code: `96116`	$164	$97	$231	0.4×
New patient office visit (30-44 min) CPT Code: `99203`	$223	$115	$110	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$190	$81	$87	0.9×
Ultrasound, pelvis CPT Code: `76856`	$99	$94	$130	0.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$131	$94	$132	0.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$284	$81	$126	0.6×
Typhoid vaccine HCPCS Code: `90675`	$740	$320	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$202	$203	unverified
Pneumococcal vaccine HCPCS Code: `90732`	$191	$129	$140	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$132	$100	$111	0.9×
Blood transfusion CPT Code: `36430`	$751	$75	$498	0.2×
Blood test, vitamin D CPT Code: `82306`	$30	$44	$31	1.4×
Orthotic fitting and training CPT Code: `97760`	$93	$45	$51	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$138	$69	$86	0.8×
Prosthetic fitting and training CPT Code: `97761`	$101	$39	$45	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	$107	$41	$49	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$40	$56	0.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$138	$44	$64	0.7×
Blood test, calcium CPT Code: `82310`	$5	$8	$5	1.6×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$6	$17	$14	1.2×
X-ray, hip CPT Code: `73502`	$212	$39	$93	0.4×
X-ray, lower back CPT Code: `72110`	$301	$45	$112	0.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$10	$16	$11	1.5×
Blood test, amylase CPT Code: `82150`	$11	$10	$7	1.4×
Blood test, basic metabolic panel CPT Code: `80048`	$7	$12	$9	1.3×
X-ray, neck (cervical spine) CPT Code: `72040`	$234	$34	$93	0.4×
Flu vaccine injection HCPCS Code: `G0008`	$75	$55	$48	unverified
Blood test, creatinine (kidney) CPT Code: `82565`	$9	$8	$5	1.6×
Blood test, clotting time (PTT) CPT Code: `85730`	$11	$9	$6	1.5×
Culture, bacterial CPT Code: `87070`	$16	$13	$9	1.4×
Blood test, lipase CPT Code: `83690`	$11	$10	$7	1.4×
Blood test, vitamin B12 CPT Code: `82607`	$30	$15	$16	0.9×
X-ray, shoulder CPT Code: `73030`	$230	$33	$92	0.4×
X-ray, hand CPT Code: `73130`	$229	$33	$93	0.4×
Blood test, sodium CPT Code: `84295`	$12	$7	$5	1.4×
X-ray, ankle CPT Code: `73610`	$229	$32	$93	0.3×
X-ray, foot CPT Code: `73630`	$199	$30	$92	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$4	$4	$3	1.3×
Blood test, magnesium CPT Code: `83735`	$11	$9	$7	1.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$9	$21	$18	1.2×
Community mental health services HCPCS Code: `H0038`	$47	$17	$16	1.1×
Blood test, glucose (blood sugar) CPT Code: `82947`	$10	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	—	$10	$10	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$20	$8	$8	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$29	$20	$20	1.0×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$77	$33	$35	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$79	$13	$14	0.9×
Physical therapy (manual therapy) CPT Code: `97140`	$76	$31	$34	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$88	$32	$38	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$7	$5	$5	1.0×
Speech therapy (group session) CPT Code: `92508`	$80	$25	$27	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$44	$23	$25	0.9×
Physical therapy (gait training) CPT Code: `97116`	$77	$30	$33	0.9×
Extended office visit (prolonged) HCPCS Code: `G2212`	$63	$29	$33	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$72	$33	$38	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	$51	$32	$37	0.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	$75	$29	$35	0.8×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$50	$31	$39	0.8×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$92	$31	$40	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$154	$18	$25	0.7×
Group therapy session CPT Code: `90853`	$51	$30	$100	0.3×
Blood test, hemoglobin CPT Code: `85018`	$11	$2	$3	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$82	$26	$49	0.5×
X-ray, chest (two views) CPT Code: `71046`	$72	$27	$93	0.3×
Blood antibody screen CPT Code: `86850`	$6	$13	$46	0.3×
X-ray, pelvis CPT Code: `72170`	$292	$27	$110	0.2×
X-ray, chest (single view) CPT Code: `71045`	$135	$21	$92	0.2×
Blood test, liver function panel CPT Code: `80076`	$7	$12	$9	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$14	$20	$14	unverified
Blood test, potassium CPT Code: `84132`	$11	$7	$5	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$18	$27	$19	unverified
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$7	$6	$4	unverified
Hepatitis C antibody test CPT Code: `86803`	$23	$21	$15	unverified
Culture, blood CPT Code: `87040`	$8	$15	$11	unverified

Showing top 25 high-impact procedures of 121 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 29.8%

Audit a Bill or Quote at Mount St. Mary's Hospital & Health Center (Zero PHI Required)

CMS CCN: 330188

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $30,859

1. Amount on Your Bill or Quote ($) Pre-filled with Mount St. Mary's Hospital & Health 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: $20,755 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $20,755

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (29.8% of gross = $20,755).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Mount St. Mary's Hospital & Health 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 +$38,895 Above Fair BaseRate

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

Your bill ($69,670) is $38,895 above the denoised Fair BaseRate ($30,775) and 3.0× 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: 161523353

Filing Period: 194603

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 (29.8% 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 Overall4/5 Stars (4/5)

Safety Composite75/100

Would Recommend71%

Rated 9 or 10 (HCAHPS)71%

Median ER Wait163 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (383 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 Mount St. Mary's Hospital & Health Center.

Price Index: 0.99× regional baseline

Quality: 73/100 CMS composite

Median Household Income$67,809U.S. Census ACS

Local Uninsured Share2.5%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 65/100 · Caution CMS CCN 330188 EIN 161523353

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

MRF Portal Indexed (16-1523353_Mount-St-Marys-Hospital_StandardCharges.csv) Verify on CMS Medicare.gov (CCN 330188) ↗ Verify IRS Form 990 (EIN 161523353) ↗ CMS HCRIS Cost Reports ↗

Published MRF File16-1523353_Mount-St-Marys-Hospital_StandardCharges.csv

Publication / Vintage04/01/2026 · 3997.82 MB

Validated Rate Rows62,871 (CMS v3.0.0)

File Integrity DigestVerified · CCN 330188

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