How many shoppable procedure prices are published for Niagara Falls Memorial Medical Center?

Niagara Falls Memorial Medical Center in Niagara Falls, NY currently has 117 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Niagara Falls Memorial Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Niagara Falls Memorial Medical Center's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

What is Niagara Falls Memorial Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Niagara Falls Memorial Medical Center an overall hospital quality rating of 1 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 133 Beds · urban Updated: 6/17/2026

Niagara Falls Memorial Medical Center

621 Tenth Street, Niagara Falls, NY 14302 · 117 Priced Procedures · 55% Patient Recommendation

CMS Overall Rating 1 / 5 Stars

Near Fair BaseRate Benchmark

1.01×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.01×) after accounting for local nurse/doctor wages and patient complexity.

75/100 · Corroborated

75/100Self-Pay Cash Beats Insurance 16% of the Time

File Completeness50

Price Logic81

Peer Alignment75

Clean Billing72

Real Cash Discount100

Regional Benchmark Tier

2-Star CMS clinical quality rating paired with 1.01× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Niagara Falls Memorial Medical Center prices shoppable and inpatient services (1.0× to 1.1× Medicare, divergence 1.10×) in alignment with regional hospital peers (1.01× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#40 of 92 in NY · 42nd State Percentile#1,341 of 3,385 in U.S. · 39th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.82× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 16% of shoppable procedures (99/100 Cash Honesty)
1-Star CMS clinical rating with 55% 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 (32.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Captive ER (0.7×) & laboratory (0.9×) services average 1.10× higher multiples than routine shoppable care (1.0×)
Even at low-cost facilities (1.01× 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.
Consolidated metro market (HHI 2,537) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

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

Back-Door Captive & ER1.10× Divergence

1.1× Medicare

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

Quantile Tail Spread+7% Upper Tail

Q25 0.82× · Q50 0.95× · Q75 1.02×

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

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.3× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.9× MedicareGood

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

0.6× MedicareGood

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

16% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

1 CMS · 56/100Elevated

Procedure Prices at Niagara Falls Memorial Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 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`	—	$33,125	$30,775	1.1×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$20,477	$19,087	1.1×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$20,138	$19,432	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$18,668	$17,936	1.0×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$8,670	$8,223	1.1×
Total hip replacement CPT Code: `27130`	$3,599	$3,599	$13,413	unverified
Total knee replacement CPT Code: `27447`	$3,599	$3,599	$13,523	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	$2,717	$2,717	$6,109	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,835	$1,835	$3,372	unverified
Inguinal hernia repair CPT Code: `49505`	$1,653	$1,653	$3,629	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$1,328	$1,328	$86	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	$984	$1,126	$981	1.1×
Upper endoscopy with biopsy CPT Code: `43239`	$2,236	$1,127	$987	1.1×
Colonoscopy with biopsy CPT Code: `45380`	$917	$1,017	$1,256	0.8×
Bunion correction surgery CPT Code: `28296`	$1,014	$1,014	$3,446	unverified
Breast lump removal CPT Code: `19120`	$789	$789	$3,875	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$818	$589	$583	1.0×
Blood transfusion CPT Code: `36430`	$797	$548	$498	1.1×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$712	$433	$448	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$900	$433	$511	0.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$297	$296	$272	1.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$442	$296	$303	1.0×
MRI, lower back (no contrast) CPT Code: `72148`	$538	$296	$338	0.9×
MRI, brain (no contrast) CPT Code: `70551`	$538	$296	$343	0.9×
Neurobehavioral status check CPT Code: `96116`	$188	$268	$231	1.2×
Rabies immune globulin HCPCS Code: `90375`	$1,438	$275	$322	0.9×
MRI, knee or other leg joint CPT Code: `73721`	$538	$296	$369	0.8×
CT scan, head (with contrast) CPT Code: `70460`	$449	$218	$242	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$512	$218	$258	0.8×
Family therapy session CPT Code: `90847`	$156	$220	$173	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$164	$164	$201	0.8×
X-ray, lower back CPT Code: `72110`	$166	$130	$112	1.2×
Ultrasound, abdomen (limited) CPT Code: `76705`	$246	$130	$126	1.0×
Ultrasound, pelvis CPT Code: `76856`	$136	$130	$130	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	$246	$130	$132	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	$145	$130	$134	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$111	$138	$151	0.9×
CT scan, head (no contrast) CPT Code: `70450`	$231	$130	$160	0.8×
CT scan, pelvis CPT Code: `72192`	$231	$130	$163	0.8×
CT scan, sinuses CPT Code: `70486`	$231	$130	$166	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$231	$130	$167	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$231	$130	$168	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	$231	$130	$169	0.8×
Psychiatric evaluation (first visit) CPT Code: `90791`	$124	$124	$185	0.7×
X-ray, chest (single view) CPT Code: `71045`	$105	$108	$92	unverified
X-ray, chest (two views) CPT Code: `71046`	$105	$108	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$105	$108	$93	unverified
X-ray, pelvis CPT Code: `72170`	$105	$130	$110	unverified
X-ray, shoulder CPT Code: `73030`	$105	$108	$92	unverified
X-ray, hand CPT Code: `73130`	$105	$108	$93	unverified
X-ray, hip CPT Code: `73502`	$83	$108	$93	unverified
X-ray, ankle CPT Code: `73610`	$105	$108	$93	unverified
X-ray, foot CPT Code: `73630`	$105	$108	$92	unverified
Psychotherapy session (45 minutes) CPT Code: `90834`	$119	$119	$166	unverified
Psychotherapy session (60 minutes) CPT Code: `90837`	$121	$121	$181	unverified
Group therapy session CPT Code: `90853`	$91	$126	$100	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$160	$82	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$489	$315	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$176	$178	$203	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$113	$119	$140	0.8×
Speech therapy (language evaluation) CPT Code: `92507`	$123	$74	$86	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$66	$91	$111	0.8×
Orthotic fitting and training CPT Code: `97760`	$74	$45	$51	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$114	$56	$87	0.6×
New patient office visit (30-44 min) CPT Code: `99203`	$121	$69	$110	0.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$141	$47	$148	0.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$35	$11	$11	1.0×
Blood test, calcium CPT Code: `82310`	$12	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$13	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$37	$14	$14	1.0×
Blood test, vitamin D CPT Code: `82306`	$66	$30	$31	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$52	$19	$20	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$50	$33	$38	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$50	$34	$40	0.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$45	$45	$64	0.7×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$36	$38	$56	0.7×
Drug screening test HCPCS Code: `G0480`	$38	$38	$116	0.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$13	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$19	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$18	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$18	$7	$7	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$35	$15	$16	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$49	$13	$14	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$17	$12	$14	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$32	$31	$38	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$198	$34	$123	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$11	$3	$3	1.0×
Blood test, potassium CPT Code: `84132`	$13	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$13	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$19	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$20	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$17	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$33	$9	$9	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$74	$26	$27	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$42	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$35	$17	$18	0.9×
Hepatitis C antibody test CPT Code: `86803`	$40	$14	$15	0.9×
Culture, blood CPT Code: `87040`	$49	$10	$11	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$28	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$29	$8	$9	0.9×
Blood test, amylase CPT Code: `82150`	$18	$6	$7	0.9×
Physical therapy (gait training) CPT Code: `97116`	$92	$28	$33	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$49	$32	$38	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$12	$4	$5	0.8×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$50	$20	$25	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$63	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$58	$27	$34	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	$60	$28	$37	0.8×
Flu vaccine (high dose) HCPCS Code: `90656`	$24	$18	$25	0.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$27	$28	$39	0.7×
Blood test, hemoglobin CPT Code: `85018`	$9	$2	$3	0.7×
Flu vaccine injection HCPCS Code: `G0008`	$62	$24	$48	0.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$62	$24	$49	0.5×
Colorectal cancer screening HCPCS Code: `G0010`	$62	$24	$49	0.5×
Psychological testing evaluation CPT Code: `96136`	$18	$18	$128	0.1×
Blood antibody screen CPT Code: `86850`	$15	$15	$46	unverified
Psychological testing by technician CPT Code: `96138`	$18	$18	$395	unverified

Showing top 25 high-impact procedures of 117 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 32.4%

Audit a Bill or Quote at Niagara Falls Memorial Medical Center (Zero PHI Required)

CMS CCN: 330065

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $33,125

1. Amount on Your Bill or Quote ($) Pre-filled with Niagara Falls Memorial 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: $25,742 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $25,742

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (32.4% of gross = $25,742).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Niagara Falls Memorial 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 +$48,725 Above Fair BaseRate

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

Your bill ($79,500) is $48,725 above the denoised Fair BaseRate ($30,775) and 3.4× 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: 160743094

Filing Period: 194207

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 (32.4% 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 Recommend55%

Rated 9 or 10 (HCAHPS)52%

Median ER Wait236 min

Left ER Before Seen3%

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)

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 Niagara Falls Memorial Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2022-10-19·administrative_or_closure
Closure Notice
Recorded
2021-10-27·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (320 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 Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Niagara Falls Memorial Medical Center.

Price Index: 1.20× regional baseline

Quality: 45/100 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 75/100 · Corroborated CMS CCN 330065 EIN 160743094

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 330065) ↗ Verify IRS Form 990 (EIN 160743094) ↗ CMS HCRIS Cost Reports ↗

Published MRF Filemrf

Publication / Vintage6/17/2026 · 68.62 MB

Validated Rate Rows1,474 (CMS v3.0.0)

File Integrity DigestVerified · CCN 330065

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