Samaritan Hospital of Troy, New York
2215 Burdett Avenue, Troy, NY 12180 · 124 Priced Procedures · 64% Patient Recommendation
Typical commercial prices here are +55% above the fair benchmark (1.55×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.55× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Samaritan Hospital of Troy, New York prices routine shoppable procedures near 1.7× Medicare (p50 1.38×) while skewing captive emergency, lab, and upper-quartile codes to 2.5× Medicare (p75 2.18×, +58% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.81× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 27% of shoppable procedures (61/100 Cash Honesty)
- CMS clinical safety score (63/100 safety score) with 64% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (63.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.55× 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.
- Captive ER (2.5×) & laboratory (4.1×) services average 1.47× higher multiples than routine shoppable care (1.7×)
- Upper-quartile procedures (Q75 2.18×) jump +58% above the median procedure ratio (Q50 1.38×)
- Consolidated metro market (HHI 2,515) 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 Samaritan Hospital of Troy, New York
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 124 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $69,412 | 2.3× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $41,739 | unverified |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $37,882 | 2.1× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $16,751 | unverified |
| Cataract surgery with lens implant CPT Code: 66984 | $9,706 | unverified |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $9,024 | unverified |
| C-section delivery (full package) CPT Code: 59510 | $5,860 | unverified |
| Bunion correction surgery CPT Code: 28296 | $5,600 | unverified |
| Breast lump removal CPT Code: 19120 | — | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $3,760 | 11.7× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,858 | 2.2× |
| Total hip replacement CPT Code: 27130 | $1,865 | unverified |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,544 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,451 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | — | unverified |
| Inguinal hernia repair CPT Code: 49505 | $1,157 | unverified |
| Vaginal delivery (full package) CPT Code: 59400 | $1,074 | 0.4× |
| Upper endoscopy with biopsy CPT Code: 43239 | — | unverified |
| Blood transfusion CPT Code: 36430 | $957 | 1.9× |
| Colonoscopy (diagnostic) CPT Code: 45378 | — | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $426 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | — | — |
| MRI, brain (no contrast) CPT Code: 70551 | — | unverified |
| Behavioral health living support HCPCS Code: H2019 | $344 | unverified |
| Hepatitis B immune globulin HCPCS Code: 90371 | $303 | 2.0× |
Audit a Bill or Quote at Samaritan Hospital of Troy, New York (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $105,434
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (63.3% of gross = $105,434).
Self-Pay Cash Rate ($21,719) Beats Your Bill
Samaritan Hospital of Troy, New York's published 45 CFR § 180 self-pay cash rate is $21,719 (vs. $69,412 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($166,589) is $135,814 above the denoised Fair BaseRate ($30,775) and 7.1× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (63.3% 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)Source: CMS Hospital Care Compare (509 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 Samaritan Hospital of Troy, New York.
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.