How many shoppable procedure prices are published for St Charles Hospital?

St Charles Hospital in Port Jefferson, NY currently has 138 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, St Charles Hospital's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

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

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

Hospital Profile Acute Care Hospital Voluntary non-profit - Church 167 Beds · urban Updated: 2026-02-19

St Charles Hospital

200 Belle Terre Road, Port Jefferson, NY 11777 · 138 Priced Procedures · 77% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

Near Fair BaseRate Benchmark

1.02×vs. Fair Market Price

Typical commercial prices here match the fair market benchmark (1.02×) after accounting for local nurse/doctor wages and patient complexity.

74/100 · Corroborated

74/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness66

Price Logic94

Peer Alignment68

Clean Billing84

Real Cash Discount50

Premium Quality Tier

3-Star CMS clinical quality rating paired with 1.02× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

St Charles Hospital prices shoppable and inpatient services (1.4× to 1.1× Medicare, divergence 0.79×) in alignment with regional hospital peers (1.02× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#43 of 92 in NY · 45th State Percentile#1,395 of 3,385 in U.S. · 41st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.86× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
5-Star CMS clinical rating with 77% patient recommendation (66/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (15.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.02× 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 0.97× Fair BaseRate (1.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.15×) jump +19% above the median procedure ratio (Q50 0.97×)
Unnegotiated chargemaster list prices average 14.3× Medicare (14¢ 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 & ER0.79× Divergence

1.1× Medicare

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

Quantile Tail Spread+19% Upper Tail

Q25 0.86× · Q50 0.97× · Q75 1.15×

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

0.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.1× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

3.5× MedicareElevated

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

1.8× MedicareGood

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

0% Cash Edge · 50/100Elevated

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 66/100Fair

Procedure Prices at St Charles Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 138 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`	—	$28,842	$30,775	0.9×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$23,775	$19,087	1.2×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$22,861	$19,432	1.2×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$21,951	$17,936	1.2×
Total knee replacement CPT Code: `27447`	—	$15,226	$13,523	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$9,678	$8,223	1.2×
Total hip replacement CPT Code: `27130`	—	$9,285	$13,413	0.7×
C-section delivery (full package) CPT Code: `59510`	—	$5,148	$2,975	1.7×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$5,154	$6,109	0.8×
Breast lump removal CPT Code: `19120`	—	$4,318	$3,875	1.1×
Inguinal hernia repair CPT Code: `49505`	—	$4,176	$3,629	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,840	$3,372	1.1×
Bunion correction surgery CPT Code: `28296`	—	$3,840	$3,446	1.1×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,699	$2,540	1.1×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,411	$2,680	0.9×
Trauma team activation HCPCS Code: `G0390`	—	$1,566	$1,453	1.1×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,395	$1,256	1.1×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$1,204	$1,021	1.2×
Upper endoscopy with biopsy CPT Code: `43239`	—	$1,132	$987	1.1×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$1,100	$981	1.1×
Injection procedure for pain management HCPCS Code: `G0260`	—	$820	$855	1.0×
MRI, knee or other leg joint CPT Code: `73721`	—	$505	$369	1.4×
Blood transfusion CPT Code: `36430`	—	$517	$498	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	—	$505	$511	1.0×
MRI, brain (no contrast) CPT Code: `70551`	—	$505	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	—	$505	$338	unverified
Rabies immune globulin HCPCS Code: `90375`	—	$463	$322	1.4×
Psychological testing by technician CPT Code: `96138`	—	$472	$395	1.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	—	$469	$583	0.8×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	—	$423	$448	0.9×
Mental health services (assessment) HCPCS Code: `H0031`	—	$333	$140	2.4×
Behavioral health assessment HCPCS Code: `H0001`	—	$333	$157	2.1×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$333	$185	1.8×
Behavioral health day program HCPCS Code: `H2012`	—	$290	$100	2.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$290	$181	1.6×
Ultrasound, leg veins (duplex) CPT Code: `93970`	—	$286	$272	1.1×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	—	$286	$303	0.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$290	$166	unverified
Residential substance abuse treatment HCPCS Code: `H2035`	—	$246	$88	2.8×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$241	$151	1.6×
Family therapy session CPT Code: `90847`	—	$246	$173	1.4×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$254	$257	1.0×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$254	$269	0.9×
Behavioral health day treatment HCPCS Code: `H0010`	—	$254	$343	0.7×
Behavioral health residential care HCPCS Code: `H0011`	—	$254	$364	0.7×
Behavioral health living support HCPCS Code: `H2019`	—	$246	$34	unverified
CT scan, head (with contrast) CPT Code: `70460`	—	$211	$242	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	—	$219	$258	0.8×
Neurobehavioral status check CPT Code: `96116`	—	$181	$231	0.8×
Group therapy session CPT Code: `90853`	—	$183	$100	unverified
Physical therapy (functional capacity test) CPT Code: `97750`	—	$123	$38	3.2×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	$122	$38	3.2×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$141	$35	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	—	$107	$35	3.1×
Orthotic fitting and training CPT Code: `97760`	—	$132	$51	2.6×
Physical therapy (manual therapy) CPT Code: `97140`	—	$98	$34	2.9×
Prosthetic fitting and training CPT Code: `97761`	—	$123	$45	2.7×
X-ray, hip CPT Code: `73502`	—	$104	$93	1.1×
X-ray, lower back CPT Code: `72110`	—	$123	$112	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	—	$126	$126	1.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$121	$123	1.0×
Ultrasound, pelvis CPT Code: `76856`	—	$126	$130	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	—	$118	$123	1.0×
Ultrasound, thyroid and neck CPT Code: `76536`	—	$126	$132	1.0×
Ultrasound, abdomen (complete) CPT Code: `76700`	—	$126	$134	0.9×
CT scan, pelvis CPT Code: `72192`	—	$141	$163	0.9×
CT scan, chest (no contrast) CPT Code: `71250`	—	$141	$167	0.8×
CT scan, lower back (lumbar spine) CPT Code: `72131`	—	$141	$168	0.8×
CT scan, neck (cervical spine) CPT Code: `72125`	—	$141	$169	0.8×
CT scan, head (no contrast) CPT Code: `70450`	—	$128	$160	0.8×
CT scan, sinuses CPT Code: `70486`	—	$128	$166	0.8×
X-ray, neck (cervical spine) CPT Code: `72040`	—	$93	$93	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$118	$148	0.8×
X-ray, ankle CPT Code: `73610`	—	$91	$93	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	—	$85	$87	1.0×
X-ray, hand CPT Code: `73130`	—	$90	$93	1.0×
X-ray, foot CPT Code: `73630`	—	$85	$92	0.9×
Review of medical records for care CPT Code: `90889`	—	$102	$114	0.9×
X-ray, shoulder CPT Code: `73030`	—	$82	$92	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	—	$92	$110	0.8×
Psychological testing evaluation CPT Code: `96136`	—	$90	$128	0.7×
Care planning with family CPT Code: `90887`	—	—	$107	unverified
Speech therapy (language evaluation) CPT Code: `92507`	—	—	$86	unverified
Typhoid vaccine HCPCS Code: `90675`	—	$388	$347	1.1×
Drug screening test HCPCS Code: `G0480`	—	$114	$116	1.0×
X-ray, chest (two views) CPT Code: `71046`	—	$75	$93	0.8×
X-ray, chest (single view) CPT Code: `71045`	—	$55	$92	0.6×
X-ray, pelvis CPT Code: `72170`	—	$63	$110	0.6×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$78	$203	0.4×
Electrical stimulation therapy HCPCS Code: `G0283`	—	$45	$14	3.2×
Physical therapy (gait training) CPT Code: `97116`	—	$65	$33	2.0×
Occupational therapy (self-care training) CPT Code: `97535`	—	$65	$38	1.7×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$46	$33	1.4×
Hospital observation (per hour) HCPCS Code: `G0378`	—	$65	$86	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	—	$38	$37	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$38	$39	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	$11	$11	1.0×
Blood test, sodium CPT Code: `84295`	—	$5	$5	1.0×
Blood test, vitamin D CPT Code: `82306`	—	$30	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	—	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	—	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	—	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	—	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	—	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	—	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	—	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	—	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	—	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	—	$4	$4	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	—	$19	$20	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	—	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	—	$17	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	—	$15	$16	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	—	$39	$49	0.8×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	—	$13	$14	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$38	$56	0.7×
Pneumococcal vaccine HCPCS Code: `90732`	—	$52	$140	0.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$38	$111	0.3×
Breathing treatment (nebulizer) CPT Code: `94640`	—	$63	$201	0.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	—	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	—	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	—	$9	$9	1.0×
Hepatitis C antibody test CPT Code: `86803`	—	$14	$15	0.9×
Culture, blood CPT Code: `87040`	—	$10	$11	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	—	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	—	$8	$9	0.9×
Blood test, amylase CPT Code: `82150`	—	$6	$7	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	—	$4	$5	0.8×
Community mental health services HCPCS Code: `H0038`	—	$11	$16	0.7×
Flu vaccine injection HCPCS Code: `G0008`	—	$30	$48	0.6×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$30	$49	0.6×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$15	$25	0.6×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$15	$25	0.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	—	$29	$64	0.5×
Blood antibody screen CPT Code: `86850`	—	$14	$46	0.3×
Speech therapy (group session) CPT Code: `92508`	—	—	$27	—
Occupational therapy (therapeutic activities) CPT Code: `97530`	—	—	$40	unverified
Blood test, hemoglobin CPT Code: `85018`	—	$2	$3	0.7×

Showing top 25 high-impact procedures of 138 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 15.4%

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

CMS CCN: 330246

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $28,842

1. Amount on Your Bill or Quote ($) Pre-filled with St Charles 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: $10,674 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $10,674

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (15.4% of gross = $10,674).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask St Charles Hospital'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 +$38,446 Above Fair BaseRate

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

Your bill ($69,221) is $38,446 above the denoised Fair BaseRate ($30,775) and 2.9× 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)

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 (15.4% 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 Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend77%

Rated 9 or 10 (HCAHPS)75%

Median ER Wait232 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3.1%

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

Source: CMS Hospital Care Compare (811 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 St Charles Hospital.

Price Index: 1.07× regional baseline

Quality: 63/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Beacon Health Options

-60.4%

Humana

-42.9%

Oscar Health

+87.1%

Magellan

+92.5%

UniCare

+102.7%

Median Household Income$128,329U.S. Census ACS

Local Uninsured Share4.6%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 74/100 · Corroborated CMS CCN 330246

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

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 330246) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-02-19

Validated Rate Rows19,933 (CMS v3.0.0)

File Integrity DigestVerified · CCN 330246

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