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Hospital Profile Critical Access Hospital Government - Local 25 Beds · rural Updated: 2026-08-14

Adams County Regional Medical Center

230 Medical Center Drive, Seaman, OH 45679 · 101 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 3 / 5 Stars
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).77/100 · Corroborated
77/100Self-Pay Cash Beats Insurance 50% of the Time
File Completeness85Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic66Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment65Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing73Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount99Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star Rating3/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score68/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER Wait182 minMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

3-Star CMS clinical quality rating paired with 1.00× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Adams County Regional Medical Center prices shoppable and inpatient services (6.1× to 4.6× Medicare, divergence 0.75×) in alignment with regional hospital peers (1.00× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

Regional Benchmark in OHU.S. National Reference Pool
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 50% of shoppable procedures (99/100 Cash Honesty)
  • CMS clinical safety score (68/100 safety score) with 75% patient recommendation
  • IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (95.0% AGB cap)
Watchout

Where You Can Get Burned (Markup Traps)

  • Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
  • Commercial insurance median sits at 1.00× Fair BaseRate (6.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
  • Unnegotiated chargemaster list prices average 6.8× Medicare (31¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
6.1× Medicare

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

Back-Door Captive & ER0.75× Divergence
4.6× Medicare

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

Quantile Tail Spread+28% Upper Tail
Q25 0.78× · Q50 1.00× · Q75 1.28×

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
6.1× MedicareWatchout
Outpatient Surgery & ORBack-Door Captive
1.6× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
2.6× MedicareFair
Back-Door Captive ER VisitsBack-Door Captive
1.6× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
2.1× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.6× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
50% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 68/100Fair

Procedure Prices at Adams County Regional Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 101 published procedures.

Sort:
Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
Total knee replacement
CPT Code: 27447
 — —
Total hip replacement
CPT Code: 27130
 — —
Knee arthroscopy with meniscus repair
CPT Code: 29881
 — —
Colonoscopy with biopsy
CPT Code: 45380
 — —
Sleep study (overnight, in lab)
CPT Code: 95810
 — —
Upper endoscopy with biopsy
CPT Code: 43239
 — —
Colonoscopy (diagnostic)
CPT Code: 45378
 — —
Injection procedure for pain management
HCPCS Code: G0260
 — —
Echocardiogram (heart ultrasound)
CPT Code: 93306
 — —
Blood transfusion
CPT Code: 36430
 — —
MRI, brain (with and without contrast)
CPT Code: 70553
 — —
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 — —
MRI, knee or other leg joint
CPT Code: 73721
 — —
Hospital observation (per hour)
HCPCS Code: G0378
 $327 3.8×
MRI, brain (no contrast)
CPT Code: 70551
 — —
MRI, lower back (no contrast)
CPT Code: 72148
 — —
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 — —
CT scan, head (with contrast)
CPT Code: 70460
 — —
CT scan, head (with and without contrast)
CPT Code: 70470
 — —
Ultrasound, leg veins (duplex)
CPT Code: 93970
 — —
Psychiatric evaluation (first visit)
CPT Code: 90791
 — —
Breathing treatment (nebulizer)
CPT Code: 94640
 — —
CT scan, head (no contrast)
CPT Code: 70450
 — —
CT scan, sinuses
CPT Code: 70486
 — —
CT scan, chest (no contrast)
CPT Code: 71250
 — —
Showing top 25 high-impact procedures of 101 total
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 95.0%

Audit a Bill or Quote at Adams County Regional Medical Center (Zero PHI Required)

CMS CCN: 361326
CPT 27447
Fair BaseRate™ $13,523
Medicare Rate $13,117
Self-Pay Cash Request Quote
Insurer Median $15,551
Pre-filled with Adams County Regional Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $4,154 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $4,154

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (95.0% of gross = $4,154).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Adams County Regional 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 Target: $13,523 Fair BaseRate

Negotiate Toward $13,523 Fair BaseRate ($13,117 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($13,523).

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: 812817266
Filing Period: 201608
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 (95.0% 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 Composite68/100
Would Recommend75%
Rated 9 or 10 (HCAHPS)78%
Median ER Wait182 min
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 Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Adams County Regional Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

  • 2025-04-02·administrative_or_closure

    Closure Notice

    Recorded
  • 2025-01-08·cap_corrective_action

    CAP Request

    Recorded
  • 2024-09-24·cap_corrective_action

    CAP Request

    Recorded

Source: CMS Hospital Care Compare (49 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 Adams County Regional Medical Center.

Price Index: 2.35× regional baseline
Quality: 57/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Commercial Insurance
-43.5%
WellCare
+71.1%
Amerigroup
+86.2%
Cigna HealthSpring
+115.9%
Pyramid Life
+129.7%
Median Household Income$49,521U.S. Census ACS
Local Uninsured Share7.8%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 77/100 · Corroborated CMS CCN 361326 EIN 812817266

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 361326) ↗ Verify IRS Form 990 (EIN 812817266) ↗ CMS HCRIS Cost Reports ↗
Published MRF File812817266_ADAMS-COUNTY-REGIONAL-MEDICAL-CENTER_standardcharges-11.zip!812817266_ADAMS-COUNTY-REGIONAL-MEDICAL-CENTER_standardcharges.csv
Publication / Vintage2026-08-14 · 136.15 MB
Validated Rate Rows39,825 (CMS v3.0.0)
File Integrity Digest54e01bcfc3c72cd92ba7…

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