How many shoppable procedure prices are published for Adena Fayette Medical Center?

Adena Fayette Medical Center in Washington Ch, OH currently has 123 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Adena Fayette Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Adena Fayette Medical Center's median negotiated commercial rate is 1.9× the regionally adjusted fair BaseRate benchmark.

What is Adena Fayette Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Adena Fayette Medical Center an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Government - Local 25 Beds · rural Updated: 2026-08-19

Adena Fayette Medical Center

1430 Columbus Avenue, Washington Ch, OH 43160 · 123 Priced Procedures · 55% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

1.92×vs. Fair Market Price

Typical commercial prices here are +92% above the fair benchmark (1.92×) even after accounting for local nurse/doctor wages and patient complexity.

70/100 · Caution

70/100Self-Pay Cash Beats Insurance 14% of the Time

File Completeness95

Price Logic81

Peer Alignment70

Clean Billing83

Real Cash Discount6

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.92× fair market pricing.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 10,000), Adena Fayette Medical Center commands a 1.92× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#128 of 137 in OH · 92nd State Percentile#3,040 of 3,385 in U.S. · 89th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.73× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 14% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (64/100 safety score) with 55% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (60.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
Commercial insurance median sits at 1.94× Fair BaseRate (2.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.4× Medicare — verify per-unit billing on itemized statements
Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.6× Medicare

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

Back-Door Captive & ER0.77× Divergence

2.0× Medicare

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

Quantile Tail Spread+4% Upper Tail

Q25 1.73× · Q50 1.94× · Q75 2.02×

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

2.6× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.6× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.0× MedicareGood

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

1.4× MedicareGood

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

14% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 64/100Elevated

Procedure Prices at Adena Fayette Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	—	$26,561	$13,413	2.0×
Total knee replacement CPT Code: `27447`	—	$26,561	$13,523	2.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$12,507	$6,109	2.0×
Breast lump removal CPT Code: `19120`	—	$8,100	$3,875	2.1×
Inguinal hernia repair CPT Code: `49505`	—	$7,407	$3,629	2.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$6,769	$3,372	2.0×
Bunion correction surgery CPT Code: `28296`	—	$6,769	$3,446	2.0×
C-section delivery (full package) CPT Code: `59510`	—	$4,898	$2,975	1.6×
Cataract surgery with lens implant CPT Code: `66984`	—	$4,775	$2,540	1.9×
Vaginal delivery (full package) CPT Code: `59400`	—	$4,380	$2,680	1.6×
Trauma team activation HCPCS Code: `G0390`	—	$2,758	$1,453	1.9×
Colonoscopy with biopsy CPT Code: `45380`	$6,673	$2,476	$1,256	2.0×
Colonoscopy (diagnostic) CPT Code: `45378`	$5,981	$1,924	$981	2.0×
Upper endoscopy with biopsy CPT Code: `43239`	$5,767	$1,876	$987	1.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$5,396	$1,777	$1,021	1.7×
Injection procedure for pain management HCPCS Code: `G0260`	$6,620	$1,460	$855	1.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,990	$1,365	$511	2.7×
MRI, lower back (no contrast) CPT Code: `72148`	$2,289	$1,250	$338	3.7×
MRI, brain (no contrast) CPT Code: `70551`	$2,320	$1,250	$343	unverified
MRI, knee or other leg joint CPT Code: `73721`	$4,232	$1,250	$369	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$3,823	$1,130	$583	1.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$4,032	$990	$448	2.2×
Psychological testing by technician CPT Code: `96138`	—	$924	$395	2.3×
Blood transfusion CPT Code: `36430`	$1,607	$913	$498	1.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,054	$875	$303	2.9×
CT scan, head (with contrast) CPT Code: `70460`	$2,016	$809	$242	3.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,390	$809	$258	3.1×
CT scan, head (no contrast) CPT Code: `70450`	$1,529	$734	$160	4.6×
CT scan, chest (no contrast) CPT Code: `71250`	$1,529	$734	$167	4.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,529	$734	$168	4.4×
CT scan, sinuses CPT Code: `70486`	$1,530	$734	$166	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$1,529	$734	$169	unverified
CT scan, pelvis CPT Code: `72192`	$1,529	$734	$163	unverified
Rabies immune globulin HCPCS Code: `90375`	$13,760	$550	$322	1.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$2,159	$494	$272	1.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$469	$453	$201	2.3×
Neurobehavioral status check CPT Code: `96116`	—	$447	$231	1.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$562	$367	$166	2.2×
Family therapy session CPT Code: `90847`	$562	$367	$173	2.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$562	$367	$181	2.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$367	$185	2.0×
Psychological testing evaluation CPT Code: `96136`	—	$275	$128	2.1×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$750	$297	$148	2.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$4,262	$280	$151	1.9×
Group therapy session CPT Code: `90853`	$381	$210	$100	2.1×
X-ray, pelvis CPT Code: `72170`	$372	$216	$110	2.0×
Screening mammogram (both breasts) CPT Code: `77067`	$288	$238	$123	1.9×
X-ray, lower back CPT Code: `72110`	$608	$216	$112	1.9×
Ultrasound, abdomen (limited) CPT Code: `76705`	$818	$216	$126	1.7×
Ultrasound, pelvis CPT Code: `76856`	$818	$216	$130	1.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$818	$216	$132	1.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$818	$216	$134	1.6×
X-ray, chest (single view) CPT Code: `71045`	$347	$180	$92	2.0×
X-ray, shoulder CPT Code: `73030`	$707	$180	$92	2.0×
X-ray, chest (two views) CPT Code: `71046`	$347	$180	$93	1.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$354	$180	$93	1.9×
X-ray, hand CPT Code: `73130`	$707	$180	$93	1.9×
X-ray, hip CPT Code: `73502`	$354	$180	$93	1.9×
X-ray, ankle CPT Code: `73610`	$707	$180	$93	1.9×
X-ray, foot CPT Code: `73630`	$707	$180	$92	unverified
New patient office visit (30-44 min) CPT Code: `99203`	$190	$190	$110	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$438	$149	$86	1.7×
Care planning with family CPT Code: `90887`	—	$173	$107	1.6×
Office visit, established patient (30-39 min) CPT Code: `99214`	$173	$173	$123	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$323	$122	$64	1.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$138	$138	$87	unverified
Orthotic fitting and training CPT Code: `97760`	$242	$88	$51	1.7×
Typhoid vaccine HCPCS Code: `90675`	$2,324	$630	$347	1.8×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$1,019	$174	$203	0.9×
Pneumonia vaccine injection HCPCS Code: `G0009`	$170	$97	$49	2.0×
Colorectal cancer screening HCPCS Code: `G0010`	$170	$97	$49	2.0×
Prosthetic fitting and training CPT Code: `97761`	$238	$78	$45	1.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$529	$95	$111	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$105	$105	$140	0.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$279	$78	$35	2.2×
Flu vaccine injection HCPCS Code: `G0008`	$170	$97	$48	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$46	$46	$10	4.6×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$67	$33	2.0×
Hepatitis B vaccine HCPCS Code: `90744`	$375	$66	$37	1.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$217	$65	$38	1.7×
Hospital observation (per hour) HCPCS Code: `G0378`	$77	$77	$86	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$88	$37	$19	1.9×
Blood test, vitamin D CPT Code: `82306`	$141	$59	$31	1.9×
Speech therapy (group session) CPT Code: `92508`	$204	$46	$27	1.7×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$242	$64	$38	1.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$244	$67	$40	1.7×
Drug screening test HCPCS Code: `G0480`	$127	$80	$116	0.7×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$17	$6	$3	2.0×
Blood test, calcium CPT Code: `82310`	$25	$10	$5	2.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$31	$10	$5	2.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$19	$8	$4	2.0×
Blood test, lipase CPT Code: `83690`	$33	$14	$7	2.0×
Blood test, potassium CPT Code: `84132`	$22	$10	$5	2.0×
Blood test, sodium CPT Code: `84295`	$23	$10	$5	2.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$70	$27	$14	1.9×
Blood test, ferritin (iron stores) CPT Code: `82728`	$65	$27	$14	1.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$58	$21	$11	1.9×
Blood test, basic metabolic panel CPT Code: `80048`	$40	$17	$9	1.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$80	$34	$18	1.9×
Physical therapy (gait training) CPT Code: `97116`	$204	$56	$33	1.7×
Occupational therapy (self-care training) CPT Code: `97535`	$240	$63	$38	1.7×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$88	$88	$20	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$223	$56	$35	1.6×
Blood test, vitamin B12 CPT Code: `82607`	$72	$30	$16	1.9×
Physical therapy (manual therapy) CPT Code: `97140`	$215	$54	$34	1.6×
Blood antibody screen CPT Code: `86850`	$51	$51	$46	1.1×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$19	$8	$4	2.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$43	$16	$8	2.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$33	$12	$6	2.0×
Hepatitis C antibody test CPT Code: `86803`	$63	$29	$15	1.9×
Culture, blood CPT Code: `87040`	$56	$21	$11	1.9×
Culture, bacterial CPT Code: `87070`	$47	$17	$9	1.9×
Blood test, amylase CPT Code: `82150`	$31	$13	$7	1.9×
Blood test, magnesium CPT Code: `83735`	$28	$13	$7	1.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$232	$25	$14	1.8×
Blood test, liver function panel CPT Code: `80076`	$35	$16	$9	1.8×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$138	$24	$27	0.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$320	$41	$56	0.7×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$22	$9	$5	1.8×
Blood test, hemoglobin CPT Code: `85018`	$10	$5	$3	1.7×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$30	$25	1.2×
Flu vaccine (high dose) HCPCS Code: `90656`	$22	$22	$25	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$220	$29	$39	0.7×

Showing top 25 high-impact procedures of 123 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 60.0%

Audit a Bill or Quote at Adena Fayette Medical Center (Zero PHI Required)

CMS CCN: 361331

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash Request Quote

Insurer Median $26,561

1. Amount on Your Bill or Quote ($) Pre-filled with Adena Fayette 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: $38,267 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $38,267

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (60.0% of gross = $38,267).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Adena Fayette 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 +$50,333 Above Fair BaseRate

Negotiate Toward $13,413 Fair BaseRate ($13,117 Medicare)

Your bill ($63,746) is $50,333 above the denoised Fair BaseRate ($13,413) and 4.9× the $13,117 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: 852985806

Filing Period: 202305

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 (60.0% 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 Composite64/100

Would Recommend55%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait128 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 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 Adena Fayette Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-07-09·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (129 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 Adena Fayette Medical Center.

Price Index: 1.00× regional baseline

Quality: 54/100 CMS composite

Median Household Income$60,047U.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 70/100 · Caution CMS CCN 361331 EIN 852985806

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 361331) ↗ Verify IRS Form 990 (EIN 852985806) ↗ CMS HCRIS Cost Reports ↗

Published MRF File852985806_adena-fayette-medical-center_standardcharges.csv

Publication / Vintage2026-08-19 · 1295.09 MB

Validated Rate Rows5,054 (CMS v3.0.0)

File Integrity Digest4e1a095767d4f1f60303…

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