How many shoppable procedure prices are published for Bluffton Hospital?

Bluffton Hospital in Bluffton, OH currently has 88 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Bluffton Hospital's median negotiated commercial rate is 1.3× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · urban Updated: 11/5/2025

Bluffton Hospital

139 Garau Street, Bluffton, OH 45817 · 88 Priced Procedures · 81% Patient Recommendation

CMS Overall Rating No CMS Rating

Above Fair Market · Negotiate

1.33×vs. Fair Market Price

Typical commercial prices here are +33% above the fair benchmark (1.33×) even after accounting for local nurse/doctor wages and patient complexity.

70/100 · Caution

70/100Self-Pay Cash Beats Insurance 7% of the Time

File Completeness100

Price Logic84

Peer Alignment70

Clean Billing73

Real Cash Discount6

Regional Benchmark Tier

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintHigh-HHI Market Leverage

Consolidated System Premium Pricer

Operating in a concentrated regional market (CBSA HHI 5,654), Bluffton Hospital commands a 1.33× BaseRate commercial premium across insurers. Self-pay cash quotes, in-state peer hospitals, and freestanding outpatient facilities offer critical leverage against consolidated system pricing.

#111 of 137 in OH · 80th State Percentile#2,324 of 3,385 in U.S. · 68th 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 7% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (82/100 safety score) with 81% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (33.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.33× 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 (0.8×) & laboratory (1.7×) services average 1.07× higher multiples than routine shoppable care (1.5×)
Upper-quartile procedures (Q75 1.69×) jump +35% above the median procedure ratio (Q50 1.25×)
Consolidated metro market (HHI 5,654) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.5× Medicare

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

Back-Door Captive & ER1.07× Divergence

1.6× Medicare

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

Quantile Tail Spread+35% Upper Tail

Q25 0.86× · Q50 1.25× · Q75 1.69×

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

1.5× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.8× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.7× MedicareGood

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

0.8× MedicareGood

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

7% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 82/100Good

Procedure Prices at Bluffton Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 88 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$70,498	$70,498	$19,432	3.6×
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$118,846	$20,627	$30,775	0.7×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$71,711	$12,292	$17,936	0.7×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$39,584	$8,788	$19,087	0.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$15,247	$5,617	$8,223	0.7×
Rabies immune globulin HCPCS Code: `90375`	$4,924	$4,924	$322	unverified
Trauma team activation HCPCS Code: `G0390`	$4,459	$3,530	$1,453	2.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,861	$928	$1,021	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$631	$527	$242	2.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,475	$502	$583	0.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,281	$454	$258	1.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,332	$467	$303	1.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,221	$479	$511	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,529	$408	$448	0.9×
Blood transfusion CPT Code: `36430`	$727	$399	$498	0.8×
Ultrasound, pelvis CPT Code: `76856`	$1,036	$265	$130	2.0×
CT scan, neck (cervical spine) CPT Code: `72125`	$836	$275	$169	1.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,244	$248	$132	1.9×
CT scan, head (no contrast) CPT Code: `70450`	$497	$249	$160	1.6×
CT scan, sinuses CPT Code: `70486`	$539	$252	$166	1.5×
MRI, lower back (no contrast) CPT Code: `72148`	$662	$271	$338	0.8×
MRI, brain (no contrast) CPT Code: `70551`	$1,465	$271	$343	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,242	$281	$126	unverified
CT scan, pelvis CPT Code: `72192`	$807	$228	$163	1.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$836	$228	$168	1.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$598	$251	$148	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$496	$220	$272	0.8×
MRI, knee or other leg joint CPT Code: `73721`	$897	$224	$369	0.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,367	$188	$134	1.4×
X-ray, hand CPT Code: `73130`	$580	$160	$93	1.7×
X-ray, shoulder CPT Code: `73030`	$574	$151	$92	1.6×
X-ray, foot CPT Code: `73630`	$563	$149	$92	1.6×
CT scan, chest (no contrast) CPT Code: `71250`	$497	$163	$167	1.0×
X-ray, ankle CPT Code: `73610`	$563	$166	$93	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$120	$120	$87	1.4×
New patient office visit (30-44 min) CPT Code: `99203`	$120	$120	$110	1.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	$120	$119	$123	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$94	$88	$38	2.3×
Speech therapy (language evaluation) CPT Code: `92507`	$168	$88	$86	1.0×
X-ray, hip CPT Code: `73502`	$280	$92	$93	1.0×
X-ray, chest (two views) CPT Code: `71046`	$263	$86	$93	0.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$604	$81	$93	0.9×
X-ray, chest (single view) CPT Code: `71045`	$250	$80	$92	0.9×
X-ray, lower back CPT Code: `72110`	$813	$97	$112	0.9×
X-ray, pelvis CPT Code: `72170`	$268	$88	$110	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$236	$81	$123	0.7×
Breathing treatment (nebulizer) CPT Code: `94640`	$232	$102	$201	0.5×
Typhoid vaccine HCPCS Code: `90675`	$914	$914	$347	2.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$333	$248	$56	unverified
Blood test, liver function panel CPT Code: `80076`	$115	$115	$9	12.8×
Drug screening test HCPCS Code: `G0480`	$138	$112	$116	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$96	$96	$14	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$69	$69	$49	1.4×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$162	$62	$64	1.0×
Blood test, lipase CPT Code: `83690`	$75	$75	$7	unverified
Blood antibody screen CPT Code: `86850`	$171	$86	$46	unverified
Culture, bacterial CPT Code: `87070`	$87	$87	$9	unverified
Culture, blood CPT Code: `87040`	$58	$58	$11	5.3×
Blood test, hemoglobin CPT Code: `85018`	$26	$26	$3	8.7×
Blood test, potassium CPT Code: `84132`	$32	$32	$5	6.4×
Physical therapy (manual therapy) CPT Code: `97140`	$81	$53	$34	1.6×
Orthotic fitting and training CPT Code: `97760`	$94	$64	$51	1.3×
Blood test, amylase CPT Code: `82150`	$72	$72	$7	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$18	$18	$5	3.6×
Blood test, basic metabolic panel CPT Code: `80048`	$94	$24	$9	2.7×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$25	$8	$3	2.7×
Blood test, clotting time (PTT) CPT Code: `85730`	$26	$13	$6	2.2×
Blood test, magnesium CPT Code: `83735`	$25	$15	$7	2.1×
Blood test, glucose (blood sugar) CPT Code: `82947`	$26	$8	$4	2.0×
Blood test, sodium CPT Code: `84295`	$10	$9	$5	1.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$61	$14	$8	1.8×
Blood test, vitamin B12 CPT Code: `82607`	$122	$27	$16	1.7×
Blood test, thyroid (TSH) CPT Code: `84443`	$133	$28	$18	1.6×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$117	$17	$11	1.5×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$141	$20	$14	1.4×
Blood test, calcium CPT Code: `82310`	$20	$7	$5	1.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$39	$14	$10	1.4×
Blood test, PSA (prostate screen) CPT Code: `84153`	$117	$25	$19	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$16	$5	$4	1.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$16	$5	$5	1.0×
Blood test, vitamin D CPT Code: `82306`	$168	$29	$31	0.9×
Hepatitis C antibody test CPT Code: `86803`	$157	$14	$15	0.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$91	$30	$35	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$81	$34	$40	0.8×
Physical therapy (gait training) CPT Code: `97116`	$78	$28	$33	0.8×
Flu vaccine injection HCPCS Code: `G0008`	$69	$40	$48	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$81	$31	$38	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$92	$30	$38	0.8×

Showing top 25 high-impact procedures of 88 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 33.0%

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

CMS CCN: 361322

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $70,498

Insurer Median $70,498

1. Amount on Your Bill or Quote ($) Pre-filled with Bluffton 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: $23,264 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $23,264

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (33.0% of gross = $23,264).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $70,498

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Bluffton Hospital's published 45 CFR § 180 self-pay cash rate is $70,498 (vs. $70,498 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$51,066 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($70,498) is $51,066 above the denoised Fair BaseRate ($19,432) and 5.0× the $14,044 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: 344429941

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 (33.0% 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

Safety Composite82/100

Would Recommend81%

Rated 9 or 10 (HCAHPS)74%

Median ER Wait126 min

Left ER Before Seen0%

Source: CMS Hospital Care Compare (29 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 Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Bluffton Hospital.

Price Index: 0.88× regional baseline

Quality: 59/100 CMS composite

Median Household Income$62,001U.S. Census ACS

Local Uninsured Share6.3%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 361322 EIN 344429941

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 361322) ↗ Verify IRS Form 990 (EIN 344429941) ↗ CMS HCRIS Cost Reports ↗

Published MRF File344429941_Blanchard-Valley-Regional-Health-Center_standardcharges.csv

Publication / Vintage11/5/2025 · 112.44 MB

Validated Rate Rows2,588 (CMS v3.0.0)

File Integrity Digestb4869f665b2f7f246c8a…

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