Institute for Orthopaedic Surgery
801 Medical Drive, Suite B, Lima, OH 45804 · 53 Priced Procedures · 81% Patient Recommendation
Typical commercial prices here are +3% above the fair benchmark (1.03×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.03× fair market pricing.
Aligned Regional Benchmark Peer
Institute for Orthopaedic Surgery prices shoppable and inpatient services (1.4× to 1.0× Medicare, divergence 0.71×) in alignment with regional hospital peers (1.03× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.93× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
- 4-Star CMS clinical rating with 81% patient recommendation (72/100 safety score)
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.8× markup over Medicare rates
- 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 1.16×) jump +20% above the median procedure ratio (Q50 0.97×)
- Consolidated metro market (HHI 5,654) 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 Institute for Orthopaedic Surgery
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 53 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $635 | 1.4× |
| MRI, knee or other leg joint CPT Code: 73721 | $430 | 1.2× |
| MRI, lower back (no contrast) CPT Code: 72148 | $430 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $430 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $316 | 1.2× |
| X-ray, pelvis CPT Code: 72170 | $189 | 1.7× |
| CT scan, head (no contrast) CPT Code: 70450 | $189 | 1.2× |
| CT scan, pelvis CPT Code: 72192 | $189 | 1.2× |
| CT scan, chest (no contrast) CPT Code: 71250 | $189 | 1.1× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $189 | 1.1× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $189 | 1.1× |
| X-ray, chest (single view) CPT Code: 71045 | $156 | 1.7× |
| X-ray, shoulder CPT Code: 73030 | $156 | 1.7× |
| X-ray, foot CPT Code: 73630 | $156 | 1.7× |
| X-ray, chest (two views) CPT Code: 71046 | $156 | 1.7× |
| X-ray, hand CPT Code: 73130 | $156 | 1.7× |
| X-ray, hip CPT Code: 73502 | $156 | 1.7× |
| X-ray, ankle CPT Code: 73610 | $156 | 1.7× |
| Hospital observation (per hour) HCPCS Code: G0378 | — | — |
| Drug screening test HCPCS Code: G0480 | $114 | 1.0× |
| Blood test, comprehensive metabolic panel CPT Code: 80053 | $11 | 1.0× |
| Blood test, calcium CPT Code: 82310 | $5 | 1.0× |
| Blood test, creatinine (kidney) CPT Code: 82565 | $5 | 1.0× |
| Blood test, ferritin (iron stores) CPT Code: 82728 | $14 | 1.0× |
| Blood test, average blood sugar (A1c) CPT Code: 83036 | $10 | 1.0× |
Audit a Bill or Quote at Institute for Orthopaedic Surgery (Zero PHI Required)
Above Standard 400% FPL Financial-Assistance Ceiling
At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Institute for Orthopaedic Surgery's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $448 Fair BaseRate ($356 Medicare)
Your bill ($4,989) is $4,541 above the denoised Fair BaseRate ($448) and 14.0× the $356 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Institute for Orthopaedic Surgery as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare (170 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 Institute for Orthopaedic Surgery.
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.