How many shoppable procedure prices are published for Kettering Health Troy?

Kettering Health Troy in Troy, OH currently has 119 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Kettering Health Troy's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Kettering Health Troy's median negotiated commercial rate is 1.2× the regionally adjusted fair BaseRate benchmark.

What is Kettering Health Troy's CMS Care Compare overall star rating?

CMS Care Compare assigns Kettering Health Troy 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 - Private 28 Beds · urban Updated: 2026-04-01

Kettering Health Troy

600 West Main Street, Troy, OH 45373 · 119 Priced Procedures · 89% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

Above Fair Market · Negotiate

1.21×vs. Fair Market Price

Typical commercial prices here are +21% above the fair benchmark (1.21×) even after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 8% of the Time

File Completeness66

Price Logic98

Peer Alignment58

Clean Billing86

Real Cash Discount100

High Quality · Fair Price

5-Star CMS clinical quality rating paired with 1.21× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Kettering Health Troy prices shoppable and inpatient services (1.7× to 1.3× Medicare, divergence 0.76×) in alignment with regional hospital peers (1.21× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#98 of 137 in OH · 70th State Percentile#2,043 of 3,385 in U.S. · 60th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.15× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 8% of shoppable procedures (99/100 Cash Honesty)
5-Star CMS clinical rating with 89% patient recommendation (83/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (9.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
Commercial insurance median sits at 1.23× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.42×) jump +15% above the median procedure ratio (Q50 1.23×)
Consolidated metro market (HHI 2,470) limits in-network hospital competition (Moderately Concentrated (1,500–2,500))

Front-Door ShoppableElective / Imaging

1.7× Medicare

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

Back-Door Captive & ER0.76× Divergence

1.3× Medicare

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

Quantile Tail Spread+15% Upper Tail

Q25 1.15× · Q50 1.23× · Q75 1.42×

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

1.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.8× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.8× MedicareFair

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

2.0× MedicareGood

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

8% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 83/100Good

Procedure Prices at Kettering Health Troy

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 119 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`	—	$38,763	$30,775	1.3×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$24,405	$19,087	1.3×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$23,837	$19,432	1.2×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$22,392	$17,936	1.2×
Total hip replacement CPT Code: `27130`	—	$21,749	$13,413	1.6×
Total knee replacement CPT Code: `27447`	—	$21,749	$13,523	1.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$15,771	$6,109	2.6×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$10,367	$8,223	1.3×
Inguinal hernia repair CPT Code: `49505`	—	$8,535	$3,629	2.4×
Breast lump removal CPT Code: `19120`	—	$8,392	$3,875	2.2×
Trauma team activation HCPCS Code: `G0390`	$8,268	$8,268	$1,453	5.7×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$8,129	$3,372	2.4×
Bunion correction surgery CPT Code: `28296`	—	$7,675	$3,446	2.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$7,000	$2,540	2.8×
Colonoscopy with biopsy CPT Code: `45380`	—	$2,807	$1,256	2.2×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,751	$987	2.8×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,181	$981	2.2×
Injection procedure for pain management HCPCS Code: `G0260`	$1,404	$2,141	$855	2.5×
Sleep study (overnight, in lab) CPT Code: `95810`	$1,862	$1,862	$1,021	1.8×
Blood transfusion CPT Code: `36430`	$1,901	$1,338	$498	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,501	$828	$583	1.4×
Hospital observation (per hour) HCPCS Code: `G0378`	$695	$695	$86	8.1×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,604	$528	$448	1.2×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,302	$528	$511	1.0×
Psychiatric evaluation (first visit) CPT Code: `90791`	$442	$442	$185	2.4×
Rabies immune globulin HCPCS Code: `90375`	—	$434	$322	1.3×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,459	$362	$272	1.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,022	$361	$303	1.2×
MRI, lower back (no contrast) CPT Code: `72148`	$965	$361	$338	1.1×
MRI, brain (no contrast) CPT Code: `70551`	$1,033	$361	$343	1.1×
MRI, knee or other leg joint CPT Code: `73721`	$1,013	$361	$369	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$250	$250	$14	17.9×
CT scan, head (with contrast) CPT Code: `70460`	$795	$266	$242	1.1×
CT scan, head (with and without contrast) CPT Code: `70470`	$909	$272	$258	1.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$246	$246	$181	1.4×
Group therapy session CPT Code: `90853`	$206	$206	$100	2.1×
Psychological testing evaluation CPT Code: `96136`	—	$202	$128	1.6×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$208	$151	1.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$220	$220	$166	1.3×
Family therapy session CPT Code: `90847`	$226	$226	$173	1.3×
Speech therapy (language evaluation) CPT Code: `92507`	$192	$192	$86	2.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$218	$210	$148	1.4×
Screening mammogram (both breasts) CPT Code: `77067`	$160	$173	$123	1.4×
CT scan, pelvis CPT Code: `72192`	$944	$195	$163	1.2×
CT scan, chest (no contrast) CPT Code: `71250`	$708	$195	$167	1.2×
CT scan, neck (cervical spine) CPT Code: `72125`	$791	$197	$169	1.2×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,166	$195	$168	1.2×
CT scan, sinuses CPT Code: `70486`	$725	$207	$166	unverified
X-ray, pelvis CPT Code: `72170`	$202	$159	$110	1.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$552	$159	$126	1.3×
Ultrasound, pelvis CPT Code: `76856`	$520	$159	$130	1.2×
CT scan, head (no contrast) CPT Code: `70450`	$637	$158	$160	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$161	$161	$201	0.8×
X-ray, lower back CPT Code: `72110`	$222	$159	$112	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$436	$183	$132	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$674	$171	$134	unverified
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$134	$134	$64	2.1×
Physical therapy (manual therapy) CPT Code: `97140`	$107	$107	$34	3.1×
X-ray, chest (single view) CPT Code: `71045`	$167	$132	$92	1.4×
X-ray, shoulder CPT Code: `73030`	$184	$132	$92	1.4×
X-ray, foot CPT Code: `73630`	$184	$132	$92	1.4×
X-ray, chest (two views) CPT Code: `71046`	$184	$132	$93	1.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$167	$132	$93	1.4×
X-ray, hand CPT Code: `73130`	$202	$132	$93	1.4×
X-ray, hip CPT Code: `73502`	$184	$132	$93	1.4×
X-ray, ankle CPT Code: `73610`	$184	$132	$93	1.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$104	$104	$40	2.6×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$98	$98	$38	2.6×
Occupational therapy (self-care training) CPT Code: `97535`	$92	$92	$38	2.4×
Behavioral health day program HCPCS Code: `H2012`	$111	$111	$100	1.1×
Neurobehavioral status check CPT Code: `96116`	$111	$111	$231	0.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$84	$84	$35	2.4×
Physical therapy (functional capacity test) CPT Code: `97750`	$81	$81	$38	2.1×
Typhoid vaccine HCPCS Code: `90675`	—	$485	$347	1.4×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$268	$203	1.3×
Pneumococcal vaccine HCPCS Code: `90732`	—	$200	$140	1.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$137	$111	1.2×
Drug screening test HCPCS Code: `G0480`	$117	$130	$116	1.1×
Physical therapy (gait training) CPT Code: `97116`	$72	$72	$33	2.2×
Orthotic fitting and training CPT Code: `97760`	$70	$70	$51	1.4×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$34	$25	1.4×
Hepatitis B vaccine HCPCS Code: `90744`	—	$48	$37	1.3×
Prosthetic fitting and training CPT Code: `97761`	$58	$58	$45	1.3×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$165	$32	$27	1.2×
Blood test, vitamin D CPT Code: `82306`	$206	$36	$31	1.2×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$43	$39	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$54	$56	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$35	$35	$48	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$35	$35	$49	0.7×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$26	$4	$3	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$27	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$36	$5	$4	1.3×
Blood test, calcium CPT Code: `82310`	$34	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$17	$6	$5	1.2×
Blood test, potassium CPT Code: `84132`	$22	$6	$5	1.2×
Blood test, sodium CPT Code: `84295`	$27	$6	$5	1.2×
Blood test, clotting time (PTT) CPT Code: `85730`	$45	$7	$6	1.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$102	$22	$19	1.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$113	$23	$20	1.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$64	$16	$14	1.1×
Blood test, amylase CPT Code: `82150`	$99	$8	$7	1.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$93	$16	$14	1.1×
Blood test, lipase CPT Code: `83690`	$68	$8	$7	1.1×
Hepatitis C antibody test CPT Code: `86803`	$110	$17	$15	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$80	$10	$9	1.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$75	$20	$18	1.1×
Culture, blood CPT Code: `87040`	$149	$12	$11	1.1×
Blood test, hemoglobin CPT Code: `85018`	$16	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$21	$5	$5	1.0×
Diagnostic procedure preparation HCPCS Code: `G0279`	$72	$21	$35	0.6×
Colorectal cancer screening HCPCS Code: `G0010`	$27	$27	$49	0.6×
Blood antibody screen CPT Code: `86850`	$117	$17	$46	0.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$111	$13	$11	unverified
Blood test, liver function panel CPT Code: `80076`	$86	$10	$9	unverified
Blood test, vitamin B12 CPT Code: `82607`	$97	$18	$16	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$94	$12	$10	unverified
Blood test, magnesium CPT Code: `83735`	$46	$8	$7	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$46	$9	$8	unverified
Culture, bacterial CPT Code: `87070`	$72	$10	$9	unverified

Showing top 25 high-impact procedures of 119 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 9.6%

Audit a Bill or Quote at Kettering Health Troy (Zero PHI Required)

CMS CCN: 360368

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $38,763

1. Amount on Your Bill or Quote ($) Pre-filled with Kettering Health Troy’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: $8,968 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $8,968

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (9.6% of gross = $8,968).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Kettering Health Troy'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 +$62,256 Above Fair BaseRate

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

Your bill ($93,031) is $62,256 above the denoised Fair BaseRate ($30,775) and 4.0× 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 (9.6% 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 Overall5/5 Stars (5/5)

Safety Composite83/100

Would Recommend89%

Rated 9 or 10 (HCAHPS)85%

Median ER Wait130 min

Left ER Before Seen2%

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

Source: CMS Hospital Care Compare (373 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 Kettering Health Troy.

Price Index: 0.99× regional baseline

Quality: 83/100 CMS composite

Median Household Income$74,175U.S. Census ACS

Local Uninsured Share5.0%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 82/100 · Corroborated CMS CCN 360368

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 360368) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows1,512 (CMS v3.0.0)

File Integrity DigestVerified · CCN 360368

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