Mercy Health Kings Mills Hospital LLC
5440 Kings Island Drive, Mason, OH 45040 · 83 Priced Procedures · 76% Patient Recommendation
Typical commercial prices here are +8% above the fair benchmark (1.08×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.08× fair market pricing.
Aligned Regional Benchmark Peer
Mercy Health Kings Mills Hospital LLC prices shoppable and inpatient services (1.1× to 1.5× Medicare, divergence 1.36×) in alignment with regional hospital peers (1.08× 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 (99/100 Cash Honesty)
- CMS clinical safety score (67/100 safety score) with 76% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (13.9% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.4× markup over Medicare rates
- Captive ER (1.6×) & laboratory (1.8×) services average 1.36× higher multiples than routine shoppable care (1.1×)
- Even at low-cost facilities (1.08× 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.
- Unnegotiated chargemaster list prices average 7.8× Medicare (14¢ true HCRIS cost per $1 gross)
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 Mercy Health Kings Mills Hospital LLC
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 83 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $21,121 | 1.1× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $20,973 | 1.1× |
| Total hip replacement CPT Code: 27130 | $12,512 | 0.9× |
| Total knee replacement CPT Code: 27447 | $12,512 | 0.9× |
| Rabies immune globulin HCPCS Code: 90375 | $8,819 | 27.4× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $8,477 | 1.0× |
| Breast lump removal CPT Code: 19120 | $3,816 | 1.0× |
| Inguinal hernia repair CPT Code: 49505 | $3,524 | 1.0× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,189 | 0.9× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,012 | 4.5× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,870 | 1.9× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,609 | 5.3× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,597 | 1.9× |
| Blood transfusion CPT Code: 36430 | $1,186 | 2.4× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,189 | 0.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,141 | 4.4× |
| CT scan, pelvis CPT Code: 72192 | $926 | 5.7× |
| CT scan, sinuses CPT Code: 70486 | $893 | 5.4× |
| CT scan, head (with contrast) CPT Code: 70460 | $900 | 3.7× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $906 | 0.9× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $827 | 4.9× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $782 | 4.6× |
| CT scan, head (no contrast) CPT Code: 70450 | $733 | 4.6× |
| CT scan, chest (no contrast) CPT Code: 71250 | $739 | 4.4× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $677 | 5.1× |
Audit a Bill or Quote at Mercy Health Kings Mills Hospital LLC (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $7,036
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (13.9% of gross = $7,036).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Mercy Health Kings Mills Hospital LLC'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 $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($50,690) is $31,603 above the denoised Fair BaseRate ($19,087) and 3.6× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (13.9% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (312 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 Mercy Health Kings Mills Hospital LLC.
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.