How many shoppable procedure prices are published for Mercy Health - Urbana Hospital?

Mercy Health - Urbana Hospital in Urbana, OH currently has 109 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Mercy Health - Urbana Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Mercy Health - Urbana Hospital's median negotiated commercial rate is 0.3× the regionally adjusted fair BaseRate benchmark.

What is Mercy Health - Urbana Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Mercy Health - Urbana Hospital an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 4/1/2026

Mercy Health - Urbana Hospital

904 Scioto Street, Urbana, OH 43078 · 109 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Good Deal · Below Fair Market

0.35×vs. Fair Market Price

Typical commercial prices here are 65% below the fair benchmark (0.35×) after accounting for local nurse/doctor wages and patient complexity.

66/100 · Caution

66/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness56

Price Logic50

Peer Alignment65

Clean Billing70

Real Cash Discount100

Regional Value Leader

4-Star CMS clinical quality rating paired with 0.35× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Mercy Health - Urbana Hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (0.5× Medicare, p50 0.35× Fair BaseRate) and emergency/ancillary services (0.5× Medicare, p75 0.35× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#1 of 137 in OH · 1st State Percentile#11 of 3,385 in U.S. · 1st National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 65% below peer Fair BaseRate (0.35×)
Self-pay cash beats commercial insurance on 0% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 69% patient recommendation (69/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (10.4% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
Commercial insurance median sits at 0.35× Fair BaseRate (0.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
Specialty infusion drugs (J-codes) average 1.1× 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

0.5× Medicare

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

Back-Door Captive & ER1.00× Divergence

0.5× Medicare

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

Quantile Tail Spread+0% Upper Tail

Q25 0.35× · Q50 0.35× · Q75 0.35×

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

0.5× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.9× MedicareFair

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

1.1× MedicareGood

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

0% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 69/100Fair

Procedure Prices at Mercy Health - Urbana Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 109 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Total hip replacement CPT Code: `27130`	$51,936	$51,936	$13,413	3.9×
Total knee replacement CPT Code: `27447`	$34,206	$34,206	$13,523	2.5×
Inguinal hernia repair CPT Code: `49505`	$16,062	$16,062	$3,629	4.4×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$11,749	$11,749	$6,109	1.9×
Rabies immune globulin HCPCS Code: `90375`	$7,680	$7,680	$322	23.9×
Cataract surgery with lens implant CPT Code: `66984`	$7,663	$7,663	$2,540	3.0×
Colonoscopy with biopsy CPT Code: `45380`	$6,132	$6,132	$1,256	4.9×
Upper endoscopy with biopsy CPT Code: `43239`	$4,843	$4,843	$987	4.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,459	$4,459	$1,021	4.4×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$2,859	$8,223	0.3×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,514	$2,514	$583	4.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,452	$2,452	$448	5.5×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,259	$2,259	$511	4.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,180	$2,180	$303	7.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$2,063	$2,063	$134	15.4×
MRI, knee or other leg joint CPT Code: `73721`	$1,997	$1,997	$369	5.4×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,806	$1,806	$151	12.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,667	$1,667	$272	6.1×
MRI, lower back (no contrast) CPT Code: `72148`	$1,574	$1,574	$338	4.7×
MRI, brain (no contrast) CPT Code: `70551`	$1,561	$1,561	$343	4.6×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,413	$1,413	$258	5.5×
CT scan, pelvis CPT Code: `72192`	$1,362	$1,362	$163	8.4×
CT scan, head (with contrast) CPT Code: `70460`	$1,304	$1,304	$242	5.4×
CT scan, chest (no contrast) CPT Code: `71250`	$1,090	$1,090	$167	6.5×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,090	$1,090	$168	6.5×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,090	$1,090	$169	6.4×
Blood transfusion CPT Code: `36430`	$1,099	$1,099	$498	2.2×
Ultrasound, pelvis CPT Code: `76856`	$1,032	$1,032	$130	7.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,032	$1,032	$132	7.8×
CT scan, head (no contrast) CPT Code: `70450`	$928	$928	$160	5.8×
CT scan, sinuses CPT Code: `70486`	$928	$928	$166	5.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$826	$826	$126	6.6×
X-ray, hand CPT Code: `73130`	$664	$664	$93	7.1×
X-ray, ankle CPT Code: `73610`	$598	$598	$93	6.4×
Physical therapy (functional capacity test) CPT Code: `97750`	$441	$441	$38	11.6×
X-ray, chest (two views) CPT Code: `71046`	$458	$458	$93	4.9×
X-ray, hip CPT Code: `73502`	$431	$431	$93	4.6×
X-ray, lower back CPT Code: `72110`	$455	$455	$112	4.1×
New patient office visit (30-44 min) CPT Code: `99203`	$434	$434	$110	3.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$392	$392	$93	4.2×
X-ray, foot CPT Code: `73630`	$352	$352	$92	3.8×
X-ray, shoulder CPT Code: `73030`	$348	$348	$92	3.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$342	$342	$166	2.1×
Psychiatric evaluation (first visit) CPT Code: `90791`	$342	$342	$185	1.8×
X-ray, pelvis CPT Code: `72170`	$305	$305	$110	2.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$317	$317	$201	1.6×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$272	$272	$64	4.3×
Speech therapy (language evaluation) CPT Code: `92507`	$272	$272	$86	3.2×
Group therapy session CPT Code: `90853`	$279	$279	$100	2.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$269	$269	$148	1.8×
Family therapy session CPT Code: `90847`	$257	$257	$173	1.5×
Psychotherapy session (60 minutes) CPT Code: `90837`	$257	$257	$181	1.4×
Speech therapy (group session) CPT Code: `92508`	$221	$221	$27	8.2×
X-ray, chest (single view) CPT Code: `71045`	$235	$235	$92	2.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$181	$181	$14	12.9×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$181	$181	$35	5.2×
Orthotic fitting and training CPT Code: `97760`	$194	$194	$51	3.8×
Hospital observation (per hour) HCPCS Code: `G0378`	$199	$199	$86	2.3×
Screening mammogram (both breasts) CPT Code: `77067`	$224	$224	$123	1.8×
Physical therapy (gait training) CPT Code: `97116`	$167	$167	$33	5.1×
Physical therapy (manual therapy) CPT Code: `97140`	$167	$167	$34	4.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$167	$167	$38	4.4×
Occupational therapy (self-care training) CPT Code: `97535`	$167	$167	$38	4.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$173	$173	$40	4.3×
Prosthetic fitting and training CPT Code: `97761`	$167	$167	$45	3.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$162	$162	$87	1.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$179	$179	$123	1.5×
Behavioral health assessment HCPCS Code: `H0001`	$97	$97	$157	0.6×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$404	$404	$203	2.0×
Blood test, basic metabolic panel CPT Code: `80048`	$205	$205	$9	22.8×
Blood test, vitamin D CPT Code: `82306`	$222	$222	$31	7.2×
Pneumococcal vaccine HCPCS Code: `90732`	$246	$246	$140	1.8×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$193	$193	$20	9.7×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$206	$206	$111	1.9×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$176	$176	$11	16.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$160	$160	$14	11.4×
Blood test, vitamin B12 CPT Code: `82607`	$157	$157	$16	9.8×
Blood test, hemoglobin CPT Code: `85018`	$124	$124	$3	41.3×
Culture, bacterial CPT Code: `87070`	$116	$116	$9	12.9×
Hepatitis C antibody test CPT Code: `86803`	$137	$137	$15	9.1×
Culture, blood CPT Code: `87040`	$109	$109	$11	9.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$131	$131	$18	7.3×
Blood test, amylase CPT Code: `82150`	$100	$100	$7	14.3×
Blood test, lipase CPT Code: `83690`	$90	$90	$7	12.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$100	$100	$8	12.5×
Blood test, liver function panel CPT Code: `80076`	$106	$106	$9	11.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$111	$111	$10	11.1×
Blood test, ferritin (iron stores) CPT Code: `82728`	$111	$111	$14	7.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$124	$124	$19	6.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$55	$55	$3	18.3×
Blood test, calcium CPT Code: `82310`	$55	$55	$5	11.0×
Blood test, magnesium CPT Code: `83735`	$77	$77	$7	11.0×
Colorectal cancer screening HCPCS Code: `G0010`	$92	$92	$49	1.9×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$102	$102	$56	1.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$55	$55	$5	11.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$65	$65	$6	10.8×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$79	$79	$27	2.9×
Blood antibody screen CPT Code: `86850`	$76	$76	$46	1.7×
Drug screening test HCPCS Code: `G0480`	$81	$81	$116	0.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	$41	$41	$4	10.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$39	$39	$4	9.8×
Blood test, sodium CPT Code: `84295`	$48	$48	$5	9.6×
Blood test, creatinine (kidney) CPT Code: `82565`	$41	$41	$5	8.2×
Blood test, potassium CPT Code: `84132`	$38	$38	$5	7.6×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$62	$62	$39	1.6×
Flu vaccine injection HCPCS Code: `G0008`	$35	$35	$48	0.7×
Pneumonia vaccine injection HCPCS Code: `G0009`	$35	$35	$49	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$24	$24	$35	0.7×
Behavioral health day program HCPCS Code: `H2012`	$28	$28	$100	0.3×

Showing top 25 high-impact procedures of 109 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 10.4%

Audit a Bill or Quote at Mercy Health - Urbana Hospital (Zero PHI Required)

CMS CCN: 361312

CPT 27130

Select Procedure to Audit:

Fair BaseRate™ $13,413

Medicare Rate $13,117

Self-Pay Cash $51,936

Insurer Median $51,936

1. Amount on Your Bill or Quote ($) Pre-filled with Mercy Health - Urbana 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: $9,011 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $9,011

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (10.4% of gross = $9,011).

Step 2 · Cash vs. Insurance Arbitrage Save $34,625 Paying Cash

Self-Pay Cash Rate ($51,936) Beats Your Bill

Mercy Health - Urbana Hospital's published 45 CFR § 180 self-pay cash rate is $51,936 (vs. $51,936 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$73,148 Above Fair BaseRate

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

Your bill ($86,561) is $73,148 above the denoised Fair BaseRate ($13,413) and 6.6× 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)

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: prospective_medicare_median

Hospital-Specific CMS HCRIS Benchmark (10.4% 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 Overall4/5 Stars (4/5)

Safety Composite69/100

Would Recommend69%

Rated 9 or 10 (HCAHPS)76%

Median ER Wait112 min

Left ER Before Seen0%

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 Mercy Health - Urbana Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-07-17·administrative_or_closure
Closure Notice
Recorded
2025-05-30·cap_corrective_action
CAP Request
Recorded

Source: CMS Hospital Care Compare (97 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 Mercy Health - Urbana Hospital.

Price Index: 1.00× regional baseline

Quality: 69/100 CMS composite

Median Household Income$74,239U.S. Census ACS

Local Uninsured Share5.1%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 66/100 · Caution CMS CCN 361312

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 361312) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage4/1/2026

Validated Rate Rows41 (CMS v3.0.0)

File Integrity DigestVerified · CCN 361312

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